WAIVERS:

Alzheimer's Assisted Living (AAL) Waiver

• Overview of AAL Waiver Waiver
   
  • The 2004 General Assembly mandated that DMAS develop a home- and community-based care waiver for individuals with Alzheimer’s disease or a related dementia. This waiver became a reality in 2005 and will initially serve 200 individuals. Participants must reside in an assisted living facility (ALF) licensed by the Virginia Department of Social Services, be in a safe and secure environment, meet Virginia’s criteria for nursing facility placement and be receiving an Auxiliary Grant (AG). In order to participate in the program, the ALF must meet certain criteria. The individual must not have a diagnosis of mental retardation or serious mental illness. It is estimated that the waiver would be approximately $50 a day per participant.

    Individuals eligible to be placed on this waiver are currently either 1) remaining at home where an adult child is typically serving as primary caregiver; 2) residing in an ALF without the benefit of specialized services, which are not provided in the base $50 per day rate; or c) residing in a more expensive institutionalized nursing facility setting. Through the Alzheimer’s Assisted Living Waiver, recipients would be able to receive an appropriate level of care within special care units of ALFs.

    To initiate services, call the local department of social services to schedule an appointment to be screened for long-term care services. If hospitalized, request a screening from the hospital social worker or discharge planner. There is no cost to be screened to determine eligibility for the waiver. Individuals receiving AAL Wavier services must also be receiving an Auxiliary Grant (AG) and have no patient pay for waiver services. DSS determines eligibility for the AG program.

    Enrollment is limited to 200 individuals and once 200 individuals have enrolled, DMAS will begin a waiting list.

    Services available in the AAL waiver are:

    •  Assisted Living: Assistance with activities of daily living, housekeeping, and supervision.
    •  Medication Administration: Medication administered by a licensed professional.
    •  Nursing evaluations: Evaluation by a registered nurse.
    •  Therapeutic and Recreational Programming: Weekly activity program based on needs and interests.
    • Individuals receiving AAL Waiver services also receive services through the Medicaid program. Examples include medications (for those individuals not covered under Medicare), physician visits, acute care hospitalizations, and certain therapies.

     

• AAL Waiver Regulations

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Assistive Technology and Environmental Modifications:

This spreadsheet is a list of enrolled Medicaid Providers who currently offer Assistive Technology and Environmental Modifications through the Home and Community Based Waiver Programs. Please use this list to locate a provider in your area if you are in need of these services.

• List of Medicaid Providers

* Effective August 28, 2006, daily administration of the waiver will be managed by the Department of Mental Health, Mental Retardation and Substance Abuse Services, Office of Mental Retardation (OMR), in collaboration with DMAS. For information, please refer to the DMHMRSAS website at http://www.dmhmrsas.virginia.gov/OMR-MRWaiverInformation.htm.

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Elderly or Disabled with Consumer Direction (EDCD) Waiver

• Overview of EDCD
   

  • The EDCD Waiver got its start in Virginia in 2005, merging two existing waivers.  Eligible individuals must the nursing facility eligibility criteria.

    Available services are:

    •  Adult Day Health Care

    •  Assistive Technology

    •  Consumer-Directed Services

    •  Environmental Modifications

    •  Medication Monitoring

    •  Personal Care Aide Services

    •  Respite Care

    •  Personal Emergency Response System (PERS)

    •  Transition Coordiantion

    •  Transition Services

    Nursing facility pre-admission screening teams conduct a pre-admission screening. A pre-authorization contractor performs prior authorizations  of services. Providers are an institution, facility, agency, partnership, corporation, or association that meets the standards and requirements set forth by DMAS and has a current, signed contract with DMAS to be a provider of waiver services.
     

• EDCD Waiver Regulations

• How To Assistive Technology Guide

• How To Environmental Modifications Guide

Training Information

• Personal Care Aide Training Curriculum

• In-State Personal Care Aide Training Programs

• Out-of-State Personal Care Aide Training Programs

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HIV/AIDS Waiver

• Overview of HIV/AIDS Waiver
   
  • The HIV/AIDS Waiver was developed in 1991. This waiver provides services to individuals who are diagnosed with the human immunodeficiency virus (HIV), who are experiencing the symptoms associated with acquired immune deficiency syndrome (AIDS), and who would otherwise require care provided in a nursing facility or a hospital.

