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The
Medicaid HCB Waiver: The Alternative to Institutionalization
with Adelle Jameson Tilton from About.com
For more articles on disabilities and special ed visit
www.bridges4kids.org.
In the not too distant past, an adult with a severe Autism
Spectrum Disorder faced a future that almost certainly
included institutionalization. Because of the unique care
needs, the expense involved, the lack of insurance coverage
and more, it was impossible for the Autistic adult to live
within his/her community, in most cases. Federal and State
funds went to institutions and the prevailing thought was that
Autistic individuals should be placed in them, "for their own
good."
Thankfully,
that thinking has changed. It is now recognized that many
Autistic adults are able to remain within their own
communities, with a minimum of actual medical care. One of the
major factors in this shift of focus was the Medicaid HCB
Waiver Program, which allows states to take Medicaid funds
that were previously only available to institutions, and apply
them to community and home based programs. According to the
U.S. Department of Health and Human Services, "Medicaid's home
and community-based services waiver program affords States the
flexibility to develop and implement creative alternatives to
institutionalizing Medicaid-eligible individuals. States may
request waivers of certain Federal rules which impede the
development of Medicaid-financed community-based treatment
alternatives. The program recognizes that many individuals at
risk of institutionalization can be cared for in their homes
and communities, preserving their independence and ties to
family and friends, at a cost no higher than that of
institutional care."
The services
that may be provided without prior approval of the Federal
Government through this program include:
Case Management Services
Homemaker Services
Home Health Aide Services
Personal Care Services
Adult Day Health, Habilitation and Respite Care Services Other
services which may be provided with approval include:
Transportation Services
In-Home Support Services
Meal Services
Special Communication Services
Minor Home Modifications
Adult Day Care Services
A quick review of these services clearly shows that most, if
not all of them could be of great benefit to an individual on
the Autism Spectrum. They could be the thing that allows the
Autistic citizen the opportunity to have a life within the
familiar confines of his/her own community or home. There is
only one drawback.
States can
implement these services as they wish, choosing which to offer
and which to ignore. It is important for the parents and care
givers of Autistic individuals to find out what services are
available within their state, and compare those with what is
allowed by law. If there are services that would benefit the
Autism community that are not being offered, action should be
taken to get your state's Health and Human Services Department
acting to provide those which are lacking. By our awareness of
what is available and what could be available, we can help to
make life a little better for all developmentally disabled
citizens within our borders. After all, "Awareness is the
Key."
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