Wyoming Medicaid Facts

The State of Wyoming

Wyoming Medicaid Resources

Wyoming Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 9,800 people with disabilities who are covered by Medicaid in Wyoming. Wyoming spent $19,762 for each Medicaid recipient with a disability in 2007.

13% of people using Medicaid in Wyoming have a disability, while the national percentage of Medicaid recipients who have a disability is 15%.

Wyoming spends 45% of all the money it spends on Medicaid on services for people with disabilities, while the national percentage of Medicaid spending on these services is 42%.

Wyoming HCBS Waiver Programs

Acquired Brain Injury waiver:

This waiver applies to people who have acquired brain injuries.

Ages: 21 to 64

Option for Self-Direction: This waiver allows people with disabilities to make choices about their own care.

Health: day habilitation, occupational therapy, physical therapy, speech therapy, cognitive retraining, dietician services, skilled nursing, specialized equipment
Home: homemaker, personal care, residential habilitation, respite, supported living, companion services, environmental modifications, home support, unpaid caregiver training and education
Social Services: case management, support broker
Work: integrated employment, prevocational services

Adult Developmental Disabilities waiver:

This waiver provides services for people who have developmental disabilities.

Ages: 21 and older

Option for Self-Direction: This program has options for people with disabilities to have a role in choosing their own care.

Health: day habilitation, occupational therapy, physical therapy, speech therapy, dietician services, skilled nursing, specialized equipment
Home: homemaker services, personal care, residential habilitation, respite, supported living, companion services, environmental modifications, in home support, unpaid caregiver training and education
Social Services: case management, support broker
Work: integrated employment, prevocational services

Child Developmental Disabilities waiver:

This waiver helps pay for services that normal Medicaid will not cover for children who have a developmental disability. Under this waiver these services can be provided in the home or community instead of in a residential facility.

Ages: under 20

Level of Care: intermediate

Options for Self-Direction: This waiver provides chances for people with disabilities to direct their own care.

Health: dietician services, skilled nursing, specialized equipment
Home: homemaker services, personal care, residential habilitation, respite care, special family habilitation in the home, companion services, environmental modifications, supported living, training and education for unpaid caregivers
Social Services: case management, support broker
Work: integrated employment

Assisted Living Facility HCBS waiver (ALF waiver):

This waiver provides support to people who want to live in their own homes instead of in nursing homes. This waiver will not pay for room and board.

Ages: 19 to 64 for people with disabilities, 65 and older for people with or without disabilities

Level of Care: nursing

Health: 24-hour supervision
Home: personal care
Social Services: case management

Long-Term Care (LTC HCBS) waiver:

This waiver is intended to provide needed services in people’s homes and communities rather than in a nursing home.

Level of Care: nursing

Restrictions: not all services are available in all counties.

Community: non-medical transportation, adult day care
Health: personal emergency response systems, skilled nursing
Home: personal care, respite care, home-delivered meals
Social Services: case management

Wisconsin Medicaid Facts

Wisconsin Medicaid Resources:

Wisconsin Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 142,700 people with disabilities who are covered by Medicaid in Wisconsin. Wisconsin spent $14,574 for each Medicaid recipient with a disability in 2007.

14% of people using Medicaid in Wisconsin have a disability, which is almost the same as the national percentage of Medicaid recipients with a disability (15%).

Wisconsin spends 43% of all the money it spends on Medicaid on services for people with disabilities, which is also almost the same as the national percentage of Medicaid spending on these services (42%).

Wisconsin Basic Medicaid Programs

Badgercare:

Wisconsin runs a program, called BadgerCare, for low-income families who have children under the age of 19, are uninsured, and do not qualify for Medicaid. If you do not qualify for Medicaid, this program is another way to get basic insurance.

Medicaid SSI Managed Care Program:

This program provides services to adults with disabilities who receive or are eligible to receive SSI. It covers some people who are also eligible for Medicare, but does not cover any children, people in family care, people in nursing facilities or intermediate care facilities, or anyone participating in the HCBS waiver.

Ages: 19 and older

Community: recreational and wellness programming, transportation
Health: dental, durable medical equipment, early and periodic screening, diagnosis, and treatment, family planning, hearing, hospice, hospitalization, immunization, mental health and substance abuse treatment, laboratory, pediatricians, physician services, skilled nursing facilities, vision, x-ray
Home: home health care, personal care
Social Services: coordination with social and vocational services

Wisconsin Family Care:

This program serves adults with disabilities and other people, including people who are eligible for also Medicare. This program is meant to supplement primary care covered by other insurance.

Community: transportation
Health: disposable medical supplies and durable medical equipment, private-duty nursing, intermediate care facilities, in-home psychotherapy, language pathology, mental health community support, occupational therapy, outpatient mental health treatment, substance abuse treatment, physical therapy, respiratory therapy, skilled nursing care, speech therapy
Home: home health care, personal care
Social Services: case management

Children Come First:

The goal of this program is to serve children who have mental health needs in their community and help keep them out of institutions. This program provides many services not usually covered by Medicaid and aims to have very personalized care plans. It does not cover people who are also eligible for Medicare, or people who participate in the HCBS waiver.