    Available services include:

    •  Assistive Technology 
    •  Environmental Modifications 
    •  Nutritional supplements
    •  Personal Emergency Response System (PERS) 
    •  Transition Services 
    •  Private duty nursing
    •  Personal care (agency or consumer-directed options)
    •  Respite care (agency or consumer-directed options)
       

Who qualifies for services?

Individuals must have a diagnosis of HIV or AIDS and be experiencing medical and functional symptoms associated with the disease that require hospital or nursing facility care to receive services under the waiver.

Individuals must meet Medicaid eligibility criteria as determined by the local department of social services. Individuals who are found to be eligible for the HIV/AIDS Waiver and choose to receive services may apply for Medicaid using special rules which allow the individual to receive a higher income and still qualify for Medicaid.

Who can help initiate services?

Call the local department of social services in your area to schedule an appointment to be screened for long-term care services or if hospitalized, request a screening from the hospital social worker or discharge planner.

There is no cost to be screened to determine the eligibility for the waiver. Individuals found eligible for waiver services must apply and be found eligible for Medicaid. The DSS worker who processes the Medicaid application will use special rules that apply to individuals found eligible for the HIV/AIDS waiver.

• HIV/AIDS Waiver Regulations

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Individual and Family Developmental Disabilities Support (IFDDS) Waiver

• Overview of  IFDDS Waiver
   

  • The IFDDS Waiver provides services to individuals 6 years of age and older with a condition related to mental retardation, but who do not have a diagnosis of mental retardation, and who have been determined to require the level of care provided in an ICF/MR. An individual is eligible for services based on three factors: diagnostic eligibility, functional eligibility, and financial eligibility.

    Available services include:

    •  Personal Emergency Reponse System (PERS)

    •  Crisis Stabilization

    •  Transition Services

    •  Day Support

    •  Companion Services (Agency or Consumer Directed)

    •  Supported Employment

    •  In-home Residential Support

    •  Therapeutic Consultation

    •  Personal Care Services

    •  Respite Care (Agency or Consumer Directed)

    •  Supported Employment

    •  Skilled Nursing Services

    •  Attendant Services

    •  Family and Caregiver Training

    •  Crisis Supervision

    •  Environmental Modifications

    •  Assistive Technology

    •  Prevocational Services
       

• IFDDS Waiver Regulations

• Eligibility Criteria for Emergency Access to the IFDD Waiver
• Request for Screening Form

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Mental Retardation (MR) Waiver

* Effective August 28, 2006, daily administration of the waiver will be managed by the Department of Mental Health, Mental Retardation and Substance Abuse Services, Office of Mental Retardation (OMR), in collaboration with DMAS. For information, please refer to the DMHMRSAS website at http://www.dmhmrsas.virginia.gov/OMR-MRWaiverInformation.htm.

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Technology Assisted (Tech) Waiver

• Overview of Tech Waiver
   
  • The Technology Assisted Waiver began in 1988. This waiver is a program designed to allow eligible recipients to be cared for in the community rather than remain institutionalized. Eligible recipients are children under the age of 21, who have exhausted available third party benefits for private duty nursing and are dependent on a technology to substitute for a vital body function and adults, over age 21.  All recipients must require substantial and ongoing skilled nursing services. While assistance with the cost of room and board is not available through Medicaid waivers, waivers provide supports that help individuals to live as independently as possible in the community.

    Available services include:

    •  Environmental Modifications
    •  Personal Emergency Response System (PERS)
    •  Transition Services
    •  Personal care (Adults Only)
    •  Private duty nursing
    •  Respite care
    •  Environmental Modifications
    •  Assistive Technology
       
  • Individuals receiving Tech Waiver services have their care coordinated by a DMAS staff. Individuals receiving waiver services also receive other services offered through Medicaid. Examples include medications (for those individuals not covered by Medicare), physician visits, acute care hospitalizations, and certain therapies.