MEDICAID

Medicaid provides funding for basic medical services for eligible children, such as hospitals, prescription drugs, and physician charges. Children with special needs may also receive coverage of medical supplies such as diapers and dietary formulas and disability-related equipment such as wheelchairs, braces, and bath lifts.
 

Personal Care Aid: This Medicaid service can help children with disabilities by providing relief to parents from their chil's day to day personal care needs. Designated workers recruit and approve providers, determine client eligibility, assess needs, and process payments.

Home Health Care: Along with traditional assistance, home health care can provide instruction to parents on meeting needs of children with disabilities. Staff determines needs eligibility and authorize and process payments.

Psychiatric Services: Medicaid's psychiatric components include home-based services, inpatient and outpatient services, and therapeutic foster homes. Department staff provide recruitment, placement, case management, and payment.

Healthcheck: Healthcheck is a free health program for anyone under 21 who is eligible for Medicaid. It provides complete checkups on a regular basis and provides diagnosis and treatment for any health problems found at a checkup. Healthcheck is the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program in Nebraska.

Meals and Lodging: Hospitals which contract with Medicaid as ambulatory room and board providers may provide meals and lodging for a child (while outpatient) and/or an attendant (while the child is hospitalized) in certain situations.

"KATIE BECKETT" PLAN AMENDMENT

This is a special means of determining Medicaid eligibility. It allows Medicaid funds to be used for children with severe medical complications whose care needs are normally provided in a hospital setting. In these special cases, parents' income is not counted in determining Medicaid eligibility. This allows Medicaid to pay for services in the child's home rather than in the more expensive facility setting. Workers identify children who may qualify and medical assessment of eligibility is handled at Central Office. The Department contracts for nurse case management for children eligible under the "Katie Beckett" plan amendment and their families.

AGED AND DISABLED MEDICAID WAIVER

This waiver allows the Department to use Medicaid funds to meet needs of Medicaid-eligible children with high medical/care needs by purchasing services not traditionally considered "medical." These services are respite care, transportation, independence skills management, and child care for children with disabilities. DSS staff recruit and approve providers, determine client eligibility, assess, refer, plan, and authorize and process payments.

WAIVER FOR CHILDREN WITH MENTAL RETARDATION AND THEIR FAMILIES

This waiver provides Medicaid funding for children to age 21 or end of special education or younger with developmental disabilities who would otherwise require ICF/MR level of care. This funding provides for family supports and/or community-based services. Services included under the waiver are: habilitation, respite care, homemaker, habilitative day care, and environmental modifications. The Department's Disability Services Specialists determine client eligibility, prior authorize services, review and approve individual and family support plans, and perform ongoing monitoring of plan implementation.

EARLY INTERVENTION WAIVER

This waiver provides Medicaid funding for children birth through the end of a school's fiscal year, August31, in which the child reaches age three. Eligible children must meet nursing facility level of care criteria and be participating in Nebraska Early Intervention services coordination. Early Intervention Waiver services include up to $100.00 per month for respite care. Early Intervention Services Coordinators initiate the eligibility determination process and assist in arranging the provision of respite care services.

EARLY INTERVENTION SERVICES COORDINATION

DSS contracts with community agencies to provide services coordination for eligible infants and toddlers (birth to age 3). Early intervention is a family-centered, interagency system supported by DSS, the Department of Education, the Nebraska Interagency Coordinating Council (NICC), the 29 planning region teams, and communities. Children with high medical needs may also receive respite funding through the Early Intervention Medicaid Waiver.

STATE SUPPLEMENTAL SPECIAL NEEDS

Supplements may be made to assistance grants to cover disability-related expenses. These special needs of AABD recipients are handled by income maintenance.

SOCIAL SERVICES FOR FAMILIES WITH CHILDREN

In addition to transportation and homemaker services available through this program, this program can serve children with disabilities in special ways such as providing childcare for a sibling while a child with a disability is hospitalized and the caregiver is at the hospital. This program can purchase airfare to fly a child with a disability and his/her parent to Mayo Clinic, for example. Department staff provide case management, determine eligibility, assess needs, and authorize payments.

CASE MANAGEMENT PLAN AMENDMENT

Case management services coordination of resources to develop and attain client goals and access needed medical, social, and other services are provided by Social Service Block Grant on behalf of children who are Medicaid-eligible. Case management is also provided for children with developmental disabilities by the Department of Public Institutions.

MEDICALLY HANDICAPPED CHILDREN'S PROGRAM

MHCP pays for special medical care for children with certain diagnoses. In addition, the program provides multi-disciplinary evaluations for children in clinic settings. Comprehensive, coordinated medical care is provided through the development of an individual medical treatment plan for each child. MHCP staff in district offices determine eligibility, set plans, authorize services, coordinate clinics, and process billings.

SUPPLEMENTAL SECURITY INCOME -- DISABLED CHILDREN‰S PROGRAM

SSI-DCP is a component of MHCP, which serves children who are eligible for SSI and are age 0 through 15. Assistance is available for disability-related expenses such as respite care, architectural modifications, and assistive devices. Needs assessment, planning, case management, and payment authorization are handled by MHCP workers.

DISABLED PERSONS AND FAMILY SUPPORT PROGRAM

This program is designed to support low and median income families who are caring for their child with a disability at home. Services include costs during treatment (such as meals and lodging), respite care, and special equipment (such as wheelchair lifts and ramps). Central Office staff, together with a committee of representatives form other state and private agencies, meet to discuss possible resources for each applicant. Central Office staff provide referral, case planning, and payment authorization and processing.

NEBRASKA RESOURCE REFERRAL SYSTEM (NRRS)

The Department is host to NRRS, an automated referral directory of resources of all types for persons of all ages. Some resources may be accessed by phone; others by personal computer.

STATE WARD SERVICES

When DSS assumes Custody of a child, under court order (due to abuse, neglect, etc.), the Department is responsible for assuring that all the child's needs are met. Therefore, when a ward has a special need, the Department must meet those needs, either directly (e.g., location, training, and support of a specialized foster family, exceptional payment level for service purchase) or indirectly (advocacy, locating appropriate medical care). DSS staff provides case management, including service coordination, communication, and planning.

SUBSIDIZED ADOPTION

The Department provides assistance to families to remove barriers to adoption, including financial assistance or assistance in meeting medical needs of the child. Before the adoption, staff determine eligibility and assist the family in determining the type and amount of assistance. This is reviewed annually.

January, 1996