Community: community support programs
Health: crisis management, emergency services, psychiatric hospitalization if needed, inpatient treatment programs for mental health and substance abuse, rehabilitation, support services, outpatient substance abuse treatment
Social Services: targeted case management

Wraparound Milwaukee (Milwaukee County):

This program provides the same kinds of supports to the same eligible individuals as the Children Come First program, described above. It is a program that takes money that used to pay for institutional treatments and puts it toward community-based care for children with special mental health needs. It provides the same kinds of services as Children Come First, but only to people who live in Milwaukee County.

Restrictions: This program is only run in Milwaukee County.

Wisconsin Partnership Program:

This program is supposed to integrate home and community based services and other kinds of medical care for adults with disabilities and older adults. Some people who are also eligible for Medicare are covered under this plan.

Ages: 18 to 64 for people with disabilities, 65 and over for people with or without disabilities

Level of Care: nursing

Community: transportation
Health: dental, durable medical equipment, family planning, hearing, hospice, immunization, hospital services, mental health, substance abuse treatment, laboratory, pharmacy, physician, skilled nursing facilities, vision, x-ray
Home: home health care
Social Services: case management

Program of All-Inclusive Care for the Elderly (PACE):

PACE programs are designed for people 55 and older who need nursing care, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary.

Ages: 55 and older

Level of Care: nursing

Restrictions: you must live close enough to an approved PACE care center to be eligible.

Community: day care, health-related transportation
Health: primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs
Home: home care, home and environmental modifications
Social Services: case management

Wisconsin HCBS Waiver Programs

Brain Injury waiver:

This waiver covers people who are disabled as the result of a brain injury, regardless of how old they were when the injury happened.

Level of Care: nursing

Community: day services
Home: alternative living arrangements, supported home care
Social Services: case management

Community Integration Program (CIP) for people with developmental disabilities:

This waiver provides transitional support for people with developmental disabilities who want to move out of state centers or nursing homes back into their communities. It can also help people who do not want to move into institutions remain at home.

Ages: 18 and older

Option for Self-Direction: This waiver offers self-directed services.

Community: adult day care, specialized transportation
Health: daily living skills training, adaptive aids, communication services, client education and training, counseling and therapy, nursing, personal emergency response systems, specialized medical and therapeutic supplies
Home: live-in caregiver, respite, one to four bed adult family homes, home delivered meals, home modifications, housing counseling, housing start-up costs, supportive home care
Social Services: support and service coordination
Work: prevocational services, supported employment

Community Options Program (COP) waiver:

This waiver serves older adults and adults with disabilities. It is designed to help people remain at home in the community instead of moving into nursing homes.

Ages: 18 to 64 for people with disabilities, 65 and older for people with and without disabilities

Community: adult day care, transportation
Health: daily living skills training, adaptive aids, communication aids, counseling and therapeutic services, nursing services, personal emergency response systems, specialized medical equipment and therapeutic supplies
Home: respite, one to four bed adult family homes, community-based residential facilities, home delivered meals, home modifications, housing start-up costs for people who relocate to their communities, residential care apartment housing, supportive home care
Social Services: case management
Work: job planning

Family Care Aged and Physically Disabled waiver:

This waiver provides services to older adults and to adults with physical disabilities.

Ages: 18 to 64 for adults with physical disabilities, 65 and older for adults with or without disabilities

Option for Self-Direction: this waiver gives people with disabilities the opportunity to direct their own care.

Community: adult day care, day center services, relocation services, specialized transportation
Health: habilitation, skilled nursing services, adaptive aids, communication aids, consumer education, counseling and therapeutic resources, personal emergency response systems, specialized medical equipment and supplies
Home: respite, adult family homes, residential apartment complexes, environmental accessibility adaptations, home delivered meals, housing counseling, supportive home care
Social Services: case management, daily living skills training, support broker
Work: prevocational, supported employment, vocational futures planning

Family Care MR/DD waiver:

This waiver provides community-based supports for adults who have intellectual and developmental disabilities.

Ages: 18 and older

Option for Self-Direction: This waiver allows people with disabilities to direct their own services.

Community: adult day care, day center service, relocation services, specialized transportation
Health: skilled nursing, adaptive aids, communication aids, consumer education and training, counseling and therapeutic resources, personal emergency response systems, specialized medical equipment and supplies
Home: respite, adult family homes, community-based residential facilities, residential apartment complexes, environmental accessibility adaptations, home delivered meals, housing counseling, supportive home care
Social Services: case management, daily living skills training, support broker
Work: prevocational services, supported employment, vocational futures planning

Self-Directed Support waivers (IRIS):

This waiver provides adults with opportunities for making decisions about their own care. Under this plan, people with developmental disabilities work together with their families and state agencies to make a unique support plan that is right for them and gives them the kind of life they want. There is also a version of this program that serves older adults and adults who have physical disabilities.

