Page 306

MRG

UPDATED: JUNE 2011

731

OTHER ELIGIBILITY REQUIREMENTS WAIVERS

OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES (OPWDD) HOME AND COMMUNITY BASED SERVICES WAIVER (HCBS)

Description: The Office for People with Developmental Disabilities (OPWDD) Home and Community Based Services waiver (HCBS) is administered by OPWDD in conjunction with the State Department of Health (SDOH). The waiver is operated on a daily basis by OPWDD Developmental Disabilities Services Offices (DDSOs).

This Medicaid waiver was authorized by the federal government in September 1991 and provides a community based alternative for providing care to adults and children with developmental disabilities who live at home, in Family Care (FC), Community Residences (CRs), or in Individualized Residential Alternatives (IRAs). The HCBS waiver allows individuals to access Medicaid for medically necessary State Plan services as well as waiver services such as: Residential Habilitation, Day Habilitation, Respite, Prevocational Services, Supported Employment, Adaptive Technologies and Environmental Modifications.

Policy: An individual participating in the OPWDD HCBS waiver must:

• Have a developmental disability as defined by MHL 1.03.(22); • Require an Intermediate Care Facility for the Mentally Retarded (ICF/MR) level of care; • Reside in a qualifying living arrangement: (FC, CR or IRA, or their own home); • Submit a waiver application to the DDSO and be approved by the DDSO for waiver services; and, • Be Medicaid eligible.

Local districts are responsible for determining Medicaid eligibility for individuals seeking enrollment in the waiver who are not already in receipt of Medicaid. Districts are also responsible for the maintenance of new and existing Medicaid cases.

References: LCMs 94 LCM-137

93 LCM-62

92 LCM-170