Home/Community Based Care Waiver ProgramsNL-5000.5000-800.30
State Medicaid programs operating under a waiver that permits them to utilize Medicaid funds, normally available only to pay for care in a skilled nursing, intermediate care or other long-term care facility, to provide case management and home care services for eligible individuals as a means of avoiding premature institutionalization. Individuals must be Medicaid eligible, must be certified or certifiable for long-term care, and must meet other criteria as specified in the state waiver, e.g., age and disability requirements. States are allowed to make waiver services available to people at risk of institutionalization, without being required to make waiver services available to the Medicaid population at large. States use this authority to target services to particular groups, such as elderly individuals, technology-dependent children, seriously emotionally disturbed children, or persons with intellectual disabilities or developmental disabilities; or on the basis of disease or condition, such as AIDS. Covered services depend on the population(s) covered in the waiver. Those for older adults and adults with disabilities, for example, include but are not limited to case/care management, homemaker services, home health aides, personal care, adult day health care, habilitation and respite care. Services for children may also include wraparound facilitation/community support, independent living/skill building services and parent support and training. Every state has its own set of waiver programs that are unique.