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Be a PCA! - Personal Care Assistant Awareness Website Click Here
Moms in Motion - a Medicaid Waiver Service Provider / Facilitator in Virginia Click Here
Waivers allow the elderly and people with disabilities to live at home. It is an alternative to home care agencies. You hire your own aide and the state/Medicaid pays them.
Updated on: 1.27.12
Medicaid Waivers were developed to encourage people with disabilities and the elderly to access services in their homes and communities. Medicaid is a joint federal-state program. Medicaid Waivers provide funding to serve people who are eligible for long-term care in institutions such as hospitals, nursing facilities, and intermediate-care facilities. Through Medicaid Waivers, states can "waive" certain requirements including the requirement that individuals live in institutions in order to receive Medicaid funding.
Consumer-directed services are controlled by the person with a disability or by someone acting on his or her behalf. The consumer recruits, hires, supervises, and fires (if need be) his or her own staff. The consumer is the employer of his or her staff and signs off on the timesheets for payment, which are then submitted to Public Partnerships LLC, the fiscal agent for payment. Timesheets can be done online. A person using consumer-directed services will have a facilitator, paid by DMAS, for assistance in learning about consumer-directed services and for ongoing support. Waivers are administered by DMAS (Virginia Department of Medical Assistance Services)
Types of Waivers:
• Mental Retardation/Intellectual Disabilities (MR/ID) Waiver
• Day Support Waiver
• Individual and Family Developmental Disabilities Support (IFDDS or DD) Waiver
• Elderly or Disabled with Consumer Direction (EDCD) Waiver
• Technology-Assisted (Tech) Waiver
In addition, there are two other home-and-community-based waivers, the HIV/AIDS Waiver and the Alzheimer’s Assisted Living Waiver.
A person may be able to receive services under one waiver while being on the waiting list for another waiver. This allows the individual and his or her family to access some services under an alternate waiver while waiting for additional services to become available through the other waiver. If a person eventually receives a slot for the preferred waiver, funding from the alternate waiver is discontinued, and services will be funded through the preferred waiver. If there's no waiver slots open to keep a person living in their home through a family support program.
You have to find a facilitator / provider of the waiver to screen you for the waiver. Centers for Independent Living often are waiver facilitators. CSB community service boards are also waiver facilitators. There are many independent waiver provider facilitators as well. When you are screened the facilitator determines how many hours you’ll need. There’re two types of hours, ADL for your necessary needs (bathing, dressing, eating) and IADL for non-necessary needs (laundry, going to grocery store, using phone, food preparation) The crazy thing is, they only access you on the first type of hours; the ADLs, which leaves no time for outside activities! (How can you eat your meals, if there’s no time to prepare them!)
Timesheets have a strict schedule that needs to be followed for the aides to be paid on time. They are mailed into DMAS(Department of Medical Services) in Richmond and the paychecks are sent to the PCA home. Or DMAS has direct deposit, so the aide may get paid faster if they choose that. DMAS now as a company to handle payroll, Public Partnerships LLC. Timesheets have a two-week cycle, and need to reach Richmond by Friday. All timesheets should be copied or saved on hard drive before they’re mailed to show the facilitator during home visits. (Not sure why DMAS won’t accept faxed copies, until the originals arrive. I’ve seen agencies do it. UPDATE 1/07: timesheets can now be faxed. UPDATE 8/09: timesheets can now be submitted online.)
More Links:
Supreme Court Olmstead Decision of 1999 affirmed the right of individuals with disabilities to live in their community.
Virginia DMAS Department of Medical Services
Virginia’s Community Service Board
Virginia’s Centers for Independent Living
Virginia’s list of Consumer Directed Facilitators (scroll down category)
Virginia’s Medicaid Waivers for Persons with Disabilities, Their Parents, and Caregivers Guide
Consumer Direction for People with Disabilities in Virginia: Waiver Services and Person Centered Supports – More information about the waiver.
Information off the DMAS site about PAS/Waiver Services - Rates, regulations, applications, facts regarding the waiver.
The Virginia Association of Personal Care Assistants - gives caregivers a voice to improve working conditions, reduce turnover, and build a stable workforce that ensures people with disabilities and seniors get the care they need to live at home as long as they choose.
Exercising Their Independence – Virginian Pilot Article - People in nursing homes strike out on their own using the ED/CD Waiver.
Beyond Planned New Facility… - Virginian Pilot Article – Talks about the $458 million proposal to improve services such as the waiver.
(ADAPT) American Disabled for Attendant Programs Today Website - Focuses on promoting services in the community instead of warehousing people with disabilities in institutions and nursing homes.