HCBS (Home & Community-Based Services)
Home and Community-Based Services (HCBS) are designed to provide a variety of health services in the home and community aimed at supporting children and their families who deal with emotional, physical, medically fragile, mental, and developmental disabilities. These services help children remain at home or within their community, reducing the risk of institutionalization. The program caters to children between the ages of 5 and 17 during enrollment but allows continued participation until age 21 if enrolled before their 18th birthday. To be eligible, participants must be enrolled in Medicaid or be Medicaid-eligible.
Eligibility Criteria
Who Qualifies? To qualify for HCBS:
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The child must be enrolled in Medicaid and have insurance coverage (except Healthfirst).
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The child must be between the ages of 5 and 17 at the time of enrollment.
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The child must have one of the following diagnoses: autism, an Individualized Education Program (IEP), or one of the listed diagnoses such as Major Depressive Disorder, Bipolar Disorder, Schizophrenia, PTSD, Anxiety Disorders, OCD, ODD, Conduct Disorder, ADHD, RAD, DMDD, Adjustment Disorders, Eating Disorders, Tourette Syndrome, and others.
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Families must be willing to comply by submitting necessary documents promptly to start services.
Enrollment Process
How to Enroll Your Loved One? The process to get your loved one services involves several steps:
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Confirm Eligibility : Ensure that your child meets the age and diagnosis requirements and is enrolled in Medicaid.
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Provide Documentation : Submit proof of insurance and any relevant medical documentation related to the child’s diagnosis.
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Submit Necessary Documents : Complete all required paperwork and turn it in without delay to avoid delays in service initiation.
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Wait Time : The turnaround time for services to begin can range from 2 to 8 weeks, depending on the completeness of the application and other factors.
Services Provided by HCBS
CFASS (Community and Family Support Services) :
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Skill Development : Focuses on teaching life skills, social skills, and functional abilities to promote independence.
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Goal-Oriented : Tailored to help individuals achieve specific personal or community goals, such as using public transportation or participating in community activities.
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Family Education and Support : Includes training and resources for families to better support their loved ones.
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Flexible Settings : Services can be delivered at home, in the community, or other appropriate settings.
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Examples : Developing social skills, learning to use community resources like libraries, and supporting families with caregiving techniques.
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Respite Services :
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Purpose : Provides temporary relief to family caregivers by taking over caregiving responsibilities for a set period.
Key Features :
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Caregiver Relief : Allows the primary caregiver to take a break, reducing stress and preventing burnout.
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Short-Term Support : Usually provided for a few hours to a few days, depending on the family's needs.
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No Skill-Building Component : The focus is on supervision and safety, not teaching or goal-oriented activities.
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Flexible Locations : Can be provided in the individual's home, the caregiver's home, or community-based settings.
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Examples : Supervising the individual while the caregiver runs errands or attends appointments, engaging the individual in activities to keep them safe and entertained, and providing overnight care during caregiver vacations or emergencies.
