Connecticut Medicaid Waiver

What Programs Are Available To Assist People With Disabilities in Connecticut?

Is there a Medicaid waiver program in Connecticut? Connecticut has several Medicaid Waiver programs.

Individual and Family Support Waiver (IFS);
The Comprehensive Support Waiver;
Connecticut Home Care Program for Elders Waiver;
Personal Care Assistance (PCA) Waiver;
Acquired Brain Injury (CT ABI) Waiver
CT HCBS Waiver for People w/Serious Mental Illness in Nursing Homes
CT Mental Health Waiver
CT Home and Community Supports Waiver for Persons with Autism
CT Employment and Day Supports
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What programs assist people who have developmental disabilities in Connecticut ? The Individual and Family Support Waiver (IFS) and The Comprehensive Support Waiver assists persons with developmental disabilities in Connecticut. Both waivers further set specific dollar limits of services and supports that can be offered based on an individual’s assessed level of support need. Also the CT Home and Community Supports Waiver for Persons with Autism Waiver was approved on 12/31/2012.

What is the best number to call to get started? The first step is to request an application. To request an application call the Toll Free number: 1-866-433-8192; for out of state, phone 860-418-6117.

Is there a website? http://www.ct.gov/dds

Who Qualifies For Assistance?

What is considered a developmental disability in Connecticut? The person's IQ score must be 69 or less. At the same time, the person must have deficits in adaptive functioning. People with a diagnosis of Prader-Willi syndrome are also eligible.

Are there income limits to receive services? Home and community based waivers require Medicaid eligibility. Individuals who are not eligible due to income or asset guidelines will be assisted to work towards Medicaid eligibility. Recent legislation will permit individuals who are working to enter into the Medicaid for the working disabled program and be qualified for waiver enrollment, which will increase the income and asset limits substantially, allowing a large number of individuals to then enroll in the Medicaid waivers. Additionally, the criteria for the level of care criteria is changing to allow people who were administratively found eligible for DMR services to also be eligible for waiver enrollment. Income is limited to 300% of the SSI Federal Benefit Rate (FBR).

How old do you have to be to start receiving waiver services in Connecticut? People can apply at any age, as long as there is evidence that the condition existed prior to age 18, but waiver services start at age 3 and above. Individual and Family Support Waiver (IFS) and the Comprehensive Support Waivers are available to persons age three and above. CT Home and Community Supports Waiver for Persons with Autism Waiver are available to persons age three and above.

Is There a Waiting List For Services?

How long is the waiting list in Connecticut? Some people in Connecticut have already been on the waiting list for many years. Every month, more than 94 people apply for services.

How many people are on the waiting list in Connecticut ? 1,846 people are on the waiting list.

How many people are currently receiving services in Connecticut? There is a set number of slots for the IFS Waiver of 3,115 people. The Comprehensive waiver has been approved for a total of 5,117 people. CT Home and Community Supports Waiver for Persons with Autism Waiver has 136 slots.

What assistance is available while you wait? The Family Support Grant (FSG), A monthly subsidy of up to $250 ($3,000 annually) to a parent or other family member who has primary responsibility for a child with a developmental disability (age 5 through 18) other than mental retardation, in order to meet the extraordinary expenses of that child. Gross income cannot be greater than 140% of the previous year's median family income for CT. The subsidy can be used for ongoing costs such as medical expenses, special equipment, medical transportation, special clothing. There are 25 slots statewide for this program. The Department has established a waiting list. Persons interested in having their names added to the list may contact any of the Department's regional offices, or Social Work Services at 860-424-5388, and complete the Waiting List Request Form.

Is there priority preference for people who are in crisis in Connecticut? Individuals in emergency situations are permitted to access services on a priority basis before other individuals on the waiting list.

What Services Are Offered & What Are The Service Limitations?

What services does the Medicaid waiver program offer? The Connecticut DDS Waiver provides a variety of home and community-based services to people with mental retardation who might otherwise be institionalized. It allows persons who live at home to receive services tailored to their needs. Categories of Services and Supports include: Home and Community Supports including Personal Assistance, Adult Companion, Supported Living, Individual Habilitation, Personal Emergency Response Systems Respite; Day/Vocational Supports including Group Day, Individualized Day Employment Services and Supports Ancillary Supports: Consultative Therapies, Specialized Medical Equipment and Supplies, non-medical transportation, home and vehicle modifications, interpreter services, family training, family and individual consultation

What services are available to people living in the family home? The Individual and Family Support Waiver is authorized to provide direct services and supports to people who live in their own or their family home. It is approved for individuals who do not require 24- hour paid supports. Services and supports are organized in four categories: Home and Community Supports; Day/Vocational Supports; Ancillary Supports; and Additional support services. Examples of available services include: personal supports, adult companion, group day, Clinical Behavioral Supports, and Vehicle Modifications.

Are there service limits? Individuals are assigned funding ranges based directly on the results of the Level of Need Assessment, and those ranges are the same for all individuals whose results fall within the same category, i.e. low, moderate or comprehensive.

All individuals who meet the target population criteria (live in his/her own or family home and can be supported with no more than $50,000 of waiver services) will be enrolled in the IFS waiver based on available openings. Individuals are considered for either the IFS waiver or the Comprehensive waiver based on the specific eligibility requirements found in each waiver.

Does this state offer community group homes? Connecticut offers Community Living Arrangements (formerly known as a group homes).

Does this state offer supported living? Yes, Connecticut does offer supported living services.

Are there still state owned institutions? How many people are living in institutions? There are over 6,000 people living in state run facilities. Connecticut has more people with developmental disabilities living in state-run residential facilities than any other state except New York. The cost is up to 2.5 times the expense of contracting with private group homes for the services.

How Do You Select A Provider?

Do providers work for the state? An individual budget is determined and enrollees may choose to hire staff independently, through a vendor agency, or a combination of both.

What is built into provider rates? Training days are built into the rates through non-direct staff hours. Mileage is built into direct care rates. A utilization factor of 90% is being built into the group day rates. No indirect time is billable as it is built into the rates for direct service .Operational costs are included in the rates.

About how many providers are there in the state? There are about 230 vendor providers.

Do you have a choice in providers? People choose to hire providers. An individual may choose to hire staff independently, through a vendor agency, or a combination of both.

Agency With Choice is an option now being offered by CT DDS. This model allows consumers to have an increased level of self-determination when they assume shared responsibility with an Agency With Choice for the hiring and management of the employees who provide waiver services to them. The Agency With Choice model designates the consumer or their family member as the managing employer while the Agency With Choice becomes the common law employer of record.

How Do You Become A Provider?

Is There A Fee? No, there is not a fee to become a provider.

Applicants interested in developing a Community Living Arrangement (formerly known as a group home) must apply to provide this service through a Request for Proposal (RFP) process. There are extensive requirements for the building and it is advisable to not purchase a property unless an agency has been awarded a CLA through the RFP process.

Additional Information

The Department of Developmental Services enrolls qualified providers for the following services: Adult Companion, Adult Day Health, Clinical Behavioral Consultant, Group Day, Healthcare Coordination, Individualized Day Supports, Individualized Home Supports, Interpreter Service, Nutrition, Personnel Support, Residential Habilitation-including Community Training Homes, Community Living Arrangements (CLA) and Continuous Residential Supports, Respite Care, Supported Employment, and Transportation. Applicants interested in developing a Community Living Arrangement (formerly known as a group home) must apply to provide this service through a Request for Proposal (RFP) process.

IFS waiver is also designated as an Independence Plus Waiver by CMS because it provides the authority for individuals to self-direct a number of services and supports to the extent desired.