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Introduction to “The Waiver”

Purpose

What is “The Waiver” and How does it work in Hawai`i?

“Medicaid is a program designed to help states meet the costs of necessary health care for low-income and medically needy populations.  Under section 1915c of the Social Security Act, states may request waivers of certain federal requirements in order to develop home and community-based services funded by Medicaid.  The State, through Medicaid, may request funding for home and community–based services to prevent the institutionalization of individuals with disabilities.  The State’s request is subject to approval by the Centers on Medicaid and Medicare Services (CMS).

Individuals within the Hawai`i Department of Health (DOH) Developmental Disabilities Division (DDD) system that are eligible for Medicaid can apply for these Medicaid funded services.  Needs and supports are identified through a person-centered planning process with case managers who coordinate, and assist individuals in accessing these services from qualified and approved providers.”1

In Hawai`i, the State has created the Home and Community Based Services for Persons with Developmental Disabilities/Mental Retardation Medicaid Waiver Program.  Because CMS “waives” certain federal requirements, the program is commonly referred to as “The Waiver”.

The State Department of Human Services (DHS) is the official Medicaid state agency.  DHS works with CMS to manage the Medicaid money.  DHS also determines who is eligible for Medicaid and “The Waiver”.

The DOH DDD is responsible for managing “The Waiver”.  The DOH DDD Case Management and Information Services Branch (CMISB) assigns case managers to assist individuals and families who wish to access “The Waiver”.

1 This information was taken from the Department of Health, Developmental Disabilities Division, Case Management and Information Services Branch Information Packet for Individuals and Families (March 2001).

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