The Childrens Mental Health Home and Community Based Services Waiver provides funding for specialize

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HCBS SED WAIVER

• The Childrens Mental Health Home and Community
  Based Services Waiver provides funding for
  specialized community based services to children
  or youth who otherwise might need institutional
  care in a State Mental Health Hospital.

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• Federal law allows states to waive Medicaid rules
  to permit states to operate programs in ways
  different from normal Medicaid rules. The waiver
  makes available an expanded array of
  community-based services and supports in a
  child-centered and family-oriented system of care.

PURPOSE
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• The goal of the SED Waiver is to allow children
  and youth to live with their families whenever
  possible, and to be included as productive
  members of their community.

GOAL
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• The Waiver program is managed by Mental Health,
  Substance Abuse Prevention Treatment and Recovery
  (MHSAPTR) within the Division of Health Care
  Policy. MHSAPTR coordinates with SRS divisions
  of Medical Services, Economic and Employment
  Services, and Community Mental Health Centers.
  The Waiver was implemented statewide on January
  1, 1998.

HOW
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WHY

• The SED waiver serves children ages 4-22 who
  would require State Mental Health Hospital
  services if they did not receive home and
  community based services. While youth may remain
  on the waiver up to age 22, the maximum age for
  initial eligibility is 18. Exceptions to the
  minimum and maximum age requirements can be
  requested by the CMHC.

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WAIVER SERVICES

• Children and youth served by the waiver are
  eligible for all Medicaid services available in
  the Medicaid State Plan.
• In addition, the waiver established 4 new or
  expanded services Wraparound Facilitation,
  Parent Support and Training, Respite Care, and
  Independent Living Services.

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WAIVER ELIGIBILITY

• The Waiver addresses needs of children and youth
  requiring an intensive level of intervention. A
  clinical eligibility process determines children
  and youth who meet the criteria for the waiver.
  Family choice is an important part of the
  process.

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WAIVER ELIGIBILITY

• Once a child is determined eligible for the
  waiver, the family has a choice of accepting a
  community-based plan of care or pursuing
  admission to a State Mental Health Hospital.
  Parent support staff can assist families in this
  decision making process by providing information
  about services and options.

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ELIGIBILITY OVERVIEW

• There are two areas of eligibility a youth must
  meet for the waiver CLINICAL and FINANCIAL (also
  known as Medicaid).

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ELIGIBILITY OVERVIEW

• Clinical A QMHP at the Community Mental Health
  Center is responsible for determining clinical
  eligibility.
• Financial/Medicaid
• SRS area/local office staff determine if the
  youth meets the financial eligibility. Only the
  youths income/assets are considered, not the
  parents.

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ELIGIBILITY OVERVIEW

• A child/youth receiving waiver services will
  receive a medical card that will pay for the
  services in the plan of care.
• The medical card will also cover physical health
  needs such as doctor, dentist and medication.

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PLAN OF CARE
WAIVER

• Once a child/youth is found eligible and the
  family chooses the waiver, an individualized plan
  of care is developed by the child and family
  team. The team includes the family, service
  providers, educators, other community
  stakeholders and persons the family chooses.

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PLAN OF CARE
WAIVER

• The wraparound plan is a strengths based plan.
  It utilizes child and family strengths as well as
  needs in the development of treatment goals and
  objectives. The plan also identifies who is
  responsible for activities and timelines for
  accomplishing goals.

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FUNCTIONS OF THE CHILD AND FAMILY TEAM

• The child and family team develops a wraparound
  plan to meet the individual needs of the the
  child and family. The team addresses crisis
  planning, identifies goals, accesses formal and
  informal supports and resources, and monitors
  services. The team meets and reviews the plan to
  make sure things are working and decide on needed
  changes.

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• The most successful wrap around teams convey
  unconditional care and long term support of the
  family after formal services are no longer
  needed.

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WAIVER SUCCESS

• The plan of care defines and guides efforts to
  achieve identified outcomes. The plan attempts
  to match child and family needs with an array of
  service options. Not only is child and family
  satisfaction a priority, but so is their quality
  of life.

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WAIVER SUCCESS

• For example, successful community involvement by
  the child in age and developmentally appropriate
  activities is one measure of how a childs life
  has been impacted by services.

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WAIVER SUCCESS

• It is expected that a strengths-based,
  child-entered, family-driven and community-based
  plan will help a child make gains in his/her
  ability to live successfully.

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WAIVER SUCCESS

• A critical element to the success of the plan
  is the coordination and collaboration with other
  agencies and people who are involved with the
  child and family.

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• A necessary condition for operation of the waiver
  is to demonstrate that the waiver costs less or
  no more than State Mental Health Hospital
  services. Data indicates this requirement is
  currently being met. State funds are used in the
  waiver program to leverage federal Medicaid
  dollars.

FUNDING
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FUNDING

• This combination of state and federal dollars
  provides funding support for the waiver.
  Currently, there are approximately 1,000
  children/youth being served by the waiver in
  Kansas.