Title XIX Home & Community
Based Waiver Services for the Elderly

The Title XIX Home and Community Based Waiver allows the Department to use Title XIX Medicaid to provide home and community based services to elderly individuals who require nursing services and otherwise would be institutionalized.

Target Population

Individuals most appropriate for this waiver include vulnerable elderly individuals who have chronic health problems, which limit their ability to function independently in the community.

Eligibility

In order to qualify, the following must occur:

• Must be age 18 years or older.
• Receiving SSI or eligible for Medicaid if institutionalized: Chapter 67:46
  
• Completion of an assessment: Chapter 67:44:01:02
  
• Not a resident of a hospital, nursing facility, or an ICF/MR.
  
• Anticipated monthly Home and Community Based Waiver cost does not exceed 85 percent of the current state average nursing facility rate.
  
• The Individual Care Plan requires one or more approved services.

Services

Services provided through the waiver include:

• Homemaker Services
  
• Private Duty Nursing
  
• Adult Day Services
  
• Emergency Response System
  
• Meals and/or Nutritional Supplements
  
• Specialized Medical Equipment/Supplies
  
• Medication Administration in Assisted Living
• Respite Care (added in 2007)

All clients receive some degree of nursing through an Individual Care Plan (ICP), whether through the waiver, obtained from their physician in a clinic, Medicare, or through requirements of the administration of medications within the assisted living facility.

Links

• Social Security Administration – SSI
  
• What you need to know when you get SSI
  
• South Dakota Medicaid Skilled Home Health Care
  
• Assisted Living