The Resource Storeroom -
Medicaid, Waivers & SSI
Resources listed by topic with
Colorado resources listed first
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Colorado Medicaid Waivers
Medicaid is a program, funded by the
federal and state governments, which
pays for medical care for low income
people and those with special health
care needs who are eligible for specific
programs.
Medicaid waivers enable people
(including children) who wouldn’t
otherwise qualify for Medicaid due to
income or assets to access Medicaid
benefits even if the person already has
private insurance. In the case of
families, parental income is not
considered for eligibility. Only a
child’s assets or income is considered.
Therefore, many children with
extraordinary health care needs qualify
for Medicaid waivers because they have
few assets and no (or virtually no)
income. A child must have
institutional-level of care requirements
to be eligible for these waivers.
For help in knowing how to see if your
child might qualify for any of the
waivers, you can start with Family
Voices at 1-800-881-8272.
Colorado Medicaid Waiver Resources
Definition of Developmental Disability
and the new
Declaratory Order dated March 14, 2008
[doc]
Medicaid Waiver FAQ
Medicaid Waiver
Chart - Home & Community Based
Waiver (HCBS)
Medicaid
Waivers
- Information on Medicaid Waivers
for families who have children with
disabilities or high medical needs.
Medicaid Provider Look-Up
Find a Provider Agency - Information
on agencies providing care services in
the home or community for Colorado
Medicaid clients.
Obtaining Services from a Different CCB
Parent as CNA (Certified Nursing
Assistant)
- Sends
a request to P2P for the CNA wisdom file to be sent to you
via email.
Doctor
Appointment Transportation for Children
who have Medicaid
Coverage for OTC Drugs
through Medicaid
Long Term Care Options
(720-974-0032) - Coordinates services
for people who need help with their
daily living activities. Services are
available on a private pay, low cost or
Medicaid basis depending on a person's
situation or ability to pay.
Colorado Health Insurance Statutes
Community
Centered Boards
manage
and deliver services, in partnership
with private service providers, to
individuals with developmental
disabilities and their families
throughout the state of Colorado.
National Medicaid Waiver Resources
Medicaid Waivers by State
(great
list if you are considering moving and want to know what
is available in other states.)
National Analysis of Medicaid Services
- Analysis of state Medicaid services
for people with developmental
disabilities including state rankings as
well as letter grades in key areas of
Medicaid service delivery.
Centers for Medicare and Medicaid
Services (CMS)
New Disability Determination Process
05/06
Families USA
- Great source for information on health
care payer systems (insurance and
Medicaid).
Understanding Medicaid Home and Community
Services: A Primer
- (P2P note - This is not a family
friendly or easy to read summary.
It is very detailed information.)
CES Waiver
Children’s Extensive Support Waiver
This is a waiver for children who
qualify for services through the
developmental disabilities system who
also have significant functioning and/or
behavioral differences. These children
require nearly 24-hour supervision.
Even at night, a parent or caregiver
must attend to them in either a
behavioral intervention or a health or
safety intervention at least every three
hours.
To be eligible for the CES Waiver the
child’s family income does not
have to be above the SSI Income
Eligibility level. A child may
already have Medicaid and still be
eligible for this waiver. In
addition to services covered by Medicaid
the child can get things like special
training, equipment, home modifications,
non-medical care while parents are not
available, special formulas or other
things that Medicaid does not cover.
The family will also get a case manager
to assist them to identify and obtain
needed services/supports.
To see if your child might qualify for
this waiver contact your local
Community Centered Board (CCB).
Family Voices can also help walk you
through the steps of accessing the CES
waiver. Call 1-800-881-8272.
CES Waiver Eligibility (scroll to
8.503.30)
Process to enroll in CES Waiver Services
and to be placed on the CES
waiting list.
CES Waiver Application -
You can contact Sheila Peil,
303-866-7467, at the State Level to see
where your child is on the waitlist.
CES Waiver Manual (probably more
than you want to know).
CHCBS Waiver
Children’s Home and Community Based
Services Waiver
A
listing of the HCBS waivers can be found
here.
Children on this waiver are
significantly impacted by health and/or
developmental disabilities or delays.
They must function well below their
peers in at least one area, passing a
screening assessment called the ULTC
100.2. (See
Long Term Care Eligibility Assessment
).
Requires that a family’s income (parents
or primary caretakers) not be low
enough that the child might qualify for
SSI (Supplemental Security Income). They
must show proof to Medicaid from the
Social Security Administration that
their income is above the eligibility
level for their child to qualify for
SSI.
To find out if your child might qualify
for a waiver contact your
Community Centered Board
or
your local
Single Entry Point for Long Term Care
(SEP).
Family Voices can also help walk you
through the steps of accessing the CHBCS
waiver. Call 1-800-881-8272.
In-Home Support Services (IHSS)
Available for people enrolled in the
HCBS-EBD or Children’s HCBS Waiver
program who want more choice and control
in their home care. IHSS is a Colorado
Medicaid service that helps people with
disabilities and families of children
with disabilities to select and direct
their in-home support services. In IHSS
you can have more independence and
flexibility. You can:
In IHSS you choose an agency from an
approved list. The agency will:
For more information call 303-866-2704,
or talk to your Medicaid Waiver Case
Manager.
CHRP
Children’s Habilitation Residential
Program
CHRP
is for children who cannot live at
home. These are children who have
developmental disabilities (mental
retardation) and emotional/behavioral
needs too significant for unskilled
parents or other caregivers to provide
for them appropriately. They
generally live in foster home families
or group facilities.
CWA Waiver
Children With Autism Waiver
CWA
is a waiver for children under age six who have the
diagnosis of autism. This waiver requires that the
child be eligible for or on another waiver program or have
Medicaid through another program (like SSI).
EPSDT
Early & Periodic
Screening, Diagnostic & Treatment
To see if your child might qualify for this waiver contact
your local
Community Centered Board
(CCB).
Comp & SLS
Supported Living Services Waiver
Obtaining Services from a Different CCB
SIS (Supports Intensity Scale)
Assessments
- For Supported Living
Services (SLS) waiver participants.
SIS Interview Guidelines & Suggestions
for Parents and Guardians
-
Developed by
PAD-CO.
Supports Intensity Scale FAQ
SSI Social
Security Insurance
SSI
Deeming
- In-Home Supportive
Services Payments
The Benefit Eligibility Screening Tool (BEST)
- Tool to find out if you could be eligible
for benefits from any of the programs Social
Security administers.
"Straight" Medicaid
Medicaid Information - General Overview
Government Benefits connects people in
need to government assistance programs.
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