What are Waiver Services?
Medicaid Waiver programs help provide services to people who would otherwise be in an institution, nursing home, or hospital to receive long-term care in the community. Prior to 1991, the Federal Medicaid program paid for services only if a person lived in an institution.
A person must have a full scale I.Q. score below 70; the individual must demonstrate significant or substantial functional limitations in three or more of the following major life activities: self-care, receptive and expressive language, learning, self-direction, mobility, and capacity for independent living all occurring prior to the age of 18.
To begin the waiver process, you must first call the Department of Mental Health Call Center at 1-800-361-4491. This referral will then be sent to the county in which the individual resides. The Intake Coordinator will then contact the family to schedule an intake appointment to obtain necessary documentation to complete the waiting list application. The application is then sent to the Department of Mental Health, Region One Community Services who will then determine eligibility. If the individual is approved, they are then added to the state wide waiting list.
Intellectual Disabilities (ID) Waiver:
Purpose: To provide services to individuals that would otherwise require the level of care available in an ICF/MR (intermediate care facility for the mentally retarded) facility.
Services Provided: Residential Habilitation, Day Habilitation, Prevocational Services Supported Employment, Individual Assessment/Discovery, Individual Job Coach, Individual Job Developer, Occupational Therapy , Speech and Language Therapy, Physical Therapy, Positive Behavior Supports, Benefits Counseling, Housing Stabilization Services, Personal Emergency Response System Services, Adult Companion Care, Out of Home Respite, In Home Respite, Personal Care, Personal Care on worksite, Personal Care Transportation, Environmental Accessibility Adaptations, Specialized Medical Equipment, Specialized Medical Supplies, Skilled Nursing Services, Crisis Intervention, Community Specialist, Individual Directed Goods and Services, Benefits Reporting Assistant Services, Community Experience Services, Supported Employment Transportation.
Groups that are eligible: Individuals receiving SSI, SSI related protected groups deemed to be eligible for SSI/Medicaid, Special HCBS waiver disabled individuals whose income is not greater than 300% of the SSI Federal Benefit Rate. Low Income Families with Children, and Federal or State Adoption Subsidy Individuals.
Enrollment Limit: There are 5,260 ID Waiver slots in Alabama; Madison County currently has approximately 385 slots.
Living at Home (LAH) Waiver:
The LAH wavier is very similar to the Intellectual Disabilities Waiver with the following exceptions. There is a $25.000.00 cap on the services an individual can receive if on the LAH waiver. The individual cannot be residing in a group home setting or environment. The services provided do NOT include Residential Habilitation, Adult Companion Services, Housing Stabilization Services.
Enrollment Limit: There are 569 slots in Alabama; Madison County currently has approximately 30 slots.
**Services that are provided under the waiver are not necessarily available in Madison County. All waiver services must be approved by the Department of Mental Health.
There is a plan and a purpose, a value to every life, no matter what its location, age, gender or disability.