Children's Waiver Program
Children's Waiver Program
The Children’s Waiver Program (CWP) makes it possible for Medicaid to fund home and community-based services for children who are under age 18. To be eligible for the CWP, the child must have a documented developmental disability and need medical or behavioral supports and services at home. In addition, the child must have behavioral or medical and habilitative needs at home on a consistent daily basis that meet requirements for the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). To start the process, the family contacts the Community Mental Health Services Program in the county of residence and requests an assessment for a prescreen for the Children’s Waiver Program.
For children who are enrolled in the CWP, parent income is not considered when the Medicaid eligibility determination is made; if the child has income or resources, they are considered. NOTE: If a child is already Medicaid eligible, in-home services can be requested directly through the Access Center in your county of residence without the Children’s Waiver Program.
Eligibility requirements include all of the following: (Can you answer yes to all these questions?)
- The child must be under the age of 18.
- The child must have a developmental disability as defined in Michigan state law. A developmental disability is not based on diagnosis. Instead, a developmental disability is based on documented evidence of “substantial functional limitations” in three or more of the following areas (considering the age of the child):
- self-care (bathing, grooming, dressing, toileting, eating),
- expressive and receptive language,
- If a child is age 16 or older: capacity for economic self-sufficiency and independent living can be considered. .
- The child must have identified needs for a consistent, aggressive program of in-home services and supports focused on developing skills for the child to function with as much independence as possible and/or to prevent the loss of current abilities.
- The child must live with a birth or legally adoptive parent or with a relative who has been named the legal guardian by the court (and who is not paid to provide foster care for the child).
- Other requirements and service descriptions can be found in the Childrens Wiaver Program section of the Medicaid Provider Manual.
Process to Request an Assessment for a Prescreen for the Children’s Waiver Program:
- Contact the Access Center in your family’s county of residence. A list of current Access Center phone numbers for each Community Mental Health agency can be found at the link below by clicking on the “Download” button next to “CMH Directory”:
When you call the Access Center, be prepared to describe your child’s needs, their functional limitations, the in-home help and services you are requesting, and your family’s income and resources (including private insurance and Medicaid eligibility).
An assessment is made by the Community Mental Health Services Program. Based on the assessment, a prescreen may be submitted through the on-line system by the assigned Community Mental Health Services Program staff person. Prescreens are scored using the Priority Weighing Criteria . After scoring, the assigned staff person will contact the family, or the family can contact the staff person if there are questions.
If significant changes occur in your child’s needs or family situation, please provide this information to the person who worked with you on the prescreen.
When an opening occurs on the CWP, an invitation to apply is issued to the child with the highest updated score that meets all requirements at that time. Medicaid status is checked before invitations to apply are issued. If your child receives an invitation to apply, you will be contacted to make sure you still want to apply for the Children’s Waiver Program.
A total of 469 children are served on the CWP annually. All openings are filled on a monthly basis, and generally, some openings become available each month.
To request more information regarding eligibility contact your local Community Mental Health Services Program.
Report Abuse or Neglect Now!
If you suspect or are aware of the abuse, neglect or exploitation of a recipient of public mental health services in Michingan, use the following link to assist you in reporting the information, or call the MDCH-ORR Hotline: 1-800-854-9090.
Contact: Kelli Dodson, Federal Compliance Departmental Analyst (517) 335-6078