Children's Waiver Services

Items/ equipment to help a child be successful with doing daily tasks. The item can be to increase, maintain or improve what the child is able to do for themselves.

Such things as:

• Three-sided toothbrush to be able to brush teeth successfully on their own. 
• Weighted blankets to calm down. 
• Bubble light to help fall asleep.

To receive this service:

• Care Plan must state need and goal of item.
  • Letter of Recommendation from a professional working with child on the goal.
• Letter must have:
  • Items being requested
  • Statement of how item will meet need
  • Trial of item to ensure it will meet the need and be used.

Provides an opportunity to try wide variety of group activities to build relationships and support in the community where the child lives. May provide one on one staff to assist with participation.

Must be:

• Listed on care plan
• Parents provide transportation

Groups must be:

• Typical activities within community
• Interact with non-disabled peers
• May provide one on one staff to assist with participation

Cannot be:

• One-time events such as concerts, professional games, movies
• Soley instructional led /private instructions = drivers education / music lessons 

Assistance in quickly finding a child with elopement behaviors by having a device attached to child’s clothing. Service allows a child to experience more independence in daily schedule, increase inclusion while at same time providing parents with ability to locate if elopement occurs.

Must be:

• Listed on the care plan
• Must have a restriction plan within care plan
• Individuals must have active elopement behaviors

A service to assist a family in gaining access to waiver services and other Medicaid state plan services as well as medical, social, educational and other services regardless of the funding source for those services. Service is provided by phone, home visits (min of 2 per year) or where parent request to meet.

Assistance can be:

• Support to parents in understanding services
• Care plan development
• Completion of authorization for services
• Helping identify community services that will meet goals

This gives parents a break from the daily stress of caring for a child with special needs. It’s an extra set of hands so parents can rest, catch up on housework, run errands, go to another child’s activities, spend time with friends or take a short break. Respite care can be provided either through an agency or by self-direction and it happens right in a child’s home. Transportation is not included.

Family hiring a respite care worker must:

• Have a child enrolled in the state’s Autism Spectrum Disorder waiver
• Have respite care listed on the child’s Person-Centered Care plan
• Be enrolled with Veridian, the fiscal agent that helps families with payroll and criminal and abuse background checks

To be a respite care worker, you must:

• Care for a child who is active on the state’s Autism Spectrum Disorder waiver
• Be 18 or older
• Live outside of the child’s home
• Pass criminal and abuse background checks

For more information on respite care, email dhsautism@nd.gov.

Enable individuals to access essential community resources/services in order to maintain themselves in their home and community and would not be seen as a natural parent responsibility.  These are non-medical needs: banks, grocery store, shopping within community.

Limitations

• A replacement for parental responsibility - to school / work for minors
• For medical appointments to include dentist, therapy
• Must not be covered by Medicaid

Additional help when the child receives up to 51 percent of his/her nutrition from supplements or the supplements are disease specific.

Limitations

• Must not be covered by Medicaid
• Must be part of medical management
• Must be scientific established be a medical evaluation

There cannot be such products as herbs, botanicals or products that have no or little scientific bases has been established.

These can only be those products that have been prescribed for the specific dietary management of a disease or condition with distinctive nutritional requirements. 

Addresses needs related to stress associated with the care of child, when child is not present for the session. Can be completed on an individual bases or with whole family when identified individual is not present.

Limitations

• Not provided by a psychiatrist or psychologist.
• If identified individual is present then Medicaid state plan is responsible for service.

Temporary relief/ assistance for the primary caregiver, within the home, by a care giving assistant.

In-Home support worker must be

• Be 18 years of age or older
• Live outside of the child’s home
• Pass criminal and abuse background checks

A service to purchase adaptive devices and supplies that can assist a child to stay home and promote independence.

Limitations

• Must not be covered by Medicaid
• Supplies are in excess of Medicaid State Plan limits

Ability to modify home and/or vehicle for more independence of individual.

Home examples

• widen doorways for accommodation of wheelchair
• wheelchair ramp
• modify bathroom to allow individual independence
  • grab bars, widen doors, change to accessible shower, change facets to encourage independence

Vehicle examples

• Chair lift
• Interior modifications to allow space for equipment
• Modifications to vehicles to encourage independent driving for individuals to legally drive

Limitations

• Must not be covered by Medicaid
• Not for routine home maintenance  
• Adaptations that add to the total square footage of home are not allowed
• All modifications must be in accordance with state and local building codes
• Vehicle must be owned by legally responsible caregiver
• Vehicle must be licensed and unsured within North Dakota
• Modifications must meet manufactories’ installations specifications.

Temporary relief for the primary caregiver. Care provided in a nursing facility or hospital which can meet the child’s unique medical needs while the primary caregiver is away.

Limitations

• Must not be covered by Medicaid
• Length of stay will not exceed 14 consecutive days.
• Must be arranged by legally responsible caregiver.

A service to assist a family in completing case plan, emergency plan, and support to family as needed. Service may consist of phone calls or accompanying to additional support agency to assist with understanding of services and responsibilities.

Case Management service would meet face to face with individual / family at least quarterly; this would include:

• Review of progress
• Satisfaction of services
• Identify barriers and 
• Discuss an action plan to resolve outstanding issues 
• May attend IEP meeting is parent requests to support

Case Management service is not considered as a monthly service to remain on the waiver.

A registered nurse will help a family get services needed, plan for emergencies and complete necessary paperwork.

Limitations

• Case management will not count towards waiver requirements of receiving one waiver services per quarter.

Nurses provide services that may be preventative, curative and restorative. This service is available after other Medicaid limits have been reached.

Limitations

• A child's needs must exceed those of a home health aide
• Service becomes a Medicaid State Plan service when life expectancy is six months or less as determined by physician’s letter at time of enrollment.

This service is similar to traditional hospice except for the continued curative measures, and service is available after other Medicaid limits have been reached.

Limitations

• This service is not available if the child needs palliative waiver services or is able to have lesser waiver services that meet the child’s needs.
• Service is only available after the Medicaid State Plan has been maximized.
• Service is only available through a hospice agency.
• Service becomes a Medicaid State Plan service when life expectancy is six months or less as determined by physician’s letter at time of enrollment.

This is supportive health care given to children to meet their physical, emotional, spiritual and social stresses experienced during illness.

Limitations

• Needs must be greater than hospice service or skilled nursing service scope of service.
• Family is able to continue to try or look for curative measures.
• Medicaid State Plan needs to be maximized before this service is available.
• Service becomes a Medicaid State Plan service when life expectancy is six months or less as determined by physician’s letter at time of enrollment.

Aide provides respite and help for a caregiver to complete routine daily activities within the home.

Limitations

• Not allowed as overnight care.
• Respite staff cannot be a family member living in the home or a sibling under 16.
• Cannot exceed 76 hours per year.
• Home health agency or hospice agency can only provide service.

Therapists use art activities to help children and their siblings to express and explore their emotions illness.

Counseling services are available for a family before and after the death of a child.

Limitations

• Family must choose if they want aftercare counseling prior to end of life. Must be part of care plan.

A service to purchase adaptive devices and supplies that can assist a child to stay home.

Limitations

• Item cannot be obtained through Medicaid.