Medicaid Waiver Interest Lists: What Families Need to Know
When discussing Medicaid waivers with families, take time to explain how interest lists work and how parents can monitor their child’s status on the lists. Although the wait can be long to receive waiver services, it is important for families to stay in touch with waiver programs to ensure their child remains on the lists.
Offer families these reminders:
- It is not necessary to prove eligibility to be placed on an interest list. Eligibility determination occurs once a person moves to the top of the list.
- Ask for an email confirmation or a mailed letter when you add your child to the Medicaid waiver interest lists. Keep this in a safe place.
- Keep family address and phone numbers up to date with the waiver program. If your child moves to the top of an interest list but the program can’t reach you, your child will be dropped from the list.
- Families or individuals must respond to any letters or phone calls from interest list programs.
- Find out how close your child is to the top of an interest list by calling the waiver program.
- Children can remain on multiple waiver interest lists while receiving waiver services. However, they cannot be enrolled in more than one waiver program at a time.
- Families can contact support groups for assistance in understanding and researching Texas Medicaid waivers for children:
- Texas Parent to Parent, a parent peer support organization for families with children who have special health-care needs
- Navigate Life Texas, an HHSC website that provides support and information for families raising children with disabilities
Sources: Texas Parent to Parent & Navigate Life Texas.
You also can help a family whose child is nearing the top of an interest list by explaining what to expect:
- The child will receive a registered letter from the waiver program that will include a list of available services to choose from.
- The family will need to choose a case management provider, who will assist in creating a budget for waiver funds.
- Families can choose to be the employer of record for attendant care and respite providers. This choice is called consumer directed services (CDS) and provides more control over who will work with a child than if a family uses care providers employed by an agency. Note that this model requires more effort by a family.
Source: Texas Parent to Parent
Why it Matters
Medicaid waivers offer an excellent opportunity for a child with special-health care needs to live and receive services at home or in the community, rather than in a nursing home or other institution. However, the Medicaid waiver program is complex and families need help navigating the system.
As a primary care provider, you have a responsibility to be knowledgeable about Texas Medicaid waivers for children. You have the opportunity to guide parents and families by helping them with a basic understanding of the programs and emphasizing the importance of adding their child to the waiver interest lists as early as possible. You can put families in touch with organizations and resources to assist them in the journey to obtaining a Medicaid waiver that can fund their child’s health-care needs at home or in the community rather than in an institution.
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