Traumatic Brain Injury (TBI) Waiver
Frequently Asked Questions


  • Medicaid has an institutional bias providing comprehensive services only on an inpatient basis; a waiver is an opportunity for comprehensive services to be
    available in the community.
  • A HCBS waiver allows states to assemble a package of carefully tailored services to comprehensively meet the needs of a targeted group in a community-
    based setting.
  • A state must assure, through an individualized service plan, the waiver participant’s health and welfare.
  • A state must assure that the overall cost of serving the waiver participants in the community is less than the cost of serving this same group in an
    institution.         


Service Coordination
  • The key to individual choice and satisfaction is person-centered service  coordination.  
  • The Service Coordinator:
  • Is responsive to the individual and helps the waiver participant identify his or her unique needs;
  • Promotes activities which will increase the individual’s independence and life satisfaction;
  • Assists in the integration of the individual in the community of his/her choice;
  • Helps in increasing the individual’s productivity and participation in meaningful activities; and
  • Assists in arranging for daily living supports and services to meet the individual’s needs.

Independent Living Skills Training and Development
  • Improves and maintains the individual’s community living skills so that the individual can live as independently as possible.  This will be done primarily in
    one-on-one training, and focuses on practical needs such as shopping, cooking, money management, use of public transportation, etc.  This service is
    provided in the individual’s residence and in the community.

Structured Day Programs
  • Improves and maintains the individual’s community living skills in a congregate non-residential, non-medical setting.  The focus will be on the development
    of social, problem-solving and task-oriented skills.

Substance Abuse Programs
  • Reduces and/or eliminates substance abuse which may interfere with the individual’s ability to be maintained in the community.  This service will be
    specifically designed to meet the needs of individuals with cognitive deficits, and will work with existing community support systems, such as AA or Al-Anon,
    to assist them in becoming more responsive to people with traumatic brain injuries.

Intensive Behavioral Programs
  • Eliminates and/or reduces an individual’s severe maladaptive behavior(s) which, if not modified, will interfere with the individual’s ability to remain in the
    community.
  • These services are provided in the individual’s residence and in the community and are provided by a highly trained team to an individual, his/her family, or
    anyone else having significant contact with the individual.

Community Integration Counseling
  • Assists the waiver to adjust to the participant and family members to more effectively manage the stresses and difficulties associated with the waiver
    participant living in the community.

Home and Community Support Services
  • Assists the individual’s with the support of non-medical assistance, and includes safety monitoring assistance with activities of daily living and integration
    into the community. These services can be provided in the individual’s residence or in the community.  These non-medical services are a compliment to
    personal care services provided under Medicaid.

Environmental Modifications
  • Provide for physical adaptations to the individual’s residence and primary vehicle which ensure the individual’s health, safety and welfare and  which
    increase the individual’s independence and integration in the community.

Respite Care
  • Provides short-term relief for informal caregivers of individuals who are unable to care for themselves.  This service will be provided primarily in the
    individual’s residence.

Assistive Technology
  • Provides durable and non-durable medical equipment not usually funded under the Medicaid State Plan.  An example of the equipment available through
    this service is a three wheel cart for mobility purposes.

Social Transportation
  • Provides the means to access non-medical services in the community in order to improve the individual’s ability to make use of needed services, and to
    improve the individual’s integration in the community.

Community Transition Services
  • Assists individuals leaving nursing homes by providing assistance with payment of a Security deposit, utility set up fees, moving expenses, purchase of
    essential furniture, and initial cleaning service. This service has a budget cap.

*Serving as the Regional Resource Development Center (RRDC), Mercy Haven does not provide these services directly to the individual with the TBI.  Other DOH
approved “provider” agencies do this.  The contact person at the RRDC is the Regional Resource Development Specialist (RRDS). The RRDS is responsible for:
  • Interviewing potential waiver participants
  • Assisting participants to access approved providers
  • Approving Service Plans
  • Reviewing Incident Reports
  • Maintaining regional budgets for waiver services
What Services does the Waiver offer?*
What is a HCBS Medicaid Waiver?
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