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| The Traumatic Brain Injury Waiver provides funding for home and community-based services (HCBS) for children and adults who have an acquired or traumatic brain injury. TBI Waiver services may be provided in a persons own home, in his/her biological or adoptive familys home, in a relatives home (e.g. sibling, aunt, grandparent etc.), in a family foster care home, in a corporate foster care home, in a board and lodging facility or in an assisted living facility. If married, a person may receive TBI Waiver services while living at home with his or her spouse. |
| Eligibility for the TBI Waiver is determined through a screening process. To be eligible for the TBI Waiver a person must meet all these criteria: |
| Be a Medical Assistance recipient or be eligible for MA based on the persons own income or assets |
| Be certified as disabled by the State Medical Review Team or by the Social Security Administration |
| Be under the age of 65 years when the waiver is opened |
| Be determined to need the level of care available in a nursing facility or neurobehavioral hospital |
| Choose services in the community instead of services in a nursing facility or neurobehavioral hospital |
| Have a documented diagnosis of traumatic or acquired brain injury or degenerative disease diagnosis where cognitive impairment is present, provided the diagnosis is not congenital |
| Experience significant/severe behavioral and cognitive problems related to the injury or disease |
| Be assessed at Level IV or above on the Rancho Los Amigos Levels of Cognitive Functioning Scale |
| Once eligibility is determined for participation in the TBI Waiver, certain questions must be asked about services including: |
| Are the services necessary to ensure the recipients health, welfare and safety? |
| Is the service covered by any other funding source, for example, Medical Assistance state plan services, private health care coverage, Medicare, education or Vocational Rehabilitation Service funding? |
| Have all options been assessed and does this option meet the individual desires, needs and preferences of the person? |
| Is the cost of the service considered reasonable and customary? |
| Extended cognitive rehabilitation therapy |
| Extended personal care assistant services |
| Extended supplies and equipment |
| Extended transportation services |
| You can apply for the TBI Waiver at your local county public health or social service agency. The DHS Disability Services Division administers the TBI Waiver. |
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