1. THE CHILDRENS MENTAL HEALTH WAIVER An introduction to the concept of a Medicaid waiver program An introduction to the specifics and parameters of the Childrens Mental Health Waiver Lin Christensen IME Program Manager

2. What is a Medicaid Waiver? A person eligible for a Medicaid waiverwaives 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.

3. When Did Waiver Services Begin? 1981 The Katie Beckett Waiver

4. History of Medicaid Waivers in Iowa Began implementation in 1984 Iowas 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

5. The Basic Concepts of a Medicaid Waiver Funded through Tittle XIX Offers a menu of services from which an individualized support 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

6. Medicaid Waivers Are: Based on a philosophy of – Individual choice – Individual rights and dignity Based on the concept of interdependence Alternatives to institutionalization To allow individuals to live and receive needed services in their homes and communities Designed to meet the specific needs of each individual For all ages

7. Medicaid Waivers Will Not Replace parental responsibility Replace natural supports Teach basic academics Provide a Cadillac service Provide emergency placement services

8. Iowas Medicaid Waivers Home & Community Based Services Ill and Handicapped Elderly Aids/HIV Mental Retardation Brain Injury Physical Disability

9. Differences Among The Waivers Eligibility requirements Availability statewide Target populations Level of care requirements Caps on dollar amounts available Menu of services available – Waiver Comparison Chart

10. The Childrens Mental Health Waiver General Parameters Individual Eligibility Criteria Service Descriptions – Environmental Modifications, Adaptive Devices & Therapeutic Resources – Family and Community Support Services – In Home Family Therapy – Respite Application Process

11. The Iowa Plan A child who is approved for CMH Waiver services will also be enrolled in the Iowa Plan for covered, required and optional mental health services.

12. 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

13. The Childs and Familys Role Active development of the service plan Learn and understand rights and responsibilities Active participation in the service plan Right to refuse and/or change services or service provision

14. The Targeted Case Managers Role Help the child and his/her family meet their needs in an effort to promote self-determination, independence and individualism Act as an advocate Facilitate the childs access to the service system & coordinate services Maintain ongoing communication with all IDT members Help providers Monitor service provision

15. The Service Providers Role Develop and carry out service provision based on the service plan developed by the child and his/her family and the IDT Communicate with the targeted case manager and other team members regarding changes in in service provision or any concerns regarding the child.

16. The Crisis Intervention 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 targeted case manager must be contacted

17. The Childrens Mental Health Waiver The beginning of great results