Pursuant to its obligations under the Hutchinson v. Patrick Settlement Agreement, the Commonwealth must expand its community-based service system for persons with brain injuries, creating opportunities for transition from nursing and rehabilitation facilities to integrated community living. Two new Medicaid home and community-based waivers have been approved by the federal government, one which includes residential services. These waivers will afford applicants access to a range of services including case management, residential habilitation, individual support and community habilitation, one-time transitional services, homemaker services, personal care, respite, supported employment, specialized medical equipment, adult companions, home accessibility adaptations, transportation and therapies.
Person Centered Planning Process
The ABI waivers include a new individual treatment planning process for waiver participants that is based on the principles of person-centered care. Waiver services will be provided pursuant to an Individual Service Plan (ISP). The waiver participant’s preferences, strengths and goals are at the heart of this planning process. A Team is formed which may include individuals from the person’s community, providers, friends, family members and other professionals of the person’s choosing. Together the Team considers the individual’s transitional needs and identifies community-based resources, including waiver and Medicaid State Plan services. Team meetings and coordination from the assigned care manager help to ensure there is effective communication and that the individual is meaningfully involved in, and actively directing, every aspect of their care.
Eligibility and Appeals
Applicants who are denied entrance to the waiver will receive a written decision and information regarding their right to appeal. Individuals who are concerned about the accuracy of this denial, and who need assistance in navigating the appeal process, should contact the Center for Public Representation at (617) 965-0776. For additional information on the status of pending waiver applications, contact the ABI Waiver Unit at (866) 281-5602
Read more about the ABI waiver program and application process.