Medicaid DDP 0208 Waiver Services

The Developmental Disabilities Program (DDP) offers long-term services through what is called a Medicaid Home and Community-Based Services (HCBS) waiver.

The DDP HCBS waiver is also called the 0208 or Comprehensive waiver.

This waiver pays for support services to help Montanans with intellectual and developmental disabilities to live in their homes and communities, instead of an institution.

There is a lengthy wait time for these services and people are encouraged to request placement on the waiting list as soon as eligibility has been established.

Eligibility

A person must be eligible to be receive services from the 0208 Waiver or to be on the 0208 Waiver waitlist. Eligibility is not based on income. Being eligible means that the person was born with a condition or experienced an illness or injury before the age of 18 that results in significant and permanent delays in development.

Children receiving Part C Early Intervention or Family Education and Support services meet temporary “at risk” eligibility requirements because they have either been diagnosed with a physical or mental condition that has a high probability of resulting in a developmental disability or have significant delays in thinking and reasoning skills, physical development (including vision and hearing), speech/language development, social/emotional development, and self-help skills. This “at risk” eligibility has to be replaced with formal eligibility by the DDP Eligibility Specialist by the age of eight.

Eligibility for people who are eight years or older is determined through the Developmental Disabilities Program and is separate from other programs. Receiving assistance from other programs does not affect a person’s potential eligibility for DDP-administered services.

Documentation of IQ score of approximately 70 or below:

Current Psychological or Neuropsychological Evaluation (within the last 3 years)
- The report must include an IQ score from standardized instrument administered by a licensed psychologist. If the report lists the person as “untestable” it must include information from Appendix K of the Determining Eligibility for Services for Persons with Developmental Disabilities in Montana: A Staff Reference Manual (6th Edition - 2013).

Documentation of intellectual disability, cerebral palsy, epilepsy, autism, or other neurological disabling condition closely related to intellectual disability and requiring treatment similar to that required by a person with an intellectual disability, which originated prior to age 18 and is expected to continue indefinitely:

Information from a physician, psychologist or neurologist that documents functional limitations to major life activities which are caused by the disability and expected to be life long, including self-care, self-direction, capacity for independent living and economic sufficiency;
Educational assessment information, Evaluation Report, and/or annual IEP;
Psychoeducational or adaptive assessment reports;
Medical reports with diagnostic information and treatment needs;
Psychiatric evaluations/reports; or
Social History/background information - narrative explaining when disability was first noted, any previous services, age of major developmental milestones and other significant personal history.

Adaptive Behavior Composite

Once the necessary documents are given to the DDP Regional Office a Vineland Adaptive Behavior assessment will be scheduled and conducted by a Quality Improvement Specialist, then the entire packet of documents is delivered to the DDP Eligibility Specialist.

If the available information supports eligibility, the person will be added to the 0208 Waiver Waiting List or maintain their place if already on the list. People who do not meet the eligibility criteria cannot receive or wait for 0208 Waiver services.

If you would like to see if you are eligible for DDP-administered services please fill out the information requested on the Eligibility Determination Checklist (this would be linked), gather the required documents and submit them to the nearest DDP Regional Office.

For more information how the eligibility process, please review the Determining Eligibility for Services to Persons With Developmental Disabilities in Montana: A Staff Reference Manual (6th Edition - 2013)

There is a waiting list for the 0208 Waiver. This is because waivers have limits to the number of people that can be served and the amount of funds available to meet their waiver service needs. People are selected off the waitlist generally based on length of time. Since July 2015, people have been automatically placed onto the waiting list for 0208 Waiver by DDP when formal eligibility has been determined. People are removed from the waiting list when offered 0208 Waiver services, or when they request so in writing. Your Targeted Case Manager, Family Support Specialist, or the DDP Regional Office can verify if you are on the waiting list.

Entry into the 0208 Comprehensive Waiver

When a person moves to the top of the waiting list and is selected into the 0208 Waiver, a letter is sent by the DDP. If a person accepts waiver services, a Targeted Case Manager (TCM) helps the person and their family with deciding which services would best meet the person’s needs.

The 0208 Waiver offers a variety of services to meet a person’s needs. These services may be delivered by enrolled providers or many services may be delivered via self-direction. Please go to the Self Direction Waiver Options page if you’d like more information in self-directing 0208 Waiver services.

The TCM helps the person find and choose a provider. Once the person has chosen a provider, the TCM helps the person and their team write a plan of care, called a Personal Support Plan (PSP)/ This plan outlines the person’s goals and is based on the services and supports the person and team have identified as important for the person to live a happy and healthy life in the community.

The PSP is updated every year and progress towards goals are reviewed mid-way through the year. Changes can be made to the person’s PSP anytime the person wants or when their needs have changed.

Service Type	Waiver Service	Overview	Traditional Provider	Self -Direction
Residential	Adult Foster	Provides payment for extraordinary care and support to the caregiver of a person living in a licensed adult foster home.	Yes	No
Residential	Assisted Living	Provides payment for a person with a developmental disability to live in a licensed assisted living setting.	Yes	No
Residential	Residential Habilitation Congregate Living	Services to assist people in acquiring, retaining, and improving self-help, socialization, and adaptive skills in a licensed group home.	Yes	No
Residential	Residential Habilitation Supported Living	Services to assist people in acquiring, retaining, and improving self-help, socialization, and adaptive skills for people living in their own, or family’s home.	Yes	No
Day & Employment	Day Supports & Activities	Teaching/training of skills and support provided in a day activity setting or the community.	Yes	No
Day & Employment	Retirement Services	Keeps people, who are of retirement age, engaged in their environment and community.	Yes	No
Day & Employment	Supported Employment Co-Worker Support	Job support provided by a person’s co-worker.	Yes	Yes
Day & Employment	Supported Employment Follow-Along Support	Services and supports to maintain employment in a competitive, customized, or self-employment setting.	Yes	Yes
Day & Employment	Supported Employment Individual Employment Support	Services and supports needed by a person to acquire or advance in a job or career in a competitive, customized, or self-employment setting.	Yes	No
Day & Employment	Supported Employment Small Group	Teaching and supports for groups of two to eight people with developmental disabilities working together in the general workforce.	Yes	No
In Home	Caregiver Training and Support	Training and support to caregivers who are not paid to provide training/teaching, companionship, or supervision.	Yes	No
In Home	Companion	Available to people 14 years old and older who live with family, friends, or on their own and need assistance with care, support, and socialization.	Yes	Yes
In Home	Environmental Modifications	Physical adaptations that are required by the member in order to live safely and have more independence at home.	Yes	Yes
In Home	Homemaker	General household activities such as meal preparation, cleaning, simple household repairs, laundry, shopping for food and supplies, and routine household care.	Yes	No
In Home	Meals	Meal services that help ensure a person receives adequate nourishment.	Yes	Yes
In Home	Personal Care	Assistance with hygiene, dressing, eating, supervision for health and safety reasons, and household tasks.	Yes	No
In Home	Personal Emergency Response System	An electronic device that a member can use to access help in an emergency.	Yes	Yes
In Home	Personal Supports	Assistance with homemaking, personal care, general supervision, and community integration.	Yes	Yes
In Home	Remote Monitoring	Electronic surveillance to provide oversight and monitoring within a supported living residence of a person, age 18 and older. Cameras are not permitted in bedrooms or bathrooms.	Yes	No
In Home	Remote Monitoring Equipment	Equipment or devices used to provide remote monitoring, and equipment used to engage in live two-way communication with the person being monitored.	Yes	No
In Home	Residential Training Support	Services to assist people in acquiring, retaining, and improving self-help, socialization, and adaptive skills for people living in a licensed adult foster home.	Yes	No
In Home	Respite	Provides for the safety, and daily care needs of a person while the primary caregiver takes a break.	Yes	Yes
Other	Behavior Support Services	Highly skilled assessment, and teaching others to carry out effective behavior interventions based on a written plan that uses positive approaches.	Yes	No
Other	Community Transition Services	One-time set-up expenses when a person transitions from an institution to an 0208 Waiver funded residential service.	Yes	Yes
Other	Companion	Available to people 14 years old and older who live with family, friends, or on their own and need assistance with care, support, and socialization.	Yes	Yes
Other	Individual Goods and Services	Services or supplies that enhance the person’s opportunities to achieve goals and be included in the community.	Yes	Yes
Other	Nutritionist	Meal planning, consultation and training provided by a registered dietician or licensed nutritionist.	Yes	No
Other	Occupational Therapy	Evaluation, consultation, treatment, and training to staff and caregivers by a licensed occupational therapist.	Yes	No
Other	Physical Therapy	Screening, evaluation, treatment, consultation and training to staff and caregivers by a licensed physical therapist.	Yes	No
Other	Private Duty Nursing	Medically necessary nursing services such as medical management, treatment, consultation and training for the person or their caregiver. Services are delivered by a registered nurse (RN) or licensed practical nurse (LPN), and are available only to people age 21 and older.	Yes	No
Other	Psychological Services	Evaluation, treatment, and consultation services delivered by a licensed psychologist, licensed professional counselor, or a licensed clinical social worker.	Yes	No
Other	Respite Other	Provides for the safety, and daily care needs of a person in a licensed day care while the primary caregiver takes a break.	Yes	Yes
Other	Specialized Medical Equipment & Supplies	Devices, controls or appliances that help people maintain or increase their independence; or items and supplies to address physical conditions that are not covered through Medicaid State Plan.	Yes	Yes
Other	Speech Therapy	Screening, evaluation, treatment, consultation and training to staff and caregivers by a licensed speech and language pathologist.	Yes	No
Other	Supports Broker	Assistance in arranging for, directing, and managing self-directed services.	No	Yes
Other	Transportation Commute	Transportation for the person to get to and from work or day services.	Yes	No
Other	Transportation Mileage Reimbursement	Reimburses a driver for some of the operational expenses of a vehicle when used to transport a person to/from work or day services, or community activities.	Yes	Yes
Other	Transportation Other	Reimburses for the cost of community transit such as bus passes or taxi fees for a person to get to and from work or day services, or community activities.	Yes	Yes
Other	Transportation Residential Integration	Transportation from a person’s residence to and from community activities.	Yes	No
Other	Transportation Work/Day Integration	Transportation from a person’s work or day setting to and from community activities.	Yes	No

DDP implemented the expanded Self-Direction with Employer Authority Option in the DDP Waivers beginning January 1, 2012.

Persons who are managing their own employees are encouraged to have the services of a Support Broker to provide assistance in Self-Directing services for the first year following choosing this option. A participant and/or their representative is advised to implement Self-Direction with Employer Authority for those services in which they manage their own employees once a Support Broker’s services have been obtained.

Support Broker services may be provided in an unpaid or paid capacity. Unpaid persons providing Support Broker services must have first passed the State of Montana DDP written Support Broker Certification Examination.

To be paid as a Support Broker, the broker must be certified by the State of Montana DDP. A link for the current list of Certified Support Brokers can be found below.

The Certified Support Broker lists should be supplied at the annual Individual Planning meetings after January 1. 2012 to all persons and their representatives who have expressed their desire to begin Self-Direction with Employer Authority.

List of Agency with Choice Providers