There are two Acquired Brain Injury (ABI) Waivers, known as ABI Waiver I and ABI Waiver II, which are administered by the Department of Social Services (DSS). These waivers provide a person-centered plan of care for an array of non-medical, home and community-based services to individuals with an acquired brain injury who currently receive or would otherwise require services in an institutional setting.
Both waivers are functionally similar, however ABI Waiver II includes new services, has a lower cost cap and does not have Transitional Living Services.
Note: ABI Waiver I is currently closed to new participants.
To be eligible for the ABI Waiver II, individuals must be:
Eligible for Medicaid
Between ages 18 and 64 with an acquired brain injury
Meet the DSS “Level of Care Requirement” which means that without the waiver services the individual would otherwise receive services in an institutional setting
Able to participate in the development of a service plan in partnership with a DSS social worker or have a conservator to do so.
An ABI is an injury to the brain that has occurred after birth which results in improper brain function. The condition cannot be congenital, developmental, or degenerative to be considered for the ABI Waiver II.
Med-Connect applicants may also meet the financial eligibility rules for the program through the Medicaid for Employed Disabled coverage group. Under the program, working individuals can have income up to $75,000 per year, $10,000 in assets and receive Medicaid subject to payment of a monthly premium.
Individuals who cannot afford the cost of care, but are over Medicaid's limits may still qualify. The state has a spend down program that evaluates an individual's care costs and their income. If it is calculated that an individual cannot meet their care costs, they can qualify for Medicaid byspending-downtheir income over the limit on their medically-necessary care costs.
Types of services and supports that can be used for Acquired Brain Injury (ABI) Waiver
Services may include assistance with Activities of Daily Living (ADLs) such as eating, bathing, dressing, transferring and toileting. Other supports include, but are not limited to:
Case management (care plan development and monitoring)
There may currently be a waiting list for the ABI Waiver. Individuals are encouraged to apply even when there is a waiting list so the evaluation process can be started.
Note: Participation in the various Medicaid Home and Community Based Waiver programs is often limited due to capacity and resources. When all available slots are filled, eligible applicants are placed on a waiting list, which is accessed on a first-come, first-served basis.
Community Options Unit at the Department of Social Services at1-800-445-5394 (Toll Free)or call860-424-4904locally in the Hartford area. The form can also be downloaded below: