Waivers are designed to meet certain specific needs or provide different benefits than traditional Medicaid. They’re called “waivers” because some Medicaid parameters are set aside, or “waived.” All waiver programs must still provide cost-effective, quality health services as good or better than the person would receive in an institutional setting. Section 2176 of the Omnibus Reconciliation Act of 1987 permits states to offer, under a waiver, a wide array of home- and community-based services that an individual may need to avoid institutionalization.
Deeper dive
Within broad Federal guidelines, States can develop home and community-based services waivers (HCBS Waivers) to meet the needs of people who prefer to get long-term care services and supports in their home or community, rather than in an institutional setting. Among the services an individual may receive are: case management, homemaker, home health aide, personal care, adult day health care, habilitation, respite care and other services. Waivers also make innovative programs like Independence at Home possible. State HCBS Waiver programs must:
- Demonstrate that providing waiver services won’t cost more than providing these services in an institution
- Ensure the protection of people’s health and welfare
- Provide adequate and reasonable provider standards to meet the needs of the target population
- Ensure that services follow an individualized and person-centered plan of care
- States can waive certain Medicaid program requirements under HCBS Waivers