MEDICAID SERVICES AT A GLANCE State Plan Mandatory ...

MEDICAID SERVICES AT A GLANCEState Plan Mandatory Services (1) State Plan Optional Services (2) DD Home & Community Based Waiver Services (3)Inpatient hospital Birthing Center COMPREHENSIVE, COMMUNITY SUPPORT, LOPEZ,Outpatient HospitalDentalAUTISM & PARTNERSHIP WAIVERSPhysician Lab/X-ray Pharmacy Personal Assistant* (allows Self-Directed Option)Nursing facility over 21 Psychiatric over 65 Environmental accessibility adaptations/ homemodificationHome Health over 21 Medicare Part B (Buy-in) Specialized medical equipment and supplies/adaptiveequipmentFamily planning Ambulance (emergency only) TransportationNurse midwife Home health under 21 Support Broker* (allows Self-Directed Option)Rural health clinic servicesOptometricFederally Qualified Health Centers Nursing facility (ICF/SNF) COMPREHENSIVE,COMMUNITY SUPPORT, LOPEZ &AUTISM WAIVERS ONLYCertified nurse practitioners ICF/MR Respite In Home* (allows Self-Directed Option LopezOnly)EPSDT/HCY ONLY (Under 21 only)-- Durable medical equipment (DME) Respite Out of HomeSpeech therapyHearing aid (audiology)Occupational therapy Podiatry COMPREHENSIVE, COMMUNITY SUPPORT, LOPEZ &PARTNERSHIP WAIVERS ONLYPhysical therapy Clinic services Community Specialist *(allows Self-Directed Option)Psychology counselingRehabilitation servicesPrivate duty nursing Ambulatory surgical care COMPREHENSIVE, COMMUNITY SUPPORT &PARTNERSHIP WAIVERS ONLYCase management Psychiatric services under 21 Professional Assessment and MonitoringOrthodontics Personal care Occupational TherapyImmunizations Adult day care Speech TherapyOther medically necessary services Transplants Physical TherapyScreening services-- Transportation Community EmploymentPhysical development Targeted case management-- Day ServiceAnticipatory guidance Pregnant women Job PreparationDental MRDD Job DiscoveryVision CPS (adults) Assistive TechnologyHearing SED (children) Positive Behavior SupportsLead assessmentHCBS Waiver-ElderlyRespiteCOMPREHENSIVE WAIVER ONLYHomemaker/ChoreAdvanced RespiteHCBS Waiver-MRDDComprehensiveCommunity SupportMOCDD (Lopez)HCBS Waiver-Physical DisabilitiesHCBS Waiver-Independent LivingHCBS Waiver-AIDSSkilled nursing facility under 21HospiceComprehensive day rehabilitationservices for head injuredCommunity psychiatric rehabilitationservices (CPR)Residential personal careGroup HomeIndividualized supported livingHost Home (Shared Living)Community TransitionCOMPREHENSIVE, COMMUNITY SUPPORT, AUTISM& PARTNERSHIP WAIVERS ONLYBehavior AnalysisPARTNERSHIP WAIVER ONLYDentalTemporary ResidentialEmployer Provided Job SupportsPersonal Electronic Response SystemCOMPREHENSIVE & COMMUNITY SUPPORTWAIVERS ONLYOctober 17, 2011

Psychotherapy 21 & overDiabetic supplies & educationCounselingCommunication SkillsCOMPREHENSIVE, COMMUNITY SUPPORT & LOPEZWAIVERS ONLYCrisis InterventionLOPEZ WAIVER ONLYBehavior TherapyDay Habilitation*Allows for a Self-Directed Option(1) All individuals who are eligible for Medicaid under regular guidelines are eligible for services in this column except EPSDT/HCY if over age 20.(2) All individuals who are eligible for Medicaid under regular guidelines are eligible for these services if they meet the specific eligibility requirements. These servicesmay be limited in scope or duration and may be limited to specific populations.(3) Individuals who participate in the Comprehensive, Community Support & Autism Waivers are eligible for services in column (1) (except EPSDT/HCY services if overage 20), and services in column 2 if they meet specific service eligibility requirements; individuals who participate in the Lopez waiver are eligible for all services incolumns (1) and (2) when they are medically necessary.(4) Individuals must be at least age 3 and no older than age 18 and must have an Autism Spectrum Disorder as per the DSM-IV or later.October 17, 2011