Employment and Day Supports Waiver - 2024 

 

 

Overview  (DDS Waiver Manual DRAFT)

 

Waivers granted by the Centers for Medicare and Medicaid Services (CMS) under Section 1915(c) of the Social Security Act authorize the Comprehensive Support Waiver, Individual and Family Support Waiver (IFS) and Employment and Day Supports Waiver (EDS).  DDS is considered the Lead Agency for day-to-day operations of the Comprehensive Supports, IFS and EDS waivers.  The Department of Social Services (DSS), as the Single State Medicaid Agency, oversees DDS' operation of the waivers.  The departments cooperate in the operation of the waivers under a Memorandum of Understanding that delineates each department’s responsibilities. State statute requires individuals to enroll in a Waiver in order to receive services from DDS.  By participating in these Medicaid Waiver programs, DDS is able to offer individuals more options for supports and services and the State is eligible for reimbursement from the federal government for approximately 50% of the cost for these services and supports. Each waiver has a specific dollar limit of services and supports that can be offered based on an individual’s assessed level of support need.

 

 

An individual’s Level of Need  is determined based on the results of a completed assessment tool.  The Level of Need is then correlated to an amount of funding that can be allocated to the individual for the purchase of services and supports.

 

 

The individual planning process results in the development of a comprehensive Individual Plan, which is the document to guide all supports and services provided to the individual.   With individual planning the person is viewed holistically to develop a plan of supports and services that is meaningful to him or her.  

 

Services and supports are identified to meet the person’s unique desires and needs, regardless of funding source and may include: waiver services, state plan services, generic resources, and natural supports.  Individual planning offers people the opportunity to lead self-determined lives and exercise greater control in their lives.

 

 

Any individual who is denied enrollment into one of the DDS HCBS waivers or who is denied requested waiver services has a right to request an evidentiary hearing from the Department of Social Services (the state Medicaid agency).  Notice of Fair Hearing Rights and the Hearing Request Form are provided to the individual with the written denial of enrollment or service.