article Medicaid Waivers for Child Services

State-Specific Medicaid Waivers for Children

State-specific Medicaid waivers can help expand access to services for children with disabilities. Programs and eligibility vary by state, and current information should be verified with your state Medicaid office. For more information about these waiver programs, visit Kids’ Waivers.

• The TEFRA of 1982 allows any state the option to extend Medicaid services to a child with a significant disability.
• States must select to offer the program in the state plan.
• Eligibility:
  • Based on the child’s income and resources
  • Does not count or deem parental income
  • The child must have a disability under SSA rules that would require placement in a hospital, nursing facility, or intermediate care facility

• HCBS waivers offer additional services that help people with disabilities live at home.
• Can be categorized for different disability types, including developmental disabilities, intellectual disabilities, serious emotional disturbance, and physical disabilities, among others.
• Three levels of care (Hospital, Nursing Facility, or Intermediate Care Facility) dictate the level of services offered based on the designated needs of the person with a disability. 

• States can use these flexible waivers to create state-specific programs or reform the state’s Medicaid system. Some states have elected to use these waivers to provide home and community-based services for people with disabilities. 

• There are state-based programs that are similar to the TEFRA option and can expand access to various services. These specialty programs can be identified with other similar state services. 
  • 1915(i): Home and community-based services, including respite and home and vehicle modifications
  • 1915(j): Self-directed personal care services
  • 1915(k): Personal assistance and in-home support