Home and Community-Based Services Medicaid Waiver for Individuals with Traumatic Brain Injury (HCBS/TBI)

Program Goal

To provide support and services to assist an individual with a traumatic brain injury (TBI) to live as independently as possible in the community of their choice.

Eligibility

  • Must have a diagnosis of TBI or a related diagnosis similar to TBI that is not a progressive degenerative disease.
  • Be assessed to need a nursing home level of care as a direct result of the TBI.
  • Be enrolled in the Medicaid Program.
  • Be between the ages of 18 and 64.
  • Choose to live in the community rather than a nursing facility.
  • Have or find a living arrangement in which to receive services.
  • Complete an Initial Service Plan, Plan of Protective Oversight (PPO) and Application Packet in cooperation with a Service Coordinator and be approved by the Regional Resource Development Specialist (RRDS).
  • Be able to be served with the funds and services available under the HCBS/TBI waiver and New York Medicaid State Plan.

Description

The HCBS/TBI waiver is accessed through a network of Regional Resource Development Centers (RRDC) which serve specific counties throughout the state. The Waiver provides a variety of services to support an individual in the community. Each waiver participant selects an approved Service Coordinator to assist them in the development of a Service Plan and to oversee the provision of all services selected by the participant.

HCBS/TBI waiver services include: service coordination, independent living skills training and development (ILST), structured day program services, substance abuse program services, positive behavioral interventions and support services (PBIS), community integration counseling (CIC), home and community support services (HCSS), environmental modifications (emods), respite services, assistive technology (AT), waiver transportation, and community transitional services (CTS).

For More Information

Call the NYS Department of Health HCBS/TBI at (518) 474-5271 to find the Regional Resource Development Center nearest you or go to the DOH website: www.health.ny.gov/health_care/medicaid/program/longterm/tbi.htm.

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Publication 0548
Revised 10/2013