Benefits for Children with Developmental Disabilities
Nancy E. Wright, Esq.
GAL Video Training 2015
1.Developmental Disability-An Assortment of Legal Definitions
A. Federal Developmental Disabilities Act 42 USC 15001 §102(8)
Age 5 and over with severe, chronic disability that
Is attributed to mental and/or physical impairment
Manifested before age 22
Is likely to continue indefinitely
Results in substantial functional limitations in three or more major life activities
Reflects long term need for special services
B. Individuals with Disabilities Education Act (IDEA) “Child with Disability”
Child with:
Intellectual disability
Hearing, visual, orthopedic, speech or language impairment
Serious emotional disturbance
Autism Spectrum Disorder
Traumatic Brain Injury
Specific Learning Disability
Other Health Impairment
Who, by reason thereof need special education and related services
C. Social Security Administration
Child under age 18 who has a physical or mental condition(s):
That has lasted or expected to last at least a year or result in death AND
That seriously limits life activities
D. Florida DD Waiver Florida Statutes §393.063
Disorder or syndrome that manifests before 18
Attributable to:
Down syndrome
Intellectual disability (generally, IQ under 70)
Autism (NOT ASD, Asperger’s or PDD-NOS)
Spina bifida
Prader-Willi syndrome, or
Cerebral palsy
Substantial handicap that can be expected to continue indefinitely
E. Florida DD Waiver High Risk Child
Age 3 to 5 with one or more:
Delay in cognition, language or physical development
Traumatic illness or infection associated with DD
Has parent or guardian with DD who needs assistance meeting child’s needs
Has physical or genetic anomaly associated with DD
2.State Plan Medicaid Services
A. State Plan Medicaid Services
Private Duty Nursing
Personal Care Assistant/Home Health Aide
ABA for Child with ASD
OT/PT/SLT/RT
Consumable Medical Supplies (e.g., diapers, wipes)
Durable Medical Equipment (e.g., wheelchair, hospital bed)
State In-Patient Psychiatric (SIPP)
B. Child Welfare-Related Services
Medicaid Foster Care (MFC)
Child Health Targeted Case Management (for MFC)
Specialized Therapeutic Foster Care (STFC)
Comprehensive Behavioral Health Assessment (CBHA)
STFC Services Level I or II
Targeted Group Care Services
Child Mental Health Targeted Case Management
Child Welfare Behavioral Health Overlay
C. Community Behavioral Health Services
Assessment Services: psychiatric, record review, bio- psychosocial,brief behavioral health, psychological testing, limited functionalassessment
Treatment Plan Development & Modification
Medical & Psychiatric Therapies: medication management and treatment, brief individual & group therapies
Behavioral Health Therapies: Individual and family, group, dayservices for 2-5 y.o.
Community Support & Rehab Services: psychosocial rehab, clubhouse for 16 and up
Therapeutic Behavioral On-site Services: wraparound in permanent home or foster care
3.DD Waiver Services
A. DD Waiver Services not available to Children on Medicaid
Residential Group Home
Supported Living Services
Respite
Environmental Modifications
Supported Employment
Companion
Adult Day Training
B. DD iBudget Waiver Enrollment: What about the wait list?
2015 Gen’l Appropriations Act SB 2502, §20
Priority enrollment in the Waiver at time of finalization:
Adoption
Reunification with family members
Permanent placement with a relative
Permanent guardianship with non-relative
Crisis Enrollment
1st Priority: Homeless
2nd Priority: Serious danger to self or others
3rd Priority: Caregiver under duress/unable to care
C. When are DD Waiver services needed?
For services not offered through SP Medicaid/EPSDT
If you can’t find providers through SP Medicaid who are qualified to work with children with DD
To ensure continued Medicaid for reunification
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