Waivers

EBD

200

What are the 3 qualifying requirements for this wavier?

• You must be 18 years or older.
• If you are between the ages of 18 and 64, you must be blind or have a physical disability, or have a diagnosis of HIV or AIDS.
• If you are age 65 and older, you must have been determined to have a significant functional impairment.

400

What document is required for all EBD services?

PMIP signed by DR

600

What are the service requirements to remain on this waiver?

A billable service every 30 days. 

Meet functional level of care 

800

What scores are required to meet functional LOC on the 100.2?

A score of 2 in two or more categories.

1000

What date will EBD services change to CFC services?

7/1/25 OR at the members CSR after 7/1

CMHS

200

What are the 4 qualifying requirements for this wavier?

• 18 years of age or older with a severe and persistent mental health need,
• Currently has or at any time during the past year leading up to assessment has a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and
• Has a disorder that is episodic, recurrent, or has persistent features, but may vary in terms of severity and disabling effects, and
• Has resulted in functional impairment which substantially interferes with or limits one or more major activities.
   

400

Members on this waiver can have(blank service) but not (blank service)

Members can have CDASS but they cannot have IHSS.

600

This wavier requires a specific type of contact at the 6M and CSR, what are they?

180 day mental health provider contacts 

800

This wavier requires members to do what monthly/or every three months?

the member MUST maintain a relationship with a counselor or psychiatrist.  

1000

What are 3 qualifying diagnosis that are required to be on the PMIP for this wavier?

Bi-Polar

schizophrenia

DID disorder

Depression

General anxiety disorders 

PSTD

OCD

BI

200

What are the 4 qualifying requirements for this wavier?

• You must be 16 years or older.
• You must have a brain injury.
• Your brain injury occurred before your 65th birthday.
• Your diagnosis must fit within certain categories.

400

Members on this waiver can have(blank service) but not (blank service)

BI members can have SLP services but cannot have ACF services. 

600

Name 3 services/benefits that are specific to the BI waiver

• Behavioral Management and Education
• Day Treatment
• Peer Mentorship
• Substance Abuse Counseling
• Supported Living Program
• Transitional Living Program
• Independent Living Skills Training (ILST)

800

This waiver requires what? in addition to normal contact requirements.

Monthly phone calls to make sure services are going well. 

1000

This wavier requires very specific signatures on the PMIP

MD, or DO, no others may sign

CHCBS

200

What are the 2 qualifying requirements for this waiver?

• Your child must need long-term support services at a level comparable to services typically provided in a skilled nursing facility and/or an acute hospital.
• Your child must meet the Social Security Administration (SSA) definition of disability.

400

If a member wants CHCBS wavier services they MUST meet what?

Targeting criteria with approval from Telligen

600

What 2 specific services are available on this waiver

IHSS HMA and the WEB benefit

800

What services can be completed under IHSS on this wavier?

ONLY IHSS HMA. 

1000

What are the financial requirements to qualify for this waiver?

What is NO SSI

CIH

200

What are the 3 qualifying requirements for this wavier?

• Be 18 years of age or older
• Have a qualifying condition of a spinal cord injury (traumatic or nontraumatic), multiple sclerosis, brain injury, spina bifida, muscular dystrophy, or cerebral palsy 
• Have been determined to have an inability for independent ambulation resulting from the qualifying condition as identified by the case manager through the assessment process. The inability for independent ambulation for the HCBS-CIH waiver means: 
  • The individual does not walk, and requires use of a wheelchair or scooter in all settings, whether or not they can operate the wheelchair or scooter safely, on their own, OR; 
  • The individual does walk, but requires use of a walker or cane in all settings, whether or not they can use the walker or cane safely, on their own, OR; 
  • The individual does walk, but requires “touch” or “stand-by” assistance to ambulate safely in all settings.

400

Name one service/benefit that is specific to the CIH waiver

• Complementary and Integrative Health Services (Acupuncture, Chiropractic, Massage Therapy)

600

Name one specific diagnosis is required on the PMIP in order to qualify for this wavier 

Spinal cord injury, MS, Spina bifida, Brain injury, muscular dystrophy or cerebral palsy.

800

This wavier was formally known as what?

SCI waiver (spinal Cord Injury)

1000

What is the main goal behind this wavier?

DAILY DOUBLE!!!!!!!

The goal is to help individuals with mobility and ambulation challenges resulting from spine and brain injuries remain in a community setting.