The Katie Beckett Waiver, administered by the Department of Social Services (DSS), provides Medicaid healthcare services and support to individuals 21 years of age and younger with a physical disability who may or may not have a co-occurring developmental disability. These services are for young adults and children who would normally not qualify for Medicaid due to family income.
The purpose of the waiver is to provide home and community-based services to individuals who would prefer to reside in their home or in the community instead of an alternative institution.
To be eligible for the Katie Beckett Waiver, individuals must be:
Age 21 and under with a physical disability and may or may not have a co-occurring developmental disability
Financially eligible for Medicaid
Meet the DSS “Level of Care Requirement” which means that without the waiver services the individual would otherwise receive services in an institutional setting
Under this Waiver, the income of a parent or spouse is not counted when determining Medicaid eligibility; however, the income must be listed. Some participants may pay a premium based on the parent or parents’ income.
Types of services and supports that can be used for Katie Beckett Waiver
Case management by a home health agency is provided in addition to standard Medicaid-covered services such as:
Personal Care services
Home Health services
Hospital inpatient and outpatient services
The cost of these services may vary but cannot exceed the cost of these services if they were provided in an institutional setting.
The DSS is currently authorized to provide services to 300 individuals on this waiver. A waiting list is maintained for those interested in gaining access to the program when an opening becomes available.
How Do You Apply When a Vacancy Occurs?
When an opening for the program becomes available, DSS will send the next applicant on the waiting list a Notice of Vacancy letter outlining the application process. The applicant will be provided with a list of Medicaid-enrolled Home Health Agencies. The selected agency will send a registered nurse to perform a waiver assessment, develop a plan of care and become the applicant's Case Manager.
The assessment and plan of care will be submitted to DSS to determine the medical eligibility of the individual, evaluate whether the applicant meets the required institutional level of care and verify that the plan of care is cost effective.
A Medicaid Eligibility Determination Document must be completed and submitted to a designated DSS office for financial determination. The DSS Resources Unit will establish whether a legally-liable relative contribution is required toward the cost of care once eligibility is determined.
If both the medical and financial requirements are met, the applicant will receive a notice indicating when benefits will begin. A CONNECT card will be delivered which should be presented to Medicaid-enrolled providers when obtaining services.
Individuals unable to complete the application form due to a disability may request an accommodation or special help. DSS can use different methods to assist people in completing their application such as providing extra time or over-the-phone help.
Due to the number of slots available, applicants may be placed on a waiting list. To be placed on the waiting list, contact the DSS Community Options Unit at 1-800-445-5394or860-424-5582.
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