WELFARE - MEDICAL ASSISTANCE (MEDICAID);

You asked for a list of all of Connecticut’s Medicaid waivers.

The federal-state Medicaid program generally provides medical services to families with children who are on welfare or have very low income, as well as low-income aged, blind, and disabled people, and people in nursing homes. Medicaid waivers are a way in which states can serve additional medically needy people who otherwise would not qualify for the regular Medicaid program because of income or other factors. With approval from the federal Centers for Medicare and Medicaid Services, states have the flexibility to (1) set somewhat higher income limits for these groups, (2) limit the number of people who can qualify (“waiver slots”), and (3) make other adjustments to regular Medicaid rules.

Connecticut has six Medicaid waivers in effect:

1. Connecticut Home Care Program for Elders Waiver provides home health care and other community services to people aged 65 and older who would otherwise be in nursing homes and meet certain income and asset limits.

2. Personal Care Assistance Waiver provides consumer-directed personal care assistance services to people with physical disabilities who are between age 18 and 64 to help them live in the community.

3.

Acquired Brain Injury Waiver provides a number of support services, including personal care assistance, to people between age 18 and 64 with acquired brain injury.

4. Department of Mental Retardation (DMR) Waiver provides a variety of home and community services to people with mental retardation who would otherwise be institutionalized.

5. Katie Beckett Waiver provides Medicaid coverage, case management, and home health services mainly to children and certain others with serious disabilities who would otherwise qualify for Medicaid only in an institution.

6. HUSKY A Managed Care Waiver allows the Department of Social Services to provide Medicaid services through a managed care HMO-type system to families with children who are on welfare or otherwise eligible because of low income. (The elderly, blind, and disabled receive their services through the regular Medicaid fee-for-service system).

The waivers are named after the different sections of the federal Social Security Act that authorize them. The first four are Section 1915(c) home and community-based wavers, the Katie Beckett waiver is a 1915(a) model waiver, and HUSKY A is a 1915(b) managed care waiver.

PENDING WAIVER REQUESTS

Two pending waiver requests, which the federal government has not yet approved, would be 1115 Research and Demonstration waivers.

• The Transfer of Assets waiver would change the start date of penalties for inappropriate asset transfers by people applying for Medicaid help in paying their long-term care costs, change the look-back period from three years to five years for real estate transfers, and exempt small amounts of transfers from the lookback and penalties.

• The ConnPACE waiver would turn the exclusively state-funded Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled program into a Medicaid waiver program and increase income limits for eligibility to 300% of the federal poverty level.

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