How to Apply for Medicaid Waivers


Eligibility Criteria


What are the criteria for the Family Supports Waiver (FSW)?
The criteria for the FSW are the same that are required for receiving any services through DDRS waiver program. Individuals meeting the state criteria for a developmental disability and meeting the criteria for an ICF/ID level of care determination are eligible to receive waiver services. "Developmental Disability" means a severe, chronic disability of an individual.
  • Is attributable to intellectual disability, cerebral palsy, epilepsy, or autism; or any other condition (other than a sole diagnosis of mental illness) found to be closely related to intellectual disability
  • Is manifested before the individual is twenty-two (22) years of age
  • Is likely to continue indefinitely
  • Results in substantial functional limitations in at least three (3) of the following areas of major life activities: Self-care, Understanding and use of language, Learning, Mobility, Self-direction, or Capacity for independent living
What are the criteria for the Community Integration & Habilitation Waiver (CIH)?
The CIH waiver is a needs-based waiver, which means that an individual must meet one of the following priority criteria:
  • Eligible individual in other setting whose health and welfare is threatened
  • Eligible individuals transitioning to the community from nursing facilities, extensive support needs homes, and state operated facilities
  • Eligible individuals determined to no longer need/receive active treatment in group home
  • Eligible individuals transitioning from 100% state funded services
  • Eligible individuals with loss or incapacitation of the primary caregiver
  • Eligible individuals with an aging primary caregiver
  • Eligible individuals aging out of Department of Education, Department of Child Services, or Supported Group Living Emergency Placement
  • Eligible individuals requesting to leave a Large Private Intermediate Care Facilities/Intellectual Disabilities (ICFs/ID)
  • Eligible individuals transitioning from Crisis Management and meet certain other criteria
Obtain the phone number for your local BDDS office by calling 1-800-545-7763