Office for People With Developmental Disabilities

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Liability for Services - Overview

02/27/12

For those seeking OPWDD services, the individual and spouse, parents or legal guardian (if he/she is under the age of 21) and any fiduciary acting on his/her behalf are liable for the cost of care.  Parents are not liable if the disabled person does not live at home, even if he/she returns for periodic visits.  Most OPWDD services are funded through the Medicaid Program, including the Home and Community-Based Services (HCBS) Waiver; the cost of room and board in group homes is funded through other benefits, such as Supplemental Security Income.  OPWDD expects each individual seeking services to file for benefits that are available to fund the services they are seeking.  For example, if a person is seeking HCBS Waiver Services, the individual will be required to file for Medicaid and the HCBS Waiver.

Certain services offered by OPWDD-certified providers are covered by OPWDD’s Liability for Services regulations; these services are referred to as “covered services”.  Individuals who wish to receive covered services must apply for Medicaid and the HCBS Waiver in order for the services to be paid for.  Individuals may elect to pay for the cost of services with their own funds instead of enrolling in a benefit program.  An unofficial version of the Liability for Services regulations can be accessed through the Department of State website (see Title 14 Department of Mental Hygiene, Chapter XIV Office for People with Developmental Disabilities).

The Liability for Services regulations cover the following services:

  • Services provided in ICF/DD facilities
  • Residential Habilitation delivered in Individualized Residential Alternatives (IRAs), Community Residences (CRs), and Family Care
  • Day Habilitiation
  • Medicaid Service Coordination (MSC), and other service coordination services
  • Day Treatment Services
  • At Home Residential Habilitation (now called Community Habilitation)
  • Prevocational Services
  • Supported Employment Services (SEMP)
  • Respite Services
  • Blended and Comprehensive Services, including any covered services provided under OPTS 

The following are brochures containing information about paying for OPWDD services: