NAPAS is
pleased to offer Medicaid Waivers, Tools For Deinstitutionalization:
Innovative Models And Legal Strategies. This paper is intended to: (1)
Demonstrate the flexibility of waivers to promote deinstitutionalization; (2)
identify the limitations of waivers; (3) describe a few waivers that provide
community-based services to disability populations for which waivers are not as
frequently utilized; and (4) discuss some of the legal issues surrounding
waivers. With this knowledge, advocates will be able to better press both
formally and informally for the development of appropriate community-based
systems of support.
Table of Contents
1.
BASIC WAIVERS
A. Services Available Under a
Home and Community-Based Service Waiver
B. Waivers as Alternatives to
Services in a Hospital, Nursing Facility or ICF/MR
C. Waivers of Statewideness,
Comparability of Services, and Income and Resource Rules
D. Cost Neutrality and
Numbers Caps
2.
UTILIZATION CONTROL
RESTRICTIONS
3.
DUPLICATION OF STATE
PLAN SERVICES
4.
FLEXIBILITY OF WAIVERS
A. HCFA Efforts to Promote
the Creation of More Community-Based Service
B. Unique Waiver Services
Developed by States for Particular Populations
5.
WRAPAROUND
SERVICES FOR CHILDREN
6.
LEGAL ISSUES SUBJECT
TO LITIGATION
A. Cases Applying Medicaid
Mandates to HCBS Waivers
B. Changes in Waivers in
Response to Litigation
Appendix I: State Limits Imposed Under the Medicaid Home Health
Benefit
Appendix II: State Limits Imposed Under the Medicaid PCS Benefit
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