Virginia Medicaid Waiver – By Shorthand

08/18/2010

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Here is a concise listing of Virginia Medicaid Waiver programs.  This is adapted from information available through the Autism Society of Northern Virginia (703-495-8444) www.asnv.org and from the Arc of Northern Virginia (703)532-3214 www.thearcofnova.org  

These are Medicaid covered programs that provide services in the home.

Intellectual Disability (ID Waiver) Diagnosis of an intellectual disability or be under six and at developmental risk and require a high level of care.

Apply – Local Community Services Boards. For Fairfax call 703-324-4400.  For CSB offices other than Fairfax County, go to www.dbhds.virginia.gov.

Individual and Family Developmental Disabilities Support Waiver (DD Waiver) Diagnosis of developmental disability or related condition requiring a high level of care. Apply by  completing Request for Screening form and send to the Fairfax County Health Department.  Call Fairfax Health Dept. 703-246-8628 

Elderly or Disabled with Consumer Direction Waiver (EDCD Waivers)Must meet nursing facility eligibility criteria including medical needs and functional capacity. Apply – obtain Uniform Assessment Instrument (UAI) evaluation through local Department of Human Services (DHS) or Aging Services.  Afterwards apply through local DHS eligibility office.

Day Support for Persons with Intellectual Disabilities Waiver  Diagnosis of an intellectual disability (ID) and on the ID waiver waitlist. Apply at 18 years old by requesting the level of Functioning Survey from the local Community Services Board

Technology Assisted Waivers  Must require ongoing skilled nursing care and be dependent on technology to substitute for a vital body function.

Apply through Virginia Department of Medical Assistance Services (DMAS)  804-786-1465

Another Medicaid Resource

Early Periodic Screening, Diagnosis and Treatment (EPDST) Program Comprehensive and preventive child health programs for individual under the age of 21, which includes  periodic screening, vision, dental, hearing services, as well as therapies and in-home supports.  Apply through DMAS 804-786-6134 for EPDST

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Virginia Medicaid Waiver – Need to Know

06/10/2010

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Recently a client came to me in order to have a guardianship petition drawn up for her intellectually disabled son.

She spoke to me of the stress inherent in living with her son. She was exhausted. His health problems required 24 hour monitoring, requiring her to stay awake at night. She was having financial problems. His out of pocket medical expenses were enormous.

I advised her to apply for the Intellectual Disability Waiver under Medicaid which could provide medical assistance, including long-term care services, for her son. She didn’t think he was eligible because he was not eligible for SSI. I explained that different rules apply to Medicaid versus SSI. SSI eligibility deems a parent’s income available to the child when below the age of 18 but this is not true for Medicaid. She applied and he was wait-listed. However, because her son needed immediate medical attention the wait-list was dropped and he received services. Now Medicaid provides a night-nurse. She also receives respite care under Medicaid.

Parents often fail to apply for Medicaid coverage believing that their income is too high for their child to qualify. This is a mistake. Since developmentally disabled children rarely have income or possess resources, they tend to be eligible for Medicaid funding and services. Parental income and resources are not used to determine eligibility.

Virginia Medicaid Waiver programs include: Elderly & Disabled Waiver; Intellectual Disability Waiver; Developmental Disabilities Support Waiver and the Technology-Assisted Waiver. Virginia funds both the ID and DDS waivers per slot. The number of slots is limited and this results in waiting lists. But this is not the only problem. Many families with developmentally disabled children simply don’t know about the programs or think their children are not eligible.

This is an important issue for advocacy groups since every child who is eligible for such Medicaid programs should be on the waiting list. This is the only way for officials to truly know the need. Knowing the true need can lead to greater funding.

The Arc of Northern Virginia and the Autism Society of Northern Virginia sponsor Medicaid Waiver and SSI workshops throughout fall, winter and spring. The next workshop is September 25, 2010 at the Northern Virginia Jewish Community Center. From 1 to 4 pm. The workshops are free.

Future blogs will explore each Virginia Waiver program in more detail. Stay tuned.

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