USING YOUR MEDICAID WAIVER Presented by Heather Dane

USING YOUR MEDICAID WAIVER Presented by Heather Dane Family Engagement Specialist Bureau of Developmental Disabilities Services (BDDS) Division of Disability and Rehabilitative Services (DDRS)

Home and Community Based Services (HCBS) Bureau of Developmental Disabilities Services (BDDS) Area Agency on Aging (AAA) • Family Support Waiver • Community Integration and Habilitation • Aged and Disabled Waiver • Traumatic Brain Injury Waiver http: //www. in. gov/fssa/ddrs/2639. htm http: //www. in. gov/fssa/2329. htm

Eligibility • Diagnosed with an intellectual, developmental disability, or related condition prior to age 22 yr and condition must be expected to continue indefinitely • Level of Care (LOC) ▫ Exhibit substantial functional limitations in at least 3 of the 6 major life areas Self Care Learning Self-Direction • Medicaid Capacity for independent living Understanding and Use of Language Mobility ▫ Must meet eligibility requirements for certain Medicaid categories ▫ Under age of 18 years, household income eligibility requirements are disregarded ▫ At age of 18 years, must apply for SSI

Medicaid • Health Insurance Plan • Early and Periodic Screening Diagnosis and Treatment (EPSDT) www. indianamedicaid. com

Community Integration and Habilitation (CIH) Waiver Individual must ALSO meet priority criteria • Individuals transitioning to the community from a nursing facility (NF), extensive support needs (ESN) facility, and state operated facility (SOF) • Individuals determined to no longer need/receive active treatment in Supervised Group Living (SGL) • Individuals transitioning from 100% state-funded services • Individuals aging out of Department of Education (DOE), Department of Child Services (DCS), or Supervised Group Living (SGL) • Individuals requesting to leave a large private Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) • Death of a primary caregiver where there is no other caregiver available • Caregiver over the age of 80 years when there is no other caregiver available • Evidence of abuse or neglect in current institutional or Supervised Group Living (SGL) placement • Extraordinary health and safety risk as reviewed and approved by the Division Director

Family Support Waiver (FSW) • Maximum Budget is $17, 300 • Wait list • Priority Criteria – 18 -24 years who have exited the school setting

Targeting o Targeting Letter with new Confirmation of Diagnosis o Level of Care Screen (LOC) o Once determined eligible, you will choose a case management company o If individual does not currently have Medicaid then a Cost Comparison Budget (CCB) is created by BDDS o Apply for Medicaid with Division of Family Resources office o Once Medicaid is approved the referral is made to chosen case management company o Person Centered Individualized Service Plan (PCISP) created, services chosen o Services begin!

Individualized Support Team (IST) • • • Individual being served Parent/Guardian Family Members Case Managers Service Providers Anyone else selected by the individual and/or guardian

Person Centered Individualized Support Plan (PCISP) About Me • Vision for Good Life • Strengths & Qualities Life Stages Infancy Early Childhood School Age Transition from School to Adult Life Adulthood Aging Life Domains Daily Life & Employment Community Living Safety and Security Healthy Living Social and Spirituality Citizenship and Advocacy

The Life. Course Framework All people have the right to live, love, work, learn, participate, play and pursue their dreams in their community.

Services Provided Adult Day Services Behavioral Support Services Case Management Community Based Habilitation – Group Community Based Habilitation – Individual Community Transitions (CIH only) Electronic Monitoring (CIH only) Environmental Modifications (CIH only) Extended Services Facility Based Habilitation – Group Facility Based Habilitation - Individual Facility Based Support Services Family and Caregiver Training Intensive Behavioral Intervention Music Therapy Occupational Therapy Participant Assistance and Care (FSW only) Personal Emergency Response System Physical Therapy Psychological Therapy Prevocational Services Recreational Therapy Rent and Food for Unrelated Live-in Caregiver (CIH only) Residential Habilitation and Support (CIH only) Respite Specialized Medical Equipment and Supplies Speech/Language Therapy Structured Family Caregiving (CIH only) Transportation Wellness Coordination (CIH only) Workplace Assistance

Choosing Providers from a Pick List Things to Consider: • Waitlist • Able to meet your time/day needs • What is important to you and what you hope to achieve from service • Talk to other families/family members who use same service • Interview potential providers • Take notes

Questions? Bureau of Developmental Disabilities http: //www. in. gov/fssa/ddrs/2639. htm The Life. Course Framework www. lifecoursetools. com

Thank you to our sponsors! Enjoy your break. Please visit the displays to learn more about services and supports available to you!