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MRG

UPDATED: NOVEMBER 2009

728

OTHER ELIGIBILITY REQUIREMENTS WAIVERS

TRAUMATIC BRAIN INJURY (TBI) WAIVER

Waiver, and the Office for People with Developmental Disabilities HCBS waiver). If an individual is determined to be eligible for more than one waiver, a choice between the TBI waiver and other HCBS waivers must be made by the applicant and/or legal guardian.

Under the waiver, waiver participants may receive existing MA services and waiver services including: service coordination, independent living skills training and development, structured day programs, substance abuse programs, positive behavioral interventions and support services, community integration counseling, home and community support services, environmental modifications, respite care, special medical equipment and supplies, community transitional services and transportation.

Local departments of social services (LDSS) are responsible for determining the financial eligibility of the TBI Waiver A/Rs.

References: LCMs

96 LCM 37

95 LCM 70

Interpretation: Individuals apply through the RRDC for participation in the TBI waiver. The RRDS will provide the potential waiver participant with a list of available Service Coordination agencies. The applicant will choose a service coordinator who will assist in the development and compilation of all documentation needed to establish the individual's financial and non financial eligibility for the waiver. The individual and the service coordinator develop a comprehensive service plan which will include informal supports, necessary State Plan Medicaid services, any other federal or state programs and specific waiver services necessary to support the individual’s health and welfare in the community.

If the individual has not been determined to be MA eligible and/or certified disabled, the RRDS will send a Letter of Introduction which is presented to the LDSS. The LDSS will determine financial eligibility and return the letter, along with the appropriate form (s) and notices, to the applicant and RRDS.

To determine eligibility of TBI A/Rs see INCOME PERSONS IN MEDICAL FACILITIES BUDGETING FOR INSTITUTIONALIZED SPOUSES IN SPECIFIED HOME AND COMMUNITY BASED WAIVERS (HCBS) and INCOME SSI-RELATED BUDGETING METHODOLOGY and RESOURCES PERSONS IN MEDICAL FACILITIES BUDGETING FOR INSTITUTIONALIZED SPOUSES IN HOME AND COMMUNITY BASED WAIVERS (HCBS).