1-774-855-6001 hello@massfamilies.org

RESOURCES

Home and Community Based Services

Home and Community Based Services (HCBS) Waivers are MassHealth programs for individuals who would otherwise require care in a facility. These programs are designed to meet the needs of those who prefer to get long-term care services and supports in their home or community, rather than in an institutional setting.

You can find the information below, as well as more detailed eligibility guidelines on the
Department of Developmental Services website
.

Overview

Home and Community Based Services (HCBS) Waivers are alternative, state-specific Long Term Services and Supports (LTSS) programs that provide services to eligible individuals in their own homes and communities. These waivers serve populations with complex needs and allow the Center for Medicare and Medicaid Services (CMS) to waive certain requirements that would otherwise apply to the Medicaid program. This gives the state the flexibility to define:

  • The target group of Medicaid members to be served, subject to certain requirements.
  • The maximum number of participants who may be served in each HCBS waiver program.
  • The services available to the waiver target group (in addition to what is already available through MassHealth).
  • The income and asset rules that usually apply to eligibility for community Medicaid.

Participants in an HCBS Waiver receive both traditional Medicaid services and the additional services available through the HCBS Waiver in which they are enrolled. Participants work with an operating agency to develop a service Plan of Care (POC) that reflects the waiver and non-waiver services and supports they need to be safely served in their homes and communities. There is a maximum number of participants who can be served by each waiver each year and, in order to be approved for a waiver, states must demonstrate the cost neutrality of each program.

MassHealth, along with the Executive Office of Elder Affairs (EOEA), Department of Developmental Services (DDS), and Massachusetts Rehabilitation Commission (MRC), work in conjunction to operate the HCBS Waivers.

 

Eligibility Criteria

Applicants must be found clinically and financially eligible. Below are the required criteria for all waiver applicants.

  • Have an intellectual disability as defined by the Department of Developmental Services (DDS);
  • Meet the level of care needed for an Intermediate Care Facility for Intellectual Disability (ICF-ID);
  • Be 22 years of age or older;
  • Need a waiver service monthly;
  • Be safe to serve in the community within the terms of the waiver in which the participant is enrolled; and,
  • Meet the financial requirements to qualify for MassHealth Standard in the community. Special financial rules exist for waiver applicants and participants.

 

List of Waivers

Massachusetts operates 10 HCBS waivers:

  • Frail Elder Waiver (FEW): This waiver provides frail elders, aged 60 and older, access to the service and supports they need to live successfully in the community.
  • Department of Developmental Services Adult ID Waivers: These waivers provide services and supports to adults with intellectual disabilities so that they can live in their communities. The three Adult ID Waivers are
      • Adult Supports (DDS-AS)
      • Community Living (DDS-CL)
      • Intensive Supports (DDS-IS)
  • Children’s Autism Spectrum Disorder Waiver: This waiver provides in-home services and supports to children birth through age 9 with an Autism Spectrum Disorder.
  • ABI–Residential Habilitation (ABI-RH) – for individuals who need supervision and staffing 24 hours a day, seven days a week in a provider-operated residence.
  • ABI–Non-residential Habilitation (ABI-N) – for individuals who can move to their own home or apartment or to the home of someone else and receive services in the community.
  • MFP Residential Supports (MFP-RS) – for individuals who need supervision and staffing 24 hours a day, seven days a week in a provider-operated residence.
  • MFP Community Living (MFP-CL) – for individuals who can move to their own home or apartment or to the home of someone else and receive services in the community.
  • Traumatic Brain Injury Waiver (TBI): This waiver helps individuals who have traumatic brain injuries who want to live in their communities

 

Visit the DDS website to find out more about services offered to participants in the HCBS waivers for adults with intellectual disabilities, service delivery options, application process information as well as who to contact.

Sign up for our newsletter to get the latest news, resources, and events from MassFamilies.