Medicaid Waiver Program Types

Explore the different types of Medicaid waiver programs and their goals

Table of Contents

 A comprehensive list of the types of agencies and other healthcare services:

1. Home Health Agencies (HHAs)

  • Provide skilled nursing, home health aide services, therapy services (physical, occupational, speech), and sometimes social services.
  • Licensed by state health departments, certified by Medicaid/Medicare.

2. Personal Care Agencies (PCAs)

  • Provide assistance with activities of daily living (ADLs) such as bathing, dressing, grooming, and meal preparation.
  • May offer non-medical care under Medicaid Waivers.

3. Adult Foster Care (AFC) Homes

  • Provide residential services to adults who cannot live independently but do not require a nursing home level of care.
  • Typically smaller, family-like settings.

4. Assisted Living Facilities (ALFs)

  • Offer housing, personal care, and some health services in a community setting.
  • Often serve individuals who need assistance with ADLs but not constant medical care.

5. Residential Group Homes

  • Provide 24-hour care and supervision in a group setting for individuals with developmental or intellectual disabilities.
  • Often serve individuals enrolled in Medicaid Waiver programs.

6. Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)

  • Provide residential care and active treatment for individuals with intellectual disabilities who require more intensive care than group homes.

7. Day Habilitation Programs

  • Offer services to individuals with disabilities to help them acquire, maintain, and enhance life skills through structured programs during the day.

8. Behavioral Health Agencies

  • Provide mental health services, substance abuse counseling, and psychiatric care to individuals enrolled in Medicaid Waiver programs.
  • Often licensed by state mental health departments.

9. Respite Care Providers

  • Offer temporary care to relieve primary caregivers of individuals with disabilities or chronic illnesses.
  • Services may be provided in-home, in respite centers, or through residential settings.

10. Hospice Agencies

  • Provide end-of-life care and support for individuals and their families, focusing on comfort rather than curative treatment.

11. Durable Medical Equipment (DME) Providers

  • Supply medical equipment like wheelchairs, oxygen equipment, hospital beds, and mobility aids.
  • Medicaid Waiver recipients often access these services through their Medicaid plans.

12. Waiver Service Coordination/Care Coordination Agencies

  • Provide case management and care coordination for individuals enrolled in Medicaid Waiver programs, ensuring access to the appropriate services and supports.

13. Private Duty Nursing Agencies

  • Provide in-home nursing services for individuals with complex medical needs that require continuous skilled nursing care.

14. Supported Employment Agencies

  • Help individuals with disabilities find and maintain employment.
  • These services may include job coaching, job placement, and ongoing support under Medicaid Waivers.

15. Transportation Service Providers

  • Offer non-emergency medical transportation for individuals who need help getting to medical appointments or day programs.

16. Behavioral Health Crisis Intervention Teams

  • Provide immediate support to individuals in psychiatric or behavioral crises.
  • These agencies often work in tandem with Medicaid-funded behavioral health services.

17. Early Intervention (EI) Providers

  • Offer services to children under 3 years old who have developmental delays or disabilities.
  • Funded by Medicaid and other early childhood education programs.

18. In-Home Supportive Services (IHSS) Agencies

  • Provide non-medical services that enable individuals to stay in their homes, including personal care, domestic assistance, and accompaniment to medical appointments.

19. Specialized Therapy Providers

  • Include providers offering physical therapy, occupational therapy, speech therapy, and other specialized rehabilitative services under Medicaid Waiver programs.

20. Pediatric Home Care Agencies

  • Focus on providing nursing care, therapy services, and personal care services to medically fragile children in their homes.

21. Community Mental Health Centers (CMHCs)

  • Provide mental health services, including outpatient counseling, psychiatric services, medication management, and case management to Medicaid recipients.

22. Family Counseling Agencies

  • Offer therapy and counseling services to families and individuals, including those covered under Medicaid Waivers for behavioral health or developmental disabilities.

23. Waiver Service Providers

  • Serve Medicaid Waiver recipients by offering specific services covered under various HCBS Waivers, such as homemaker services, personal care, respite, or environmental modifications.

24. Health Homes

  • Coordinate care for Medicaid recipients with chronic conditions by integrating primary, behavioral, and long-term services and supports.

25. Long-Term Care Facilities (LTCFs)

  • Include nursing homes and other institutional care settings that provide long-term medical and personal care to individuals who cannot live independently.

26. Community Living Supports (CLS) Providers

  • Offer assistance with daily living skills in a community setting for individuals with disabilities, focusing on helping them maintain independence.

27. Consumer-Directed Service Agencies

  • Allow individuals to hire and manage their caregivers directly under Medicaid Waivers, with the agency providing payroll and administrative support.

28. Program of All-Inclusive Care for the Elderly (PACE) Organizations

  • Provide comprehensive medical and social services to elderly individuals eligible for nursing home care but who prefer to stay in the community.

29. Independent Living Centers (ILCs)

  • Offer support and advocacy to people with disabilities to live independently in the community, including access to Medicaid Waiver services.

30. Autism Service Providers

  • Provide behavioral therapies, such as Applied Behavior Analysis (ABA), for children and adults with autism spectrum disorders, often through Medicaid Waivers.

31. Traumatic Brain Injury (TBI) Waiver Providers

  • Offer specialized services, including cognitive rehabilitation, case management, and behavioral health support for individuals with brain injuries.

32. Personal Emergency Response System (PERS) Providers

  • Supply devices that allow individuals to call for help in emergencies, often funded through Medicaid Waiver services.

33. Housing Support Services Agencies

  • Provide housing-related supports to Medicaid Waiver recipients, including finding housing, assisting with housing retention, and modifying homes for accessibility.

34. Rural Health Clinics (RHCs)

  • Provide primary care and preventive services to Medicaid recipients in rural and underserved areas.

35. Federally Qualified Health Centers (FQHCs)

  • Offer comprehensive primary and preventive healthcare services to underserved communities, including Medicaid recipients.

36. Medicaid Enrollment Broker Agencies

  • Assist individuals in navigating Medicaid Waiver program enrollment, eligibility, and choosing providers.

37. Substance Abuse Treatment Providers

  • Offer Medicaid-funded services for individuals with substance use disorders, including outpatient and inpatient treatment.

38. Community Care Organizations (CCOs)

  • Provide care coordination and management services for individuals with developmental disabilities, especially those on Medicaid Waivers.

This list covers various agency types that operate within the Medicaid Waiver and broader healthcare field, offering services that range from personal care to medical, rehabilitative, and behavioral health services across the United States.
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Need help starting any one of these programs? Visit www.waivergroup.com or call 302.888.9172