Technology Assisted Waiver

Virginia Department of Medical Assistance Services
600 E. Broad St, Suite 1300
Richmond, VA 23219
(804)786-7933
dmasinfo@dmas.virginia.gov

The Technology Assisted Waiver (Tech Waiver) is a Medicaid program that provides eligible individuals