Office for People With Developmental Disabilities

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Comprehensive Home and Community-Based Services (1915-c HCBS) Waiver

11/03/15

Welcome to the Comprehensive Home and Community-Based Services (HCBS) Waiver page.  The HCBS Waiver operated by the OPWDD is a program of supports and services that enables adults and children with intellectual and developmental disabilities to live in the community as an alternative to Intermediate Care Facilities (ICFs). Over 70,000 individuals currently receive services through the waiver.

Proposed Waiver Agreement

    • Proposed “Amendment 01”  Proposed Effective Date January 1, 2017
    • The submitted Amendment includes:
      • A transition plan for Conflict-Free Case Management (CFCM) which will ensure that service planning is separate from service provision to allow for true person-centered planning based on the person’s wants and needs.
      • Technical changes to both Community Transition Services and Environmental Modifications and Assistive Technology Waiver services to make it consistent with the New York State Plan Community First Choice Option (CFCO).
      • A change of Residential rates to offer increased staffing for people with high needs.
      • A request for a phase-in to a new Respite fee methodology.
  • WebEx Sessions - August 2, 2016
    Held to provide an overview of the draft 1915 (c) Comprehensive HCBS Waiver agreement, “Amendment 01”.

Current Waiver Agreement

2014 Waiver Renewal (Effective 10/1/14)
Approved by the Centers for Medicare and Medicaid Services (CMS) - March 2016

Previous Waiver Agreement

07 Amendment

Approved by CMS in September 2015 

What are the services and who provides them?

The waiver program supports individuals in the community by providing a variety of services and supports that are uniquely tailored and individualized to meet each person's needs. Services can include habilitation services, respite care, supported employment, and adaptive technologies. Services are provided either by OPWDD's Developmental Disabilities State Operated Office (DDSOO) staff or through voluntary not-for-profit agencies that are authorized to provide HCBS waiver services by OPWDD and the NYS Department of Health.

Who is eligible?

To be eligible for opportunities in the OPWDD HCBS Waiver, an individual must:

  • have a diagnosis of a developmental disability,
  • be eligible for the ICF/MR level of care,
  • be Medicaid eligible,
  • have chosen HCBS waiver services over institutional care, and
  • live in an OPWDD eligible setting (the person’s own or family home, an Individual Residential Alternative (IRA), Community Residence or Family Care home)
  • A person who is eligible and lives in NYS can request to be enrolled in the HCBS waiver by contacting the DDRO or a provider agency that serves the county in which the person lives.

For an overview of specific services offered through the waiver, see the Front Door page (http://www.opwdd.ny.gov/welcome-front-door/resource-booklet).  For the specific billing requirements for each service, the Administrative Memoranda for services can be found here: http://www.opwdd.ny.gov/opwdd_regulations_guidance/adm_memoranda.

The currently effective version of the OPWDD Comprehensive Waiver can be found on the CMS website at the following location:

http://www.medicaid.gov/medicaid-chip-program-information/by-topics/waivers/waivers_faceted.html

CMS Regulation Changes

In 2014, CMS issued regulations that define the settings in which it is permissible for states to pay for Medicaid Home and Community-Based Services (HCBS). The People First Waiver application will contain the HCBS Settings Transition Plan.  For more detailed information on this topic please go the HCBS Waiver Setting page available at: http://www.opwdd.ny.gov/opwdd_services_supports/HCBS/home.

OPWDD also operates “Care at Home” (CAH) waivers for medically frail children with developmental disabilities.  Information regarding the CAH program can be found here (link: http://www.opwdd.ny.gov/opwdd_services_supports/supports_for_independent_and_family_living/Care_at_Home.