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Home
and Community Based Services
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| ELIGIBILITY GROUP (ALSO SHOWN AS THE SPECIAL POPULATION) | >>Age 16-55 have external traumaticallly acquired
non-degenerative structural brain injury resulting in residual
deficits and disabilities >>Financially eligible for Medicaid |
| LEVEL OF CARE REQUIREMENTS (ALSO KNOWN AS FUNCTINAL ELIGIBILITY RULES) | >>Have external traumaticallly acquired non-degenerative
structural brain injury resulting in residual deficits and disabilities >>Meet criteria for in-patient care in a head injury rehabilitation hospital |
| ASSESSMENT AND ACCESS (CASE MANAGEMENT) | Centers for Independent Living and Home Health Agencies using qualified and trained professionals enrolled as Medicaid providers assess all individuals applying for HIRF placement using Developmental Disability Profile-2 |
| CHOICE OF CASE MANAGEMENT AGENCIES AVAILABLE | Yes, statewide choice among all qualified agencies is allowed |
| FINANCIAL ELIGIBILITY RULES | Only individuals own income and resources are considered beginning in the first month of HCBS (income over $691 per month must be contributed towards cost of care) plus for individuals under 18, parental income and resources are not counted. |
| NUMBER
OF UNDUPLICATED CONSUMERS PER MONTH |
78 |
| TOTAL FY 98 HCBS WAIVER EXPENDITURES | $3,837,000 |
| MONTHLY AVERAGE COST PER CONSUMERS FY 98 (WAIVER SERVICES) | $4,095 |
| MONTHLY AVERAGE COST PER CONSUMER FY 98 (XIX SP SERVICES) | $470 (includes case management cost) |
| CONSUMER DIRECTED ATTENDANT OPTION AVAIL | Yes, for age 18 and older |
| SERVICES (THOSE LISTED ARE PROVIDED IN ADDITION TO REGULAR TITLE XIX STATE PLAN SERVICES | >>Personal services >>Assistive services >>Rehabilitation services >>Transitional living skills (Case management is available through Title XIX state plan) |
| QUALITY ASSURANCE | >>Program manager in AMS authorizes and reviews
all plans of care >>Annual evaluation for level of care by fiscal agent home care review >>Fiscal agent post pay reviews of providers >>Fiscal agent provider and consumer assistance unit to register and follow up on any complaint or grievance |
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For more information visit Health Care Policy |
Page last updated January 16, 2003