Understanding Medicaid HCBS Waivers for Adults with Special Needs

Understanding Medicaid HCBS Waivers for Adults with Special Needs

Home and Community-Based Services (HCBS) waivers are programs that offer services designed to permit individuals to remain in their own homes or communities rather than in institutions. Illinois waivers address different services for individuals with similar levels of needs. Illinois has nine HCBS (1915(c)) waivers, which include:

  • IL Supportive Living Program
  • IL Waiver for Adults w/Developmental Disabilities
  • IL HCBS Waiver for Persons with Brain Injury
  • IL HCBS Waiver for Children that are Medically Fragile, Technology Dependent
  • IL HCBS Waiver for Persons w/HIV or AIDS
  • IL HCBS Waiver for Persons Who are Elderly
  • IL Persons with Disabilities
  • IL Support Waiver for Children and Young Adults with Developmental Disabilities
  • IL Residential Waiver for Children and Young Adults with Developmental Disabilities

Eligibility for HCBS Waivers

Individuals must meet various criteria to be eligible for HCBS waivers:

  • Individuals must be U.S. citizens or legal permanent residents and legal Illinois residents;
  • Individuals must meet applicable Medicaid financial eligibility criteria;
  • Individuals must require the institutional level of care specified in the relevant waiver;
  • The service provider must be able to provide for the individual’s needs at a cost equal to or less than the cost of institutional care; and
  • Individuals must meet other requirements specific to the waiver program, such as age or diagnosis.

Benefits of HCBS Waivers

In many cases, allowing adults with special needs to remain in their homes or communities instead of being institutionalized is highly beneficial to them. Being in a familiar environment can allow these adults to thrive and maintain close relationships with their families.

However, doing so can be prohibitively expensive for many families, and traditional Medicaid and other health insurance programs may not cover the needed services. HCBS waivers can provide the support and other services necessary to allow these individuals to remain at home or in their communities. Additionally, caring for loved ones with special needs can be exhausting. Having HCBS waiver services can take some of the burden of caregiving off family members.

IL Waiver for Adults w/Developmental Disabilities

The Waiver for Adults with Developmental Disabilities is one of the most common HCBS waivers for adults with special needs. This waiver aims to provide supportive services for adults ages 18 or older with intellectual or developmental disabilities meant to delay or prevent out-of-home residential care that otherwise would be required. Eligible individuals must be eligible for institutional care, but they may not require 24-hour skilled nursing care. The individuals also must be safely maintained in the home or community setting with the services provided in the plan of care.

This waiver may provide home-based support services (HBS), such as community day programs, adaptive equipment, non-medical transportation, and personal support workers. It also can provide residential services, including a variety of therapies. The waiver also offers day programs and vocational services.

Support Waiver for Children and Young Adults with Developmental Disabilities

Another commonly used HCBS waiver is the Support Waiver for Children and Young Adults with Developmental Disabilities. This waiver provides services to children aged three through 21 who live at home with their parents and require an institutional level of care but do not require 24-hour skilled nursing care.

This waiver is designed to prevent the out-of-home residential care these individuals would otherwise require. The waiver offers services based on the individual’s specific needs, including personal support workers from contracted provider agencies, adaptive equipment, assistive technology, home accessibility modifications, and vehicle modifications.  

Contact Us Today to Learn More About Our Legal Services

Rubin Law is the only Illinois law firm to dedicate itself exclusively to providing compassionate legal services for children and adults with special needs. We offer unique legal and future planning techniques to meet your family’s individual needs.

Call us today at 866-TO-RUBIN or email us at email@rubinlaw.com to learn more about the services we can offer you and your family.