Home care is available for Developmentally Disabled Children, providing help for families and children living at home with severe disabilities or medical conditions.

Care Coordination Organizations (CCOs) provide Health Home Care Management services to help individuals with developmental disabilities and their families in receiving access to services and supports that are suitable for their needs. Health Home Care Management services are intended to do the following:

  • Comprehensive, person-centered care planning is provided through a network of care managers and service providers (team approach)
  • Improvements in the coordination and integration of primary care and mental health treatments, as well as improved access to medical and dental services, are required.
A young female tutor having a lesson with an absentminded child with concentration issues.
  • Develop an understanding of community-based resources and establish links to community-based programs and services, such as housing, social services, or family services.

The ​​Care at Home Medicaid Waiver for Developmentally Disabled Children (Office for People with Developmental Disabilities [OPWDD])

The ​​Care at Home Medicaid Waiver for Developmentally Disabled Children (Office for People with Developmental Disabilities [OPWDD]) provides medical support to families who have children living at home who have significant impairments or medical issues, as well as to their caregivers.

Case management, respite, house adaptations, and vehicle modifications are all covered under the Medicaid Care at Home Waiver program, which permits Medicaid to pay for services that would otherwise be covered under “normal” Medicaid. Children and their families may find that home care is a possibility as a result of these services. Despite the fact that this Medicaid money is limited to the child, it can be utilized to assist cover the costs of caring for the child in the home setting.

In order to qualify for this program, the following criteria must be met:

  • The individual must be under the age of eighteen.
  • The person must have a developmental impairment or a severe debilitating condition.
  • The person must have the ability to receive the degree of care offered by an intermediate care facility or skilled nursing facility (ICF/DD, i.e., a certified nursing home).
  • There is no need for an inpatient stay at a hospital.
  • The individual must not be eligible for Medicaid when the income and resources of the parents are taken into consideration; and Must be eligible for Medicaid when the income and resources of the parents are not taken into consideration.

Care at Home (CAH I/II) Program for Physically Disabled Children

It is possible to get community-based services for physically handicapped children who require hospital or skilled nursing home level of care through the Medicaid-waiver CAHI/II program. This program permits the child to remain at home rather than in an institutional environment. In order to assist families in caring for their impaired kid at home, Medicaid state plan and waiver services are offered. These services include case management, respite, home adaptations, vehicle modification, transportation services, and palliative care, among other things. When taken as a whole, the cost of care for children enrolled in CAH I/II cannot be more expensive than the cost of care for children enrolled in a skilled nursing facility or hospital.

To be eligible for the Care at Home (CAH I/II) Program for Physically Disabled Children, the following criteria must be met:

  • The person must be under the age of eighteen.
  • Care at the level given by a skilled nursing facility or a hospital is required.
  • It is essential that they can be cared for safely at home.
  • The individual must be eligible for Medicaid based on his or her parents’ income and, if applicable, resources; or he or she must be ineligible for Medicaid due to his or her parents’ excess income and/or resources, but be eligible for Medicaid when his or her parents’ income and/or resources are not taken into consideration.
  • The person must not be married in order to be eligible for Care at Home (CAH).

Eligibility

Developed in response to inquiries seeking clarification on eligibility for Health Homes among Medicaid members who have intellectual and developmental disabilities, following is the list of eligible Intellectual and Developmental Disabilities:

  • Mild intellectual disabilities
  • Moderate intellectual disabilities
  • Severe intellectual disabilities
  • Profound intellectual disabilities
  • unsp intellectual disabilities
  • expressive language disorder
  • mixed receptive-expressive language disorder
  • speech & language develop delay due to hearing loss
  • oth develop disorders of speech & language
  • oth develop disorders of scholastic skills
  • specific develop disorders of motor function
  • autism disorder
  • other childhood disintegrative disorder
  • asperger’s syndrome
  • Pervasive Development Disorder – Not Otherwise Specified (PDD-NOS)
  • other disorders of psychological develop
  • unsp disorder of psychological develop
  • local-rel sympto epi w/simp prt seiz, not intrct, w/o stat epi
  • local-rel sympto epi w/simp prt seiz, intrct, w/o stat epi
  • local-rel sympto epi w/cmplx prt seiz, not intrct, w/o stat epi
  • local-rel sympto epi w/cmplx prt seiz, intrct, w/o stat epi
  • gen idiopathic epilepsy, not intractable, w/stat epi
  • gen idiopathic epilepsy, not intractable, w/o stat epi
  • gen idiopathic epilepsy, intractable, w/stat epi
  • oth gen epilepsy, not intractable, w/o stat epi
  • oth gen epilepsy, intractable, w/o stat epi
  • oth gen epilepsy, not intractable, with stat epi
  • oth epilepsy, not intractable, w/o status epilepticus
  • oth epilepsy, intractable, w/o status epilepticus
  • epilepsy, unsp, not intractable, w/o status epilepticus
  • epilepsy, unsp, not intractable, with status epilepticus
  • epilepsy, unsp, intractable, w/o status epilepticus
  • epilepsy, unsp, intractable, with status epilepticus
  • absence epileptic syndrome, not intractable, w/stat epi
  • absence epileptic syndrome, not intractable, w/o stat epi
  • absence epileptic syndrome, intractable, w/stat epi
  • absence epileptic syndrome, intractable, w/o stat epi
  • spastic quadriplegic cerebral palsy
  • spastic diplegic cerebral palsy
  • spastic hemiplegic cerebral palsy
  • oth cerebral palsy
  • cerebral palsy, unsp
  • familial dysautonomia [riley-day]
  • anoxic brain damage, not elsewhere classified
  • benign intracranial hypertension
  • encephalopathy, unsp
  • disorder of central nervous system, unsp

Eligible individuals and families should apply for Pediatric HRA services beginning with a Medicaid Application.

At AC Cares, we work tirelessly to secure the services best suitable for your child, so that your child and entire family can live successful and happy lives. From our initial intake to assess your needs through the research and application phases, we will walk alongside you in navigating these often difficult and confusing situations.