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Home and Community-Based PAS > Reports > Medicaid Research and Demonstration Waivers

Home and Community-Based Services:
Medicaid Research and Demonstration Waivers.

Martin Kitchener, Micky Willmott, Alice Wong & Charlene Harrington.
UCSF National Center for Personal Assistance Services.

Updated November 2006.

Notes and sources
• The table includes all programs reported by CMS as being 1115 ‘research and demonstration’ programs and all 1915(c) IP waiver programs. Unless otherwise stated, information is from CMS ‘A Map of State Waiver Programs and Demonstrations’. At: http://www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/08_WavMap.asp (Accessed 11/17/06).
• States marked * received IP Systems Change Grants from CMS in 2003.
• N/A denotes where the information was not available. RWJF is the Robert Wood Johnson Foundation.

ⁱ This refers to the section of the Social Security Act under which the waiver has authority.
ⁱⁱ The date the first application was submitted regardless of whether amendments have been made to the original waiver design
ⁱⁱⁱ The date the application was first approved by CMS regardless of whether amendments have been made to the original waiver design.
^iv This is the date that the waiver was first implemented, regardless of any subsequent amendments to the program design.
^vThe expiry date is the most recent approved expiration date for the waiver.
^vi The target group categories are those used by the CMS to categorize different population groups covered by waivers.
^vii Another 1115 waiver program ‘Colorado Alternatives in Medicaid Home Care’ was approved Oct 1997. It would permit greater flexibility in defining where Medicaid home health visits can occur, so that visits can be made in schools, work sites or day treatment centers and would allow delegation of some skilled nursing functions to allow people flexibility in selecting home health aides of their choice. The limit would be 200 slots but it is not expected to be implemented. There are two other proposed 1115 waiver programs, Children's HCBS Program with Premium and Children's Extensive Support Program with Premium, these would replace existing 1915(c) programs for children with disabilities and would provide self-directed or family-directed in-home support services (http://www.chcpf.state.co.us/HCPF/MedicaidEligibility/mefcc.asp).
^viii Florida received approval to convert it's ‘Cash and Counseling’ 1115 Demonstration waiver to an IP waiver (Dec 2003). From 2004 the program no longer has an experimental design (http://cdcplus.org/).
^ix Formerly known as Consumer Directed Care.
^x This includes adults with TBI/SCI who are eligible for the Florida TBI/SCI waiver at the time they seek to enroll.
^xi Louisiana has a 1915(c) HCBS waiver serving people with lost sensory or motor function that was amended in 2000 to allow consumer directed PAS. It is not an IP program.
^xii This figure is for year 3 of the program. The number of approved slots available in year 1 are 4,251 and year 2 are 4,576.
^xiii This refers to the section of the Social Security Act under which the waiver has authority.
^xiv The date the first application was submitted regardless of whether amendments have been made to the original waiver design.
^xv The date the application was first approved by CMS regardless of whether amendments have been made to the original waiver design.
^xvi This is the date that the waiver was first implemented, regardless of any subsequent amendments to the program design.
^xvii The expiry date is the most recent approved expiration date for the waiver.
^xviii The target group categories are those used by the CMS to categorize different population groups covered by waivers.
^xix Information direct from the state website, state officials state that the waiver will begin early in 2005.
^xx Figure is the proposed number of slots in the 3rd (final) year of the waiver. In year 1, the proposed number of slots is 200, In year 2 the proposed number of slots is 400. North Carolina's application for the IP 1915(c) waiver, Appendix G – Financial Documentation, p.50. Available at: http://www.cashandcounseling.org/resources/20060118-130916/northcarolina.doc
^xxi Number of slots in the final year of the program. In year 1 the number of approved slots is 180, in year 2 the number of slots is 190.
^xxii New Jersey is converting the Cash & Counseling 1115 Demonstration waiver to an IP 1115 waiver as the program no longer has an experimental design. In the meantime, the state still has 1115 demonstration authority until April 2005. CMS Approval Letter – Revised implementation Date. http://www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/MWDL/itemdetail.asp?filterType=data&filterValue=New%20Jersey&filterByDID=2&sortByDID=2&sortOrder=ascending&itemID=CMS048009.
^xxiii Number of slots in the final year of the program. In year 1, the number of approved slots is 300, in year 2 the number of slots is 600