Developmental Disabilities

Group Residential Housing (GRH)

This funding source is for room and board in a facility licensed under GRH rules.  These facilities may include adult foster home, room and board, and assisted living.

Home and Community Based Waivers

Must be on MA and eligible for the waiver based on information gathered at an assessment performed by a case manager.  Waiver allocations must be available at the county level to receive one for use.

Medical Assistance

A Federal program that pays for medical care and some support services for low income families and individuals eight years or older.

Private Health Insurance

May pay for assessments, adaptive equipment, therapy, counseling, and support services.

Supplemental Security Income(SSI) and Retirement and Survivors Disability Insurance (RSDI)

Cash benefits payable to children with qualifying disabilities whose families have a very limited income. At age eighteen, the family income is no longer considered for eligibility.

Tax Equity and Financial Responsibility Act (TEFRA) of 1982

A program that provides MA for children with qualifying disabilities who live with their families and do not qualify for MA because the family’s income is above eligibility criteria. There is a parental fee based on family income and family size.

Personal Care Assistant Services are provided to assist and support persons with disabilities living independently in the community. This includes the elderly and others with special health care needs. PCA services are provided in the recipient’s home or in the community when normal life activities take him/her outside the home.

Eligibility for PCA

• Medically necessary
• Prior authorized
• A PCA assessment establishes the need for PCA Services
• A physician has signed the “Physician Statement of Need”
• Approved in the recipient’s PCA care plan
• Documented in the recipient’s PCA care plan
• Provided by a PCA under the direction of a qualified professional, the recipient, or their responsible party

For individuals who have been assessed by a Public Health Nurse and are determined in need of PCA services and are eligible, the Consumer Support Grant may be a way to allow the family to use those authorized PCA services to arrange for and direct the care of the child.

This would mean the family decides what services or goods they need to assist the child with daily living skills, respite, or other needs. There needs to be someone in the family who can direct the cares for the child.

The Family Support Grant (FSG) is an effective resource for children with disabilities who live or will live in their family home. Many families with children with disabilities living at home incur higher than average expenses that are directly related to the child's disability.

The Family Support Grant provides cash grants to families to offset some of these expenses and gives the families the flexibility to purchase an array of supports and services to meet the child's needs. The amount of and number of grants varies by county. Families wishing to access the program need to complete an application form and provide information to certify the child has been certified disabled, a description of the family's need, and other information as needed to determine grant eligibility.

Eligibility

• Under 21 years of age AND
• Certified disabled by the Social Security Administration(SSA), State Medical Review Team(SMRT), or the lead agency Rule 185 DD case manager.
• Living in their biological or adoptive family home; OR
• Residing in a treatment center, ICF/DD, or other licensed residential service or nursing facility and would return to their family home if the grant were awarded.
• People who are receiving services through a Home and Community Based Waiver including CAC/CADI/TBI. People receiving the DD waiver are not eligible for Family Support Grant dollars.

Family income limits are determined annually by DHS. Considerations may include size of the family, presence of a disability in other family members and substantial debt due to the child's disability. Agency must have funds available for use in order to receive the grant.