1. THE CHILDREN’S MENTAL HEALTH WAIVER
ATTACHMENT A
THE CHILDREN’S MENTAL HEALTH WAIVER
An introduction to the concept of a Medicaid waiver program
The services and parameters of the Children’s Mental Health (CMH) Waiver
Lin Christensen
IME Program Manager
rev. 1-06

2. What is a Medicaid Waiver?
ATTACHMENT A
What is a Medicaid Waiver?
A person eligible for a Medicaid waiver “waives” his(her) entitlement to receive services in an institution.
Approximately 2/3 of the cost of waiver services is covered by the Federal govt. and 1/3 of the cost of waiver services is covered by the county or the state.
Special Medicaid programs provided to maintain person in their own homes or communities who would otherwise require care in a medical institution.
Intent was to redirect Medicaid dollars into community-based settings. AND enabling the consumer to return to or remain in their communities and/or home
Vs. Costs in an RCF-MR – all county dollars.
rev. 1-06

3. History of Medicaid Waivers in Iowa
ATTACHMENT A
History of Medicaid Waivers in Iowa
Began implementation in 1984
Iowa’s Medicaid waiver program is referred to as Home & Community Based Services (HCBS).
Over 15,000 persons currently receive waiver services
Nearly 7,000 waiver service providers
I/H 1984; Elderly 1990; A/H 1991; MR 1992; BI 1996; PD 1999
Nationally, it is the first time more people are receiving HCBS services than are receiving ICF/MR services
Iowa services continue to shift to the HCBS Model
rev. 1-06

4. Iowa’s Medicaid Waivers Home & Community Based Services
Ill and Handicapped
Elderly
Aids/HIV
Mental Retardation
Brain Injury
Physical Disability
Children’s Mental Health Waiver
rev. 1-06

5. The Basic Concepts of a Medicaid Waiver
Funded through Title XIX
Offers a menu of services from which an individualized service plan is developed to meet the support needs of each individual
Each individual is supported by an interdisciplinary team in which the individual is the focus and the main source of information
rev. 1-06

6. Supporting The CMH Waiver Eligible Child
State Plan Services
Iowa Plan Services
CMH Waiver Services
rev. 1-06

7. Teamwork Teamwork is an integral part of providing quality services.
Each child approved for the CMH Waiver and his/her family is part of an interdisciplinary team (IDT).
Each child, as a requirement for the CMH Waiver,must receive service oversight and service coordination from a Medicaid targeted case manager.
Other IDT members:
Service providers
Teachers &/or education personnel
Iowa Plan
Other persons that the child and family would like to participate
rev. 1-06

8. The Crisis Intervention Plan (Mental Health Wellness Plan)
This plan will be developed during IDT planning.
The targeted case manager will write the plan.
All members of the IDT will use the same crisis intervention plan.
If changes occur or become necessary, the TCM must be contacted.
The TCM will redistribute the dated and revised plan to IDT members.
rev. 1-06

9. The Crisis Intervention Plan (Mental Health Wellness Plan)
The focus should be on wellness not crisis.
This plan should include the following for the child:
Things to do everyday to maintain wellness or feeling right
Things that need to be done (or would be good to be done)
Triggers
What to do if triggers happen
Early warning signs
Symptoms of breaking down
What to do if symptoms occur
Supporters-family and friends
Medical Information
Professionals involved in care
Medications
Treatment centers and/or facilities
The targeted case manager will write the plan.
All members of the IDT will use the same crisis intervention plan.
If changes occur or become necessary, the TCM must be contacted.
The TCM will redistribute the dated and revised plan to IDT members.
rev. 1-06

10. The Crisis Intervention Plan (Mental Health Wellness Plan)
This plan should also include these components:
Supporters
Family, friends, neighbors
Medical Information
Professionals involved in care
Medications
Treatment that must be provided or must be avoided
Treatment centers and/or facilities
rev. 1-06

11. If you want to play the game . . . .
You have to follow the rules!
rev. 1-06

12. Iowa Administrative Code Rules for the CMH Waiver
Chapter 77
Service Provider Standards
Chapter 78
Service Descriptions
Chapter 79
Service Reimbursement Rates
Chapter 83
Recipient Eligibility and Appeal Rights
rev. 1-06

13. Where Can I Find the Iowa Administrative Code Rules Online?
Click on A-Z services.
Click on Administrative Rules.
Click on Policy Analysis.
Click on Medical Assistance book icon.
Click on desired IAC chapter.
rev. 1-06

14. I’m overwhelmed!!! I need help!
Do not fear! Your friendly HCBS-CMH Waiver specialist is near.
Geri Derner
Mary Jacobs (Jake)
Lori LaCarte
Cheri Reisner
Susan Slauson
Annie Volker
rev. 1-06

15. Two Ways To Contact Your HCBS-CMH SpecialistBy
On the CMH Waiver website Waiver.html
click on the link in the Questions box. An message is automatically created to the specialist assigned to each county.
By telephone:
Refer to the telephone listing by county. It is also posted on the website.
rev. 1-06