Waiver 101: What You Need to Know

Maybe you’ve overheard a coworker talk about it, or watched something about it on the news. So what exactly is this thing called Waiver? Please take a few minutes to learn more about this cool Medicaid program.

What is the Waiver?

The Iowa Home-and Community-Based Services (HCBS) are Medicaid programs for people with disabilities who live in Iowa and are in place to provide funding, individualized supports and the right level-of-care for individuals who qualify. There are several programs that provide Home-and Community-Based Services, but for the purpose of this blog, I will focus on the HCBS Waiver Program.

Iowa has seven HCBS Waivers as well as a Consumer Choice Option, which provide varying amounts of service funding and supports such as therapies, transportation and social opportunities. These supports are home and community based, allowing individuals to live, work and thrive in their own communities, instead of living in places that would isolate them. This is the primary goal of the Medicaid waiver.

How can the Waiver be used?

Individuals can choose how to use their Iowa Medicaid waiver services. Hand in Hand, one

of many waiver providers in the Scott County area, provides 4 different waiver services:

Respite is designed to give parents/guardians a much-needed break and can be used at times when the usual caregiver is not working. Parents often use respite time to run errands, spend time with their spouse and other children or for some much needed ‘me time’.

IMMT (Interim Medical Monitoring & Treatment) is a specialized service for individuals who have medical needs that are not be easily met by typical caregivers or programs. A child who needs to be monitored for seizure activity, severe allergies or other significant medical conditions will often qualify for this waiver service. IMMT allows parents/guardians to work knowing their child’s caregivers will respond to any medical concerns that occur.

SCL (Supported Community Living) - Some individuals desire to work on goals that help them achieve greater independence. During SCL time, individuals interact 1:1 with caregiver staff to practice and further develop skills in areas such as peer interaction, communication, personal hygiene, safety, managing negative behaviors or other activities of daily living.

NEW for Fall 2019- Day Habilitation is provided during People with Purpose activities for young adults who seek socialization, meaningful volunteer activities, and opportunities to learn and thrive. Day Hab is an option for those 18 years or older who qualify for the ID waiver. It is unique in that it can be provided while an individual’s parent or guardians are working.

HCBS waivers allow individuals and their families to combine these and many other services to best support their needs. As an enrolled provider of Medicaid waiver services, Hand in Hand can bill both the ID (Intellectual Disability) and HD (Health & Disability) waivers for these services, offering our participants more choices and reducing the out of pocket costs for those who participate in our programs.

How do I apply for the Waiver?

The enrollment process for any of the HCBS waivers requires a coordinated effort between the Department of Human Services (DHS) and other agencies on behalf of the applicant. Although waiver eligibility requirements vary, a person must first be deemed eligible for Medicaid (Title XIX) based on his or her own income and assets. This is important, since many families assume their annual income is too high to qualify for state or federally funded programs. An individual may already be Medicaid eligible prior to applying for waiver services, but this is not required. There may be a lengthy waiting period (about 2 years) for some waiver programs, so it is a good idea to start the process as early as possible.

For more information about Iowa Medicaid Waiver services, explore http://dhs.iowa.gov/ime/members/medicaid-a-to-z/hcbs/waivers or call the DHS Contact Center at 1-855-889-7985, Monday-Friday 7am- 6pm.

To learn more about using waiver services at Hand in Hand, please contact: Molly Steil Rowland, Director of Waiver Care at molly@handinhandqc.org.