Technology Dependent Medicaid Waiver 525-05-25-12

(Revised 7/1/15 ML #3460)

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In order for services to be payable under the provisions of the Medicaid Waiver for Home and Community Based Services, the person receiving the service must meet all of the following:

  1. Recipient of Medicaid Program under the State Plan for Medical Assistance as set forth in Service Chapter 510-05, Medical Assistance Eligibility Factors;  
  2. Age 18 or older and physically disabled as determined by the Social Security Administration, or be at least 65 years of age;
  3. Eligible to receive care in a skilled nursing facility;
  4. Ventilator dependent minimum of 20 hours per day;
  5. Medically stable - documented by primary physician at a minimum on annual basis;
  6. Has an informal caregiver system for contingency planning;
  7. Is competent to participate in development of care plan as documented by physician annually;
  8. Have Person Centered Plan of Care SFN 404, developed and approved by the applicant/client or legal representative and HCBS case manager that adequately meets the health, safety, and personal care needs of the recipient
  9. Voluntarily choose to participate in the Technology Dependent Waiver after discussion of available options. This is documented by the completion of Explanation of Client Choice, SFN 1597;
  10. Receive services on a monthly basis (does not include Case Management); and
  11. Not eligible or receiving services through other waivers.