Guiding You Through Every Step
Waiver Information
Assistance with the Waiver Application
What is a Medicaid waiver?
A Medicaid waiver is a program that allows Louisiana to provide services to individuals with developmental disabilities while receiving federal funding. Waivers allow our state more flexibility in how care is delivered, focusing on Home and Community-based Services (HCBS) rather than funding care inside an institution. What is the difference between Medicaid and a Medicaid waiver? Traditional Medicaid covers broad medical needs, including mandatory services like inpatient and outpatient hospital care, physician services, and prescription drugs. In contrast, waivers focus on specific long-term care services provided in a home or community setting, such as personal care, case management, respite care, and home modifications, which may not be covered under standard Medicaid.
Where to start . . .
Capital Area Human Services
https://cahsd.org/developmental-disabilities/
CAHS is the single point of entry for people with developmental disabilities in our area who are seeking government-funded comprehensive services at home or in the community. CAHS serves the seven parishes of Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe Coupee, West Baton Rouge and West Feliciana. You will be assigned a representative who will provide information and work with you on an individualized Comprehensive Plan of Care (CPOC), which requires
Office for Citizens with Developmental Disabilities (OCDD)
https://ldh.la.gov/disabilities
OCDD is a division of Louisiana Department of Health and is the agency that facilitates and oversees the waiver Medicaid waiver system. Whether you need services now or anticipate future needs, sign up early for a “protected date” on the Request for Services Registry (RFSR). Next your loved one will complete a Screening for Urgency of Need (SUN).
Your SUN score means:
4 – Emergent – support needed in the next 90 days
3 – Urgent – support needed in the next 3-12 months
2 – Critical - support needed in the next 1-2 years
1 – Planning - supported needed in the next 3-5 years
0 – Currently there are no unmet needs
Waiver offers are made first to persons with a SUN score of 4 starting with earliest registry date, followed by SUN score of 3 starting with earliest registry date, and so on. As your needs change you can be rescreened.
Frequently Asked Questions
https://ldh.la.gov/assets/docs/OCDD/SystemTransformation/RFSRandTieredWaiverSystemFAQsforwebpage.pdf
4 waiver tiers under HCBS:
New Opportunities Waiver (NOW)
Residential Options Waiver (ROW
Supports Waiver (SW)
Children’s Choice Waiver (CC)
Your individualized Comprehensive Plan of Care (CPOC), will be the basis for your waiver services. The CPOC is a tool used to identify your expectations and desired outcomes, and guide your service activities. It will communicate your priorities to all support personnel and provide a point of reference for reviewing progress and change. Typical and Alternate Weekly Schedules Quarterly or Annual Units Review Budget Sheet
Choose your providers
Once approved for a waiver, you will be provided the Freedom of Choice (FOC) list of Medicaid providers licensed and approved for Region 2. From this list you will choose a Support Coordinating Agency to assure that your Plan of Care is up to date and being followed, and a Provider Agency for each service approved. These are critical decisions as they are the individuals who will work hands-on, day in and day out, with you and your waiver participant. You should meet and interview them with careful consideration as they will deliver the services that you have worked so patiently and diligently to obtain.
https://ldh.la.gov/directory/foc?rID=109&sIDs=
Port City Disabilities Services accepts Louisiana Medicaid funding through the NOW, ROW, Supports and Children’s Choice Waivers. Private pay options are also available.
