Overview
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.
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/IDD facilities
- Residential Habilitation delivered in Individualized Residential Alternatives (IRAs), Community Residences (CRs), and Family Care
- Day Habilitation
- Care Management and other service coordination services
- Day Treatment Services
- Community Habilitation
- Prevocational Services
- Supported Employment Services (SEMP)
- Respite Services
- Blended and Comprehensive Services, including any covered services provided under OPTS
Resources
The below materials are also available to providers in understanding their responsibilities under the Liability for Services regulations:
Notice for Pre-existing Services
Liability Notices Instructions
Liability notices instructions for forms LIAB 05 to 10.
Notice for Persons Applying for Services
Pre-existing Services Liability Notice
Limited Exception Notice for Persons Meeting Exception
Limited Exception Notice for Individuals Applying for Other Services
Limited Exception Notice for Persons Applying for Other Services
Information about the Limited Exception for Respite
Information About the Limited Exception
Information About the Limited Exception for Supported Employment for Individuals Eligible to be Grandfathered