New Choice Waiver Medicaid

Posted on

Jan 26, 2012

Book/Edition

Utah - Utah

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What is a Medicaid Waiver?

In 1981, Congress passed legislation allowing states greater flexibility in providing services to people living in community settings.
This legislation, Section 1915 of the Social Security Act, authorized the waiver of certain Medicaid statutory requirements
The Waiving of these mandatory statutory requirements allowed for the development of joint federal and state funded programs called Medicaid 1915 Home and Community Based Services Waivers


The New Choice Waiver program
Purpose
This waiver helps eligible individuals to move out of nursing facility settings. Services are designed to help people transition out of a nursing facility and re-establish themselves back in the community.
Eligibility

Must be 21 years plus 1 month old;
The primary condition must not be attributable to a mental illness;
The individual does not meet Intensive Skilled level of care criteria; and
The individual does not meet level of care criteria for admission to an intermediate care facility for people with mental retardation (ICFMR)

In addition, eligible individuals must be:

Receiving Medicaid reimbursed nursing facility care on an extended stay basis of 90 days or more;
Currently receiving Medicare reimbursed care in a licensed Utah medical institution (that is not an Institution for Mental Disease), on an extended stay of at least 30 days, and will discharge to a Medicaid certified nursing facility for an extend stay of at least 60 days; or
Receiving Medicaid reimbursed services through another of Utahs 1915 waivers and have been identified as in need of immediate or impending nursing facility care.

Waiver Services

Adult Day Care
Adult Residential Services
Assistive Technology
Attendant Care
Caregiver Training
Case Management
Chore Services
Consumer Preparation Services
Emergency Response Systems
Environmental Accessibility Adaptations
Financial Management Services
Habilitation Services
Home Delivered Meals
Homemaker Services
Institutional Transitional Services
Medication Assistance Services
Non-Medical Transportation
Personal Budget Assistance
Respite Care
Specialized Behavioral Health Services
Specialized Medical Equipment
Supportive Maintenance


Editors Note:This article was submitted by Blake Minardi. For more information contact: Vicki Ruesch (801) 538-6148 or Blake Minardi (801) 538-6497; UDOH Bureau of Authorization and Community Based Services 288 North 1460 West (PO Box 143112) Salt Lake City, Utah 84114-3112.

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