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Getting Started
Get Diagnosed
Gathering Important Information
Organizing Your Information
The Educated Parent
Early Intervention
What To Do First
What is Early Intervention?
Research
Introduction
Keeping an IEP Notebook
Preparing for an IEP Meeting
Conducting an IEP Meeting
Individuals With Disabilities Act
IDEA ACT - A Quick Reference
IDEA Legal Text
Family Finances
Recommended Resources
Housing
Introduction to Universal Housing Design
Housing options
Building a New House ~ That Works!
Introduction to Universal Housing Design
Entrances and Thresholds
Single Family Home Resources
Remodeled Bathroom
Ceiling Lifts
Problem Spaces
Adding a Ramp
Good Restroom
Not So Good Restrooms
Great Space Adaptions
Not So Great Adaptations
Ramp Design
Ramp Design (Part 2)
Commercial Ramps
Public Access Ramps
Adding a Ramp
Retrofit Door Sill Ramp
Insurance
Medical Bills
Filing an Appeal
Medical Expenses and Income Taxes
Finding Help for the Uninsured or Underinsured
Free or Discounted Prescription Programs
Medicaid Waivers
Legal Adults - Introduction
Guardianship and Declaration of Incapacitation
Establishing Guardianship and Obtaining a Declaration of Incapacitation
Dependency Determination (Military)
When to Start the Transition Process
Begin Transition - Age 14-16
Exploring Possibilities and Guardianship Issues - Age 17
Age 18
After High School Graduation - Age 19-22
Post High School Education Options
Future Housing Options
Specialized Medical Equipment
Wheelchair Evaluation
Wheelchair Safety
Introduction: Special Needs and the Military Family
DEERS & ID Cards
Dependency Determination
TriCare Introduction
TriCare Program Options
Exceptional Family Member Program (EFMP)
Individual Case Management
TriCare Extended Care Health Option (ECHO)
Early Intervention
Housing Options
Family Support Services
Community Contacts
Letters of Medical Sufficiency
Wheelchair Accessible Vans
Van Conversion: A good Example
Fund Raising - The Flamingo Air Project
Utah DSPD Complaint List Winter 2011
 

Medicaid Waivers

Medicaid is one of the primary supports for people with disabilities in the United States. Program titles may vary by state but most services are similar.

Medicaid is available to low-income families and those receiving Supplemental Security Income. Most families should apply for SSI, even if it is just for the denial, as a denial letter is often required for other services. Once denied SSI benefits many families may apply for Medicaid Waivers in their respective states.

Each State has it's own Medicaid program. Individuals with special needs may qualify for benefits and funding through these waiver programs once they have been denied benefits through traditional programs. Non-traditional waivers have more liberal eligibility guidelines that are not based on family income. People may be eligible if they have qualifying disabilities and substantial functional limitations in three or more of the following activities: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, economic self-sufficiency, etc.

When a person is found eligible, generally an evaluation called a "critical needs assessment" is completed by a caseworker from the state Department of Services for People with Disabilities (DSPD). This assessment considers the individual's school records, when applicable, a questionnaire generally administered by a division support coordinator or manager, medical records, and psychological evaluations. In most states, once you have gone through the eligibility intake process, if you are found eligible, you will immediately receive services. In some states the demand for services is so great you may be put on a waiting list and prioritized.

*Note: It is important you make sure that once you are put on a waiting list, you contact your assigned case manager frequently to keep them updated on the current status of your family situation and any changes that may occur. This really is a case of the squeaking wheel gets the grease. If they do not hear from you, they assume everything is fine, and they will give you a lower priority. If you feel that you need to be moved up in priority then you need to be maintaining contact with your DSPD case manager.

Funding for these services are allocated by state legislatures every year and budgets are tight. As funds are available they will notify families and bring them on to the service. Be sure you keep your case manager updated periodically. Failure to do so can result in your being passed over for services. Keep your Case Manager informed.

Once you begin receiving services through DSPD, you may be eligible for a Medicaid waiver. By using Medicaid waivers, each state receives Federal-matching dollars to help fund services for people with disabilities. The different Home and Community Based Services Waivers that are available vary by state but in general fall under the following categories:

  • Developmental disability or mental retardation (DD/MR) waivers
  • Brain Injury waivers
  • Physical disabilities waivers

The biggest majority of applicants generally qualify under the last category. For more information about these specific waivers you will need to contact the department in your state directly. (See our "Resource Links" section for websites and contact information.)

You may need to apply for traditional Medicaid, be denied, and then apply for a waiver. Most individuals who do apply for traditional Medicaid do not receive it the first time because their family income does not meet Federal Guidelines. If this happens, then you will need to apply for a waiver. DSPD is the agency that you need to make your application through for that waiver here in Utah. They will also do an evaluation to assist the family with any further needs such as respite care, facility facilitation, individual rehabilitation programs etc.