Minnesota Brain Injury Waiver Policy Essay

Their cognitive functioning scale is assessed at any Level IV or above facility, they must be certified as disabled by the two bodies responsible for the task i.e. the State Medical Review Team (SMRT) and the Social Security Administration (SSA), they should be eligible for medical assistance, the Brain Injury Waiver should be opened before they are sixty-five years of age, the assessment done should establish that they need the level of care available in an established neurobehavioral hospital, the diagnosis that has been made for traumatic or acquired brain injury that is linked with cognitive impairment should not be congenital and must be experiencing significant behavioral and/or cognitive problems which are linked to the brain injury. Minnesota Brain Injury Waiver Policy Essay.
According to William (2015), traumatic brain injury was not understood well until the 1980s making it is known as the ‘silent epidemic’. The National Head Injury Foundation has played a major role in establishing public awareness of the problem. New York was the first to develop public policies based upon diversity of input. Though the progress in the states’ in response to the TBI cases is significant, none has managed to develop a comprehensive system that addresses the needs of the TBI victims as well as their families. The policy-making process has been influenced by various factors such as the rising cost of healthcare as well as the drop in public funding for such services. The changes made in delivering services to people with TBI has come to address the traditional problem where the model used was strictly medical and just aimed at fixing the patient. As earlier indicated, New York was the first to make significant progress to address the problem with the programs developed before 1990.

The Brain Injury Waiver provides funding for home and community-based services for children and adults who have an acquired or traumatic brain injury.

People may receive BI Waiver services in their home, in a biological or adoptive family’s home, a relative’s home (e.g. sibling, aunt, grandparent etc.), a family foster care home, a corporate foster care home, a board and lodging facility or in an assisted living facility. Minnesota Brain Injury Waiver Policy Essay. If married, a person may receive BI Waiver services while living at home with his or her spouse.

Who is eligible for BI Waiver services?

A screening process determines if you are eligible for the BI Waiver. You are eligible if you meet the following criteria:

• Are assessed at Level IV or above on the Rancho Los Amigos Levels of Cognitive Functioning Scale
• Are certified as disabled by the State Medical Review Team or by the Social Security Administration
• Are eligible for Medical Assistance
• Are under the age of 65 years when the waiver is opened
• Are 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

What else is important for participation in the BI Waiver?

Once your eligibility is determined for participation in the BI Waiver, certain questions must be asked about services including:

• Are the services necessary to ensure your recipient’s health, welfare and safety?
• Have all options been assessed and does this option meet your needs and preferences?
• Is the cost of the service considered reasonable and customary? Minnesota Brain Injury Waiver Policy Essay.
• 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?

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How can persons apply for the BI Waiver?

You can apply for the BI Waiver at your local county agency or tribe (PDF). For more information, view the Brain Injury Waiver fact sheet (PDF).

The brain injury waiver provides funding for home and community-based services for certified disabled individuals with an acquired brain injury, on Medical Assistance, and who require community support in order to avoid or delay nursing facility or neurobehavioral hospital placement. This is a federal Medicaid program.

Personal care assistance program

This program provides services to people who need help with day-to-day activities to allow them be more independent in their own homes. A personal care assistant is trained to help with basic daily routines. A PCA may be able to help you if you have a physical, emotional, or mental disability, a chronic illness or an injury.

Community Access for Disability Inclusion waiver

The Community Access for Disability Inclusion (CADI) waiver program provides support for people younger than 65 who are certified disabled, eligible for Medical Assistance, and need support to avoid or delay institutional living.  Minnesota Brain Injury Waiver Policy Essay.

Community access for disability inclusion information
Community access for disability inclusion brochure

Some programs require a person be certified disabled; this disability status can be obtained through Social Security or the State Medical Review Team (SMRT)

Social Security Disability Determinations
FAQs about the State Medical Review Team

Consumer Directed Options

These programs allow people to write their own plans and hire and direct their own staff. Programs include consumer-directed community support, consumer support grant, and family support grant.

Consumer-directed community supports

Consumer directed community supports (CDCS) is a service option for people with disabilities that gives the flexibility and responsibility to tailor services and supports to their unique needs.

With this program, you:

• Decide how to spend your budget allowance based on your assessed needs
• Have the option to hire people you know, such as family, friends and neighbors
• Choose as much responsibility as you want to hire, train and manage your workers

Eligibility:
CDCS is an option for people who qualify for Medical Assistance and are enrolled in at least one of the following programs:  Minnesota Brain Injury Waiver Policy Essay.

• Alternative Care (AC)
• Brain Injury (BI) Waiver
• Community Alternative Care (CAC) Waiver
• Community Access for Disability Inclusion (CADI) Waiver
• Developmental Disabilities (DD) Waiver
• Elderly Waiver (EW)

How it works:

A. Budget
Your budget is determined using information from your most recent assessment and screening documents. You must be assessed by your county case manager, tribal entity or health plan representative every year to remain in the program. If your needs stay the same, you should expect that your budget will remain about the same from year to year.

B. Write a community support plan
The community support plan is your roadmap for care. It addresses your assessed needs within your budget, and it may contain a mix of paid and unpaid services, and formal and informal supports. Your plan should include:

• Supports and services you need and plan to use
• Costs of each support or service – all funds must focus on the assessed needs of the disabled person, meet health and safety standards, and be fiscally responsible
• Qualifications of the people that will provide your services or supports
• Training you want your staff to have
• Plans to monitor your services or supports
• Goals and outcomes you hope to achieve

If you need help writing your plan or managing any element of your plan, you can hire a state-certified support planner. Ask you case manager for a current list.

C. Hire and supervise staff
You can choose to hire staff from a formal provider or hire people you know, like family, friends or neighbors. Minnesota Brain Injury Waiver Policy Essay. If you are already receiving services from an agency, you can choose to continue those services and pay for them out of your CDCS budget.

D. Hire a fiscal support entity
Your fiscal support entity bills the state for waiver services, provides payroll assistance and helps you develop the financial part of your community support plan to ensure it is within your budget amount. You may choose to have this person:

• Review time cards and expenditures
• Produce exception reports when you have overspent, underspent or when you have unapproved overtime
• Pay staff, reimburse families for expenses . Minnesota Brain Injury Waiver Policy Essay.