Virginia Medicaid Waivers for Individuals with Autism

Spectrum Disorder

by Bradford Hulcher

Virginia Medicaid Waivers Provide

Home and Community Services

Home & Community Based Care Waivers

Waivers give States the flexibility to develop and implement alternatives to

institutionalization

Possible Waivers for Individuals with ASD

• Elderly or Disabled with Consumer Direction (EDCD) Waiver

• Individual and Family Developmental Disabilities Support (DD) Waiver

• Intellectual Disabilities (ID) Waiver

Waiver Eligibility Process

• Screening first

• Financial eligibility second

• Screening for Waivers provided without any cost to the individual

Screening• EDCD Waiver:

Pre-Admission Screening Teams of the Department of Health & Department of Social Services

• ID Waiver:Community Services Board

• DD Waiver:Department of Health Local Clinics or Child Development Clinics

Developmental Disabilities (DD) Waiver

• 6 years of age or older and have a developmental disability

• No diagnosis of intellectual disability

• Must meet criteria for institutional placement

Screening for DD Waiver

• Screening by Local Department of Health or Child Development Clinics

• Over 1,000 on waiting list

• Screening request

Please download the forms from the website titled– “Request for Screening” – “Screening Facility Regions”

Screening for DD Waiver

• Level of Functioning Survey

http://www.dmas.virginia.gov/downloads/forms/DMAS-458.pdf

Please download the form from the website titled– “Level of Functioning Survey”

Intellectual Disabilities(ID) Waiver

• Diagnosis of Intellectual Disabilityor

• Under the age of 6 and at developmental risk

• Must meet criteria for institutional placement

ID Waiver Services• Adult companion• Assistive technology• Crisis stabilization• Day Support and Prevocational services• Environmental modifications• Personal emergency response system• Personal assistance services• Residential support (individual’s home or group home)• Respite care• Skilled Nursing• Supported employment• Therapeutic consultation

Screening for the ID Waiver

• Screening by local Community Services Board

• Call to request screening

• Level of Functioning Survey or Developmental Milestones Assessment

• Over 5,000 on waiting list

Elderly or Disabled with Consumer Direction (EDCD) Waiver

• Must be 65 or older or disabled

• Must meet nursing home criteria

EDCD Waiver Services

• Adult Day Health Care

• Personal Care Services

• Personal Emergency Response System (PERS)

• Respite

Screening for EDCD Waiver

• Screening by local Departments of Social Services and Health

• Call to request screening

• Uniform Assessment Instrument (UAI) http://www.dmas.virginia.gov/downloads/forms/UAI.pdf

• No waiting list

More Info

• Join discussion group– VaWaivers-subscribe@yahoogroups.com

• www.VaMedicaidWaivers.org

• Medicaid Waiver Info Center– 866-323-1088 Toll Free– 757-461-8007 Tidewater

More Info

• Medicaid Waiver Documents

Please download the documents from the website titled– Medicaid Waiver Mentors– Medicaid Waiver Services Guide