Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-10.0 - INDEPENDENT LIVING WAIVER ELIGIBILITY

Current through June 25, 2024
The Independent Living (IL) waiver provides services to clients who, but for the provision of such services, would require the level of care found in a nursing facility. The IL Waiver is a Medicaid home and community-based waiver operated jointly with the Division of Medicaid.
Eligibility is limited to individuals age sixteen (16) or older who have severe orthopedic and/or neurological impairments and possess maximum medical improvement potential. Maximum medical improvement potential, as defined by DOM, has been achieved when all of the following criteria are met:
* Client/applicant is able to communicate effectively with caregiver, Personal Care Attendants (PCA's, Counselors and others);
* Client/applicant is certified as medically stable by their primary physician. Medical stability is defined as the absence of the following:
* an active, life threatening condition (e.g. sepsis, respiratory, or other condition requiring systematic therapeutic measures);
* intravenous drip to control or support blood pressure;
* inter-cranial pressure or arterial monitoring; and
* a diagnosis of dementia, Alzheimer's, mental illness, mental retardation or any related condition of such severity that renders the individual unable to direct his/her own care.
Clinical eligibility for the IL waiver will be determined through the utilization of a comprehensive pre-admission screening tool which encompasses the following areas: activities of daily living, instrumental activities of daily living, sensory deficits, cognitive deficits, client behaviors, medical conditions, and medical services.
Clients/applicants must be Medicaid eligible either as an SSI recipient or meet the 300% of the Supplemental Security Income Federal benefit rate.
Note:
All services are provided pursuant to an individualized plan of care approved by the Division of Medicaid and the development of an Independent Living Plan.
Additional Eligibility for Enrollment:
The basic eligibility criteria include:
* age - be 16 years of age or older
Note:
Elderly and Disabled Waiver serves individuals 21 years of age and older.
MR/DD Waiver services children under age 21.
* financial eligibility the individual must be eligible for Medicaid as described in the waiver
* medical necessity the individual must meet the level of care criteria for nursing facility (NF) care based on Physician Certification Form.
* waiver specific criteria the individual must meet based on his/her choice of services and service planning. They must:
- have a severe orthopedic and/or neurological impairment
- choose home and community based services in lieu of nursing facility care/informed choice;
- have an on-going need for waiver services;
- need assistance with one or more of the activities of daily living such as dressing, bathing, eating, toileting, transferring;
- be able to communicate effectively with caregivers, Personal Care Attendants, case managers, and others involved in their care, and
- be at risk of nursing facility placement if services were not available
Enrollment in the Independent Living Waiver is limited to:
* the number of individuals approved by the Centers for Medicare and Medicaid Services (CMS) or the availability of state funding
* individuals are enrolled from the Independent Living Waiver Referral List on a "first come, first served" basis
* MDRS suspends enrollment into the waiver program when it is determined that the existing caseloads exceed funds within the current budget year.