Office for People With Developmental Disabilities

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Care at Home


care at home - happy childOPWDD currently operates three Care at Home (CAH) Medicaid Home and Community Based Waivers. The OPWDD CAH waivers (III, IV and VI) provide services to children with severe developmental disabilities and complex medical conditions living at home with their families. 

The Care At Home Waiver program allows Medicaid to pay for some services not provided through "regular" Medicaid, such as case management, respite, home adaptations and vehicle modification. These services can make home care an option for children and their families. Although this Medicaid funding applies only to the child, it can be used to help cover the costs of caring for the child at home.

Who is eligible for CAH III, IV or VI?  

To be eligible, a child must meet all of the following requirements:

  • Be under 18 years of age
  • Have a developmental disability as defined by New York State’s Mental Hygiene Law
  • Demonstrate complex health care needs that are expected to continue for at least 12 months
  • Be eligible for the level of care provided by an intermediate care facility (ICF) for persons with developmental disabilities
  • Not be in a hospital, skilled nursing facility, ICF/DD facility or other institution
  • Have an assessment indicating that the child is able to be cared for at home if the proper services are provided
  • Be ineligible for Medicaid because of parental income and resources
  • Be able to be cared for at less cost in the family home than in an ICF facility

What Services are available to a CAH child?

  • The CAH waivers provide coverage for all routine State Plan Medicaid services including Nursing
  • Case Management Services are provided to assist and enable the child and family to access the full range of available services and resources
  • Respite Services are available to provide the family time to meet its other obligations as well as attend to the needs of other children living in the family
  • Assistive Technologies/Home Adaptations are available to help a child live safely at home with independence and dignity

For more information on CAH, contact:

Lynda Baum-Jakubiak, Statewide CAH Coordinator
(518) 474-6471
or  Local Regional Office CAH Coordinator

CAH Waiver Agreement (effective 4/1/16) 

Approved by the Centers for Medicare and Medicaid Services (CMS) - 1/20/17

CAH Waiver Final 1-20-17

February 3, 2017: CAH Provider WebEx 


Questions and Answers   

February 16, 2017: CAH Families Session 


Questions and Answers

CAH Provider Guidance 

New Billing Guidance Effective for Dates of Service Beginning April 1, 2017

CAH Manual 



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