Ages: 18 and older

Options for Self-Direction: This waiver encourages people with disabilities to be in charge of their own care.

Community: adult day care, day services, specialized transportation
Health: nursing, adaptive aids, communication aids, consumer education and training, counseling and therapeutic services, personal emergency response systems, specialized medical equipment and supplies,
Home: live-in caregiver, respite, adult family home, home delivered meals, home modifications, housing counseling, housing start-up costs, residential care apartment complex, supportive home care
Social Services: daily living skills training, support broker
Work: prevocational services, supported employment, vocational planning

West Virginia Medicaid Facts

West Virginia Medicaid Resources:

West Virginia Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 109,000 people with disabilities who are covered by Medicaid in West Virginia. West Virginia spent $9,777 for each Medicaid recipient with a disability in 2007.

28% percent of people using Medicaid in West Virginia have a disability, which is almost double the national percentage of Medicaid recipients who have a disability (15%).

Half of all the money West Virginia spends on Medicaid is spent on services for people with disabilities, which is also higher than the national percentage of Medicaid spending on these services (42%).

West Virginia Basic Medicaid Programs

Mountain Health Trust:

This program provides children and adults with disabilities access to basic medical services. You may not always get to choose your service provider under this plan. Different services might be available in different counties. Services available might also differ if you receive care under the HCBS waiver.

Health: chiropractic, dental, disease management, durable medical equipment, early and periodic screening, diagnosis and treatment, family planning, hearing, hospice, immunization, hospital, laboratory, occupational therapy, physical therapy, physician, podiatry, speech therapy, vision, x-ray
Home: home health care

Mountain Health Choices:

This program covers children who have special needs (disabilities) and may cover some adults with disabilities as well. People who also qualify for Medicare are not eligible for this program. Children are guaranteed one year of eligibility.

Community: non-emergency transportation
Health: dental, durable medical equipment, early and periodic screening, diagnosis, and treatment, family planning, hospice, immunization, hospital services, mental health, laboratory, physician, prescription drugs, skilled nursing facilities, vision, x-ray
Home: home health care

West Virginia HCBS Waiver Programs

MR/DD waiver (Developmental Disabilities waiver):

This waiver serves people with intellectual and developmental disabilities of all ages. In order to qualify, the disability or related condition must be apparent before the person turns 22.

Level of Care: intermediate

Community: transportation
Health: nursing services, day habilitation
Home: respite, residential habilitation, adult companion services, environmental accessibility modifications
Social Services: service coordination
Work: prevocational services, supported employment

Aged and Disabled waiver:

The aged and disabled waiver provides community-based alternatives to nursing home care.

Ages: 18 to 64 for people with physical disabilities, or 65 or older for people with or without disabilities

Level of Care: nursing

Option for Self-Direction: This waiver allows people with disabilities to control some of their own care.

Home: homemaker services, personal assistance
Social Services: case management

Washington Medicaid Facts

Washington Medicaid Resources:

Washington Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 173,700 people with disabilities who are covered by Medicaid in Washington. Washington spent $12,999 for each Medicaid recipient with a disability in 2007.

15% of all people covered by Medicaid in Washington have a disability, which is the same as the national percentage of Medicaid recipients with a disability.

Washington spends 42% of all the money it spends on Medicaid on services for people with disabilities, which is also the same as the national percentage of spending on these services.

Washington Basic Medicaid Programs

Integrated Mental Health Services Program:

This program provides mental health services to adults and children with disabilities who need mental health care. You may not always get to choose your service provider under this plan.

Health: crisis management, inpatient and outpatient treatment, rehabilitation
Social Services: case management

Chronic Care Management Plan:

This program provides disease management services to adults with disabilities and other chronic health conditions. Children and people also eligible for Medicare are not eligible for health care through this program.

Community: education about health care
Social Services: coordination with other services

Washington Medicaid Integration Partnership:

This program covers adults with disabilities and children with “special needs” as defined by the state of Washington and the BBA (this will include most children with disabilities). It provides coverage to people who are also eligible for Medicare.

Health: disease management, durable medical equipment, family planning, hearing, hospice, immunization, hospitalization, mental health, substance abuse treatment, laboratory, long-term care, occupational therapy, pharmacy, physical therapy, physician services, podiatry, speech therapy, vision, x-ray
Home: home health care

Program of All-Inclusive Care for the Elderly (PACE):

Ages: 55 and older

Level of Care: nursing

Restrictions: You must live close enough to a PACE center to be eligible.

Community: day care, health-related transportation
Health: primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs,
Home: home health care, home and environmental modifications
Social Services: social services

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