Summary of Services, Programs, and Initiatives Provided to Virginians with Disabilities

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

1. Name of Service/Program/Initiative: AIDS Waiver
2. Service Description and Eligibility Requirements, If Any: Home and Community Based (1915 (c)) waiver whose purpose is to provide care in the community rather than in nursing facilities or hospitals.
3. Service Preauthorization Required: Yes - Service must be preauthorized through a preadmission screening team.
4. Target Population/s: Individuals of any age who have a diagnosis of AIDS or AIDS Related Condition (ARC) and have documentation that they are experiencing medical and functional symptoms associated with AIDS or ARC which would require nursing facility or hospital care. Must be eligible for Medicaid and meet screening criteria; income limit is 300% of the SSI payment limit for one person ($1,635/month). No patient pay.
5. Method of Administration: State -- DMAS.
6. General Availability of the Service Across the Commonwealth (e.g., statewide, only available in certain localities): Available statewide. Services are provided by case management providers or personal care and nursing agencies that have a provider agreement with DMAS.
7. Number of Persons Served Annually (Provide and indicate most recent year
   available): 417 people were served in FY 2001.
8. Annual Service Cost/Allocation (Provide and indicate the most recent year available): Waiver costs were $1,355,960 in FY '01. Other costs for people on the Waiver were $6,613,803 ($4.8 million was for pharmacy).
9. Other Information or Comments About the Service: Available services: Case
   management; Nutritional supplements; Private duty nursing; Personal care; Respite care
   
   FOR ADDITIONAL INFORMATION, CONTACT:
   Diana Thorpe
   804-692-0481
   dthorpe@dmas.state.va.us

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

1. Name of Service/Program/Initiative: Elderly and (or) Disabled Waiver.
2. Service Description and Eligibility Requirements, If Any: Home and Community Based (1915 (c)) waiver whose purpose is to provide care in the community rather than in nursing facilities. Must be eligible for Medicaid and meet screening criteria; income limit is 300% of the SSI payment limit for one person ($1,635/month). Could have patient pay if income is in excess of SSI income limit for one ($545).
3. Service Preauthorization Required: Yes - Service must be preauthorized through a preadmission screening team.
4. Target Population/s: Individuals 65 or older or who are disabled and who meet screening criteria and are at imminent risk of nursing facility placement. (42 CFR 441.302(c)(1).
5. Method of Administration: State - DMAS.
6. General Availability of the Service Across the Commonwealth (e.g., statewide, only available in certain localities): Available statewide. Services are provided by personal care and nursing agencies that have a provider agreement with DMAS.
7. Number of Persons Served Annually (Provide and indicate most recent year available): 9,567 people were served in FY 2001.
8. Annual Service Cost/Allocation (Provide and indicate the most recent year available): Waiver expenditures for FY 2001 were $87,997,814. Other costs for Waiver recipients were $52,683,300
9. Other Information or Comments About the Service: Available services: Adult day health care; Respite care; Personal care; Personal Emergency Response System
   
   FOR ADDITIONAL INFORMATION, CONTACT:
   Diana Thorpe
   804-692-0481
   dthorpe@dmas.state.va.us

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

1. Name of Service/Program/Initiative: Consumer-Directed Personal Attendant Services Waiver.
2. Service Description and Eligibility Requirements, If Any: Home and Community Based (1915 (c)) waiver whose purpose is to provide care in the community rather than in nursing facilities. Must be eligible for Medicaid and meet screening criteria; income limit is 300% of the SSI payment limit for one person ($1,635/month. Could have a patient pay if income is in excess of SSI income limit for one ($545). Due to expenses of employment, can keep additional amount of earned income if working more than 8 hours/ week.
3. Service Preauthorization Required: Yes - Service must be preauthorized through a preadmission screening team.
4. Target Population/s: Individuals 65 or older or who are disabled and 18 years or older, who meet screening criteria and are at imminent risk of nursing facility placement, AND who have no cognitive impairments. The individual must be able to hire, train and fire, if necessary, his or her own attendant.
5. Method of Administration: State -- DMAS.
6. General Availability of the Service Across the Commonwealth (e.g., statewide, only available in certain localities): Available statewide. Personal attendants are hired by the recipient. Service coordination is provided by registered nurses, social workers or case managers who have a provider agreement with DMAS. Service coordinators assess, develop and monitor the care plan.
7. Number of Persons Served Annually (Provide and indicate most recent year
   available): 151 people were served in FY 2001
8. Annual Service Cost/Allocation (Provide and indicate the most recent year available): The cost of waiver services was $609,765 in FY '01; the cost of acute care services was an additional $1,222,905.
9. Other Information or Comments About the Service: Available services: Personal care.
   
   FOR ADDITIONAL INFORMATION, CONTACT:
   Diana Thorpe
   804-692-0481
   dthorpe@dmas.state.va.us

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

1. Name of Service/Program/Initiative: Technology Assisted Waiver
2. Service Description and Eligibility Requirements, If Any: Home and Community Based (1915 (c)) waiver whose purpose is to provide care in the community rather than in a nursing facility or hospital. Must be eligible for Medicaid and meet screening criteria; income limit is 300% of the SSI payment limit for one person ($1,635/month).
3. Service Preauthorization Required: Yes - DMAS Health Care Coordinator (RN)
4. Target Population/s: Individuals who need both a medical device to compensate for the loss of a vital body function and substantial and ongoing skilled nursing care.
5. Method of Administration: State -- DMAS.
6. General Availability of the Service Across the Commonwealth (e.g., statewide, only available in certain localities): Available statewide. Case management is provided by DMAS staff. Nursing services are provided by nursing agencies that have a provider agreement with DMAS.
7. Number of Persons Served Annually (Provide and indicate most recent year
   available): 280 people were served in FY 2001.
8. Annual Service Cost/Allocation (Provide and indicate the most recent year available): The cost of waiver services was $17,363,236 in FY '01; the cost of acute care services was an additional $7,489,017.
9. Other Information or Comments About the Service: Available services: Private duty nursing (differences in amount of hours for under and over 21 years of age); Respite care; Durable medical equipment; Personal care; Environmental modifications.
   
   FOR ADDITIONAL INFORMATION, CONTACT:
   Diana Thorpe
   804--692-0481
   dthorpe@dmas.state.va.us

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

1. Name of Service/Program/Initiative: Mental Retardation Waiver
2. Service Description and Eligibility Requirements, If Any: Home and Community Based (1915 (c)) waiver whose purpose is to provide care in the community rather than in an Intermediate Care Facility for the Mentally Retarded. Must be eligible for Medicaid and meet screening criteria; income limit is 300% of the SSI payment limit for one person ($1,635/month). Must have deficits in two or more of seven areas of life functioning. Could have a patient pay if income is in excess of SSI income limit for one ($545). Due to expenses of employment, can keep additional amount of earned income if working more than 8 hours/ week.
3. Service Preauthorization Required: Yes-- by Department of Mental Health, Mental Retardation and Substance Abuse Services
4. Target Population/s: Individuals with mental retardation and individuals under the age of 6 at developmental risk who have been determined to require the level of care provided in an Intermediate Care Facility for the Mentally Retarded (ICF/MR).
5. Method of Administration: State Administration - DMAS. Department of Mental Health, Mental Retardation, and Substance Abuse Services is the operational authority. Local: CSBs and BHAs manage the slots and their local waiting lists and process applications for Waiver services. Local Departments of Social Services make local eligibility determinations.
6. General Availability of the Service Across the Commonwealth (e.g., statewide, only available in certain localities): Available statewide. Services are provided by providers who have an agreement with DMAS
7. Number of Persons Served Annually (Provide and indicate most recent year
   available): 5,056 people were served during FY 2001. There is a waiting list for services.
8. Annual Service Cost/Allocation (Provide and indicate the most recent year available): Waiver costs were $170,062,664 in FY '01. Other costs were $41,854,849.
9. Other Information or Comments About the Service: Available services: Day support; Supported employment; Residential supports (Congregate and In-Home); Therapeutic consultation; Personal assistance services; Respite care; Skilled nursing services; Crisis Stabilization; Environmental Modifications; Assistive Technology; Adult Companion; Consumer-directed personal care, companion, and respite.
   
   FOR ADDITIONAL INFORMATION, CONTACT:
   Diana Thorpe
   804-692-0481
   dthorpe@dmas.state.va.us

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

1. Name of Service/Program/Initiative: Individual and Family Developmental Disabilities (DD) Support Waiver
2. Service Description and Eligibility Requirements, If Any: Home and Community Based (1915 (c)) waiver whose purpose is to provide care in the community rather than in an Intermediate Care Facility for the Mentally Retarded (ICFMR). Must be eligible for Medicaid and meet screening criteria; income limit is 300% of the SSI payment limit for one person ($1,635/month). Could have a patient pay if income is in excess of SSI income limit for one ($545). Due to expenses of employment, can keep additional amount of earned income if working more than 8 hours/ week.
3. Service Preauthorization Required: Yes: The Virginia Department of Health's Child Development Clinics
4. Target Population/s: Individuals 6 years of age and older with a condition related to mental retardation, who do not have a diagnosis of mental retardation, and who have been determined to require the level of care provided in an ICF/MR.
5. Method of Administration: State -- DMAS.
6. General Availability of the Service Across the Commonwealth (e.g., statewide, only available in certain localities): Available statewide. Services are provided by providers who have an agreement with DMAS
7. Number of Persons Served Annually (Provide and indicate most recent year
   available): 323 individuals will be served FY 2002. 235 people are enrolled in the waiver as of June, 2002. There is a waiting list for services. 1,269 people have applied for the waiver. There is a 45% denial/withdrawal rate for the first 700 applications.
8. Annual Service Cost/Allocation (Provide and indicate the most recent year available): $10.8 million for FY 2002.
9. Other Information or Comments About the Service: Available services: Day support;
   Adult Companion Care; Supported employment; In-home residential support; Therapeutic consultation; Personal care services Respite care (agency and consumer-directed); Skilled nursing services; Attendant care; Family and caregiver training; Crisis stabilization; Environmental modifications; Assistive technology; Personal emergency response systems.
   
   FOR ADDITIONAL INFORMATION, CONTACT:
   Diana Thorpe
   804-692-0481
   dthorpe@dmas.state.va.us

   

Tim Kaine	Marilyn B. Tavenner	Patrick O. Gottschalk	Pierce R. Homer	Dr. Thomas R. Morris
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