Medicaid Waiver Program

The Medicaid Waiver, sometimes referred to the Med Waiver Program, is a way the state of Tennessee can use Medicaid  dollars for services of people with intellectual developmental disabilities. It allows the state to pay for services related to the individual to live in a community setting instead of an institutional environment. Services are approved based on established protocol. Services are to be Approved prior to provided.

What is the Medicaid Waiver and Who Benefits from this Program?

Available Med Waiver Services:
There are a wide variety of services available, depending on need, qualifications, and availability.  Services via the Medicaid Waiver are not to replace services that can be secured via alternative resources- ie TN Care , private insurance
These services include:

  • Adult Dental Services - Services include fillings, root canals, extractions, dentures, and other dental treatments. Does not  include preventative care.
  • Behavior Services -Assessment and treatment of behavior that presents a health or safety risk to the person supported or others and/or behavior that significantly interferes with home or community activities.
  • Independent Support Coordination/Case Management - Services to assist the person supported in obtaining and coordinating both paid services and natural supports for community integration.
  • Day Services - Services and supports that teach and improve skills that support semi­ independent living.
  • Environmental Accessibility Modifications -Interior or exterior physical modifications to the home that are required for health, welfare and safety or help to function with  greater independence.
  • Nursing Services - Skilled nursing services provided directly to the person supported that are based on a physician's orders.
  • Nutrition Services - Services provided by a licensed dietician or nutritionist to assess nutritional needs and provide counseling and education for food purchase, preparation, and assistance in eating.
  • Occupational Therapy - Services to help improve or maintain the ability to perform
    activities of daily living.
  • Orientation and Mobility Training - Services to assist a severely visually impaired person move independently and safely at home and in the community.
  • Personal Assistance - Assistance with activities of daily living like bathing, dressing, and household chores.
  • Personal Emergency Response System - An electronic device used in the home of the person supported to secure help in an emergency.
  • Physical Therapy - Services to help increase ability to move around in different settings. Residential Services - Services vary depending on the capacity of the person supported. Typically a 24/7 service where the person resides in a home of their own, outside of their family's home.
  • Respite Services - Services for when caregivers are not able to provide care for a short period of time. 7
  • Specialized Medical Equipment & Supplies and Assistive Technology - Assistive devices, adaptive aids, controls or appliances that help with daily living.
  • Speech, Language, and Hearing Services - Services range from providing effective communication methods to helping someone swallow safely.
  • Supported Employment - Services to help the person supported work at a job  in the community.


There are now 3 new services or kind of services:

  • In-Home Day Services - In-Home Day Services are provided in the person's residence if there is a health, behavioral, or other medical reason or if the person has chosen retirement or is unable to participate in services outside the home: such as Community-Based, Facility-Based, and Supportive Employment.
  • Intensive Behavior Residential Services (IBRS) - The Intensive Behavioral Residential Service is a clinical treatment model designed to meet the specific needs of each person supported by the program. The target population for this program is adults with intellectual disabilities who have exhibited high risk behavior, placing themselves and or others in danger of harm. This program is designed to be flexible enough to respond to the changing levels of need (LON) of the person supported and the level of risk (or lack thereof) presented by the person's current behavior. It is not an indefinite, long te1m, residential support se1vice. A person with high risk behavior who is involved in this program will have opportunities to develop a lifestyle which includes developing healthy and meaningful relationships with others.
  • Semi-Independent Living Service (SILS) - Semi-Independent  Living Services (SILS) are designed to include training and assistance in managing money, preparing meals, shopping, personal appearance and hygiene, interpersonal and social skills building, and other activities needed to maintain and improve the capacity of an individual with an intellectual disability to live in the community. The service also includes oversight and assistance in managing self-administered medication and/or medication administration as permitted under Tennessee's Nurse Practice Act. The target population for this service is people who need intermittent or limited suppo1t to remain in their own home and do not require staff that lives on-site. However, access to emergency supports as needed from the provider on a 24/7 basis is an essential component of this residential service and is what differentiates it from Personal Assistance services
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