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About the Ill and Handicapped (IH) Waiver
We hope the following information will help you better understand the services that are offered with the Ill and Handicapped (IH) Waiver. Insurance and Medicaid will be billed before waiver funds.
Medicaid Benefits (Medicaid is the same as Title XIX)
When your child receives IH Waiver services, he/she is entitled to Medicaid benefits. These benefits cover such items as doctors’ visits, prescription drugs, physical therapy, transportation to therapy visits, some medical equipment, diapers (age 4 years and above), etc. It is important for you to ask if your child’s provider(s) accept Medicaid for payment.
Intermittent Medicaid (regular Medicaid) may be used to provide nursing and/or home health aide services. These services are provided only in your home.
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) or also called
Care for Kids (expanded Medicaid) can be used if more hours are necessary for private duty nursing and personal care for your child. A RN or skilled therapist from the home health agency will make supervisory visits of their staff in your home.
Waiver Services
- Respite is temporary care to your child to provide relief for the usual
caregiver. This CANNOT be used while a parent works. A home health
agency, an accredited camp, or a licensed group living foster care facility may provide respite care.
- IMMT (Interim Medical Monitoring & Treatment) is monitoring and treatment of a medical nature requiring specially trained caregivers. This service may be used when the usual caregiver is employed, hospitalized for a short time, looking for employment or in school. Your child must have regular or expanded Medicaid services before using IMMT.
- Homemaker services are tasks such as shopping for basic items, limited house cleaning, laundry and meal preparation for your child to aid the usual caregiver.
- Home Health Aides provide direct care for your child. Some examples include bathing, developmental activities specified in your child’s education or therapy plan, accompanying to medical appointments or school.
5. Nursing services are provided by a nurse. Examples include giving
medications, tube feedings, etc.
- CDAC (Consumer-Directed Attendant Care) services are activities where a person helps the consumer with self-care tasks, which he/she would typically be doing independently. CDAC is not a substitute for respite care. CDAC does not include supervision. A CDAC provider may not be the spouse of the consumer, parent, stepparent or guardian of a consumer aged 17 or under.
- Personal Emergency Response System is an electronic device which allows the consumer to get assistance twenty-four hours a day in the event of an emergency.
8. Home or Vehicle Modification is physical modifications to the home or vehicle to assist
with the health, welfare and safety of the consumer and to increase or maintain
independence.
- Adult Day Care services are available for young adult’s age 18 or older.
- Nutrition Counseling is provided for a nutritional problem that requires on going
management by a nutritionist.
- Counseling services are available for a short duration to help your child and caregiver(s)
learn coping skills.
12. Home Delivered Meals are prepared outside the consumer’s home and delivered to the
consumer.
13.Consumer Choices Option is a self-determination option that gives consumers more control over a targeted amount of waiver dollars to use to purchase the support services they need. Consumers can use Consumer Choices Option dollars to directly hire employees and/or purchase other goods and services. These services can be used in combination with traditional waiver services. Only non-skilled services can be provided through the Consumer Choices Option. To access Consumer Choices Option, consumers must first identify a Financial Management Service to help them to manage their individual budget and an Independent Support Broker to help them to develop their budget.
The monthly maximum amount of money available to pay for all the above waiver services will depend on your child’s level of care. The lowest level is the Intermediate (ICF), also referred to as a Nursing Facility (NF), and services may not exceed $904 per month. The other levels of care: Pediatric Skilled (Peds SNF) and Intermediate Care Facility/Mentally Retarded (ICF/MR) have higher monthly maximums, $2631 per month and $3203 respectively.
The consumer may receive more than one waiver service, as long as the total cost for all waiver services in your child’s plan does not exceed the monthly maximum and services are necessary. Input from Child Health Specialty Clinics (CHSC), Department of Human Services (DHS), providers and parents will determine the necessity of services. One hour of waiver service must be used every calendar quarter (Jan-Mar, April-June, July-Sept, Oct-Dec). If your family’s situation and needs change, waiver services may be changed on a case-by-case basis with approval from your DHS service worker.
Other
Health Insurance Premium Payment (HIPP) program is one of the services available to people who get Medicaid. The HIPP program helps people get insurance or keep insurance they already have by paying for the premiums. Ask your DHS worker for details and a brochure.
Please discuss any questions about these programs with your DHS worker or CHSC staff member.
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