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Home- and Community-Based Services (HCBS) Waivers for Adults with Intellectual Disabilities: Information for Providers

MassHealth offers three HCBS waivers that make long-term home- and community-based services available to eligible adults with intellectual disabilities.

Table of Contents

HCBS Waivers

The HCBS Waivers are administered by the Executive Office of Health and Human Services (EOHHS) through MassHealth  which pays for health care and services in the home for individuals living in Massachusetts who have limited income. The Department of Developmental Services (DDS) is the lead agency within EOHHS responsible for the day-to-day operation of these three HCBS waiver programs for adults with intellectual disabilities.

Participants in an HCBS waiver receive both traditional MassHealth services and the additional services available through the HCBS waiver in which they are enrolled. In each of the three HCBS waivers for adults with intellectual disabilities, participants work with a DDS Service Coordinator to develop a service plan that reflects the waiver and non-waiver services and support they need in the community.


Providers may enroll with the Department of Developmental Services to provide some of the services under the three home- and community-based service waivers described below.


HCBS Waivers for Adults with intellectual disabilities (ID)


DDS operates three HCBS waiver programs specifically for adults with intellectual disabilities.


Adult Supports Waiver – The Adult Supports Waiver provides services to individuals who meet the eligibility criteria and require at least one home- and community-based waiver service per month.  Participants do not require the levels of support provided under either the Community Living Waiver or the Intensive Supports Waiver.  Participants live in family homes, adult foster care, or independently and do not require 24 hour care.  Their health and welfare needs can be met in these community settings.  Waiver services may vary depending on the living arrangement of the participant.  Participants will only receive services through the waiver that are needed in order to remain safely in the community.  Participants in the Adult Supports Waiver can choose to direct their services if they are interested. The Adult Supports waiver offers both budget authority and employer authority as options for participant direction.  

Community Living Waiver – 
The Community Living Waiver provides services to individuals who meet the eligibility criteria and require at least one home- and community-based waiver service per month.   Participants require more support than those in the Adult Supports Waiver, but less than those in the Intensive Supports Waiver.  Participants live in the family home, adult foster care, with a live-in caregiver, or independently and do not require 24 hour care.  Their health and welfare needs can be met in these community settings.  Waiver services may vary depending on the living arrangement of the participant.  Participants will only receive services through the waiver that are needed in order to remain safely in the community.  Participants in the Community Living Waiver can choose to direct their services if they are interested. The Community Living waiver offers both budget authority and employer authority as options for participant direction.  


Intensive Supports Waiver – 
The Intensive Supports Waiver provides services to individuals who meet the eligibility criteria and require supervision and support 24 hours a day, seven days a week due to significant behavioral, medical and/or physical support needs. Participants will only receive services through the waiver that are needed in order to remain safely in the community.  Participants in the Intensive Supports Waiver can choose to direct their services if they are interested. The Intensive Supports waiver offers both budget authority and employer authority as options for participant direction.  


Services Available in the HCBS Waivers for Adults with Intellectual Disabilities

Participants in the HCBS waivers for Adults with intellectual disabilities work with a DDS Service Coordinator to develop their individual service plan and plan of care, which include the participant’s goals as well as the waiver and non-waiver services and supports the participant needs in the community.
Waiver services include the following:
•    Adult Companion
•    Assistive Technology
•    Behavioral Supports and Consultation
•    Chore Service
•    Community Based Day Supports
•    Day Habilitation Supplement
•    Family Training
•    Group Supported Employment
•    Home Modifications and Adaptations
•    Individual Goods and Services
•    Individual Supported Employment
•    Individualized Day Supports
•    Individualized Home Supports
•    Live-in Caregiver
•    Peer Support
•    Residential Habilitation
•    Respite
•    Specialized Medical Equipment and Supplies
•    Stabilization
•    Transitional Assistance Services
•    Transportation
•    Vehicle Modification
•    24-Hour Self Directed Home Sharing Support

All services included in these three waivers are contracted through the Department of Developmental Services. The DDS policies that describe waiver services and provider requirements may be found through the link below.
 

Additional Resources

Waiver Service Providers

Providers of services in the HCBS waivers for Adults with intellectual disabilities must successfully complete the application and meet the qualifications outlined in the official procurement record system for the Commonwealth of Massachusetts, Commbuys. To facilitate the provider application and qualification process, DDS offers the Provider Data Management (PDM) system, which offers Waiver service providers guidance on the application, qualification, and post-qualification aspects of services.

Providers who wish to be paid directly through MassHealth must first respond to the applicable procurement on COMMBUYS and must meet all applicable licensing and/or certification standards for the service. Qualified providers should notify DDS of their interest in payments to be received directly from MassHealth. DDS will work with MassHealth to enroll the provider and establish direct submission of claims to MassHealth through the Provider Online Service Center (POSC). Claims submitted directly by the provider will be adjudicated in MMIS with payment made directly to the provider. Providers will be subject to post-payment review of claims submitted to validate that the claims were authorized in the waiver Plan of Care. Overpayments to providers, including as a result of payment for services not authorized in a Plan of Care, may be subject to withholding or recoupment in accordance with130 CMR 450.000.

The Provider Data Management page, is a useful source of information. This page will help you Find a Provider and the guide to Agency Provider Maintenance. Click this link to additional information about Chapter 257, regarding the determination and implementation of rates for human and social services in the Commonwealth.

Service rate information can be found here

 

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Contact

Phone

DDS Waiver Management Unit 888-367-4435

At prompt, please press 2 for the Waiver Management Unit

Address

DDS Waiver Management Unit
500 Harrison Avenue
Boston, MA 02118-2439
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