What Do Individuals/Families Need to Do to Keep Getting Med Waiver Services?

What Do Individuals/Families Need to Do to Keep Getting Med Waiver Services?

People getting services and their families must do ce1iain things to be able to keep getting Med Waiver services. These things are done to protect the person. They are done so people continue to receive good services and are safe in his/her community.

Circle of Support (COS) - Each person has a COS made up of the individual who is supported, their family and others whom the individual may choose (ie people who support the person on a day to day basis) to help in planning services and supports.

The services and supports a person needs to live in the community are in a narrative or bullet form in the person's ISP (Individual Supp011Plan). The ISP includes what the individual identifies as important to /important for in order to promote areas such as choice, involvement, value and health/safety.  All entities work together with the ISC to write the ISP. This development is completed via the use of Person centered tools/Person centered planning.  This helps assist the person in receiving the correct services and supports.

The Individual Support Plan is reviewed and renewed at a minimum eve1y 365 days. The annual review process is to be used to facilitate this review and renewal. Individual, their conservators, their family or anyone on their Circle of Supports can, at any time, request a comprehensive review of the person's Individual Support Plan and/or a Circle of support meeting.

Circumstances that might lead to a request for a review include but are not limited to:

  • Problems with implementing the ISP plan,
  • No progress is noted for outcomes/actions,
  • Outcome/action is occurring on a consistent basis
  • Significant changes in health


What to Do to Schedule Such a Review or Circle of Support Meeting:

Contact the ISC via email, phone, text.

Contact the ISC Provider's main office - ask for the supervisor of your ISC or ask for the Office Manager to contact the ISC or ISC supervisor for you.

Home Visits - ISC's must make visits to a person's home several times a year, generally eve1y three months if the individual receives supports in their home through the med waiver program. The person, family, and ISC will choose the times for the visits. To continue receiving supports from the med waiver program these home visits must be completed.

Annual Physical Exam - Everyone in the med waiver must have an annual physical nnless indicated by the physician that an annual is only needed every two to three years, but this must be indicated on the physical consult report. The times for a physical depend on the person's age and medical needs. The physical must be done on time to keep getting waiver services each year. The ISC will remind the family or provider when it is due each year.

Financial Information - People must show that they do not have more money than allowed to be placed in the Med Waiver program. Families will be asked to answer questions about the person's income. They also will be asked to provide proof of the person's income. This must be done every year for a person to keep getting waiver services. The local Department of Human Services (DHS) office will look at the amount of money the person has and they will decide if
the person can receive Medicaid.

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