Get Latest WorkWORLD

VA Medicaid Waivers

Virginia provides services under community-based care waivers to specifically targeted individuals. These services are not available to all Medicaid recipients in the state. The waivers and the services offered include the following:

·   Alzheimer's Assisted Living (AAL) Waiver

·   HIV/AIDS Waiver

·   Elderly or Disabled with Consumer Direction (EDCD) Waiver

·   Day Support Waiver

·   Intellectual Disabilities/Mental Retardation (ID/MR) Waiver

·   Technology Assisted (Tech) Waiver

·   Individual and Family Developmental Disabilities Support (IFDDS) Waiver

All individuals receiving waiver services must meet the non-financial and financial Medicaid eligibility criteria and be Medicaid eligible in a medical institution. The resource and income rules are applied to waiver eligible individuals as if the individuals were residing in a medical institution.

For all aged, blind, and disabled (ABD) groups, the resource limit is $2,000 per individual.

For individuals receiving Medicaid Waiver services, the real property resource limit is $5,000. Note, however, that none of the real property exclusions in sections M1130.100, M1130.140, S1130.150, or M1130.160 of the DSS Medicaid Manual apply to the property. (See VA Medicaid Resources Defined and Medicaid Resource Exclusions.)

The earned income limit for the Medicaid waiver and aged, blind, and disabled covered group is 300% of the FPL. This policy still applies. The income limit this year is $2,199 per month.

To be income eligible for Medicaid Waiver services, the individual's Gross Income must not exceed 300% of the SSI Individual Payment Limit (the Federal Benefit Rate).

Alzheimer's Assisted Living (AAL) Waiver

Provides services for individuals with Alzheimer's disease or a related dementia who do not have a diagnosis of mental retardation or serious mental illness. Participants must reside in an assisted living facility and be receiving an Auxiliary Grant. Through the Alzheimer’s Assisted Living Waiver, recipients would be able to receive an appropriate level of care within special care units of ALFs.

The following services are offered under the Alzheimer's Assisted Living Waiver:

·             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.

HIV/AIDS Waiver

Provides services to qualifying individuals who have a diagnosis of HIV or AIDS and are experiencing medical and functional symptoms associated with the disease that require nursing facility or hospital care.

The following services are offered under the AIDS Waiver:

·             Case management

·             Nutritional supplements

·             Private duty nursing

·             Personal care

·             Respite care

Elderly or Disabled with Consumer Direction (EDCD) Waiver

Provides services to qualifying individuals 65 years of age or older or who are disabled and who meet screening criteria and are at imminent risk of nursing facility placement.

The following services are offered under the Elderly and Disabled Waiver:

·             Adult day health

·             Medication monitoring

·             Respite care

·             Personal care aide

·             Personal Emergency Response System (PERS)

·             Transition Coordination

·             Transition Services

Day Support Waiver

Provides services to qualifying individuals with a diagnosis of mental retardation who have been determined to require the level of care provided in an Intermediate Care Facility for the Mentally Retarded (ICF/MR).

The following services are offered under the Day Support Waiver:

·             Day Support

·             Prevocational services

Intellectual Disabilities/Mental Retardation (ID/MR) Waiver

Provides services to qualifying individuals with a diagnosis of mental retardation and individuals under the age of 6 at developmental risk who have been determined to require the level of care provided in an Intermediate Care Facility for the Mentally Retarded (ICF/MR).

The following services are offered under the Intellectual Disabilities/Mental Retardation Waiver:

·             Day support

·             Supported employment

·             Residential supports

·             Therapeutic consultation

·             Personal assistance services

·             Respite care

·             Skilled nursing services

·             Crisis Stabilization

·             Environmental Modifications

·             Assistive Technology

Technology Assisted Waiver

Provides services to qualifying individuals over age 21 who need both a medical device to compensate for the loss of a vital body function and substantial and ongoing skilled nursing care. This waiver is a program designed to allow eligible recipients to be cared for in the community rather than remain institutionalized.

The following services are offered under the Technology Assisted Waiver:

·             Private duty nursing

·             Respite care

·             Assistive Technology

·             Personal care

·             Environmental modifications

·             Personal Emergency Response System (PERS)

·             Transition Services

Individual and Family Developmental Disabilities Support (IFDDS) Waiver

Provides services to qualifying individuals 6 years of age and older who have a condition related to mental retardation -- but who do not have a diagnosis of mental retardation -- if they have been determined to require the level of care provided in an Intermediate Care Facility for the Mentally Retarded (ICF/MR).

The following services are offered under the DD Waiver:

·             Day support

·             Adult Companion Care

·             Supported employment

·             In-home residential support

·             Therapeutic consultation

·             Personal care services

·             Respite care

·             Skilled nursing services

·             Attendant services

·             Family and caregiver training

·             Crisis stabilization

·             Environmental modifications

·             Assistive technology

·             Personal emergency response systems

·             Personal Care services

·             Prevocational services

·             Transition services

See Also:

VA Medicaid Income Limits

VA Medicaid Resource Limits

Back to:

VA Medicaid Eligibility

VA Medicaid Covered Groups

VA Medicaid Overview

VA Benefit Information System Welcome and Introduction

Source:

Some information for this topic was drawn from the Department of Medical Assistance Services (DMAS) Medicaid Handbook.

Additional sources include:

Chapter 1460.500 of the Department of Social Services (DSS) Medicaid Manual

http://www.dmas.virginia.gov/ltc-home.htm.

http://www.dbhds.virginia.gov/ODS-default.htm.

WorkWORLD™ Help/Information System

   Share/Save: Click the button or link at left to select your favorite bookmark service and add this page.

This is one topic from the thousands available in the WorkWORLD™ software Help/Information System.
Complete information about the software is available at: http://www.WorkWORLD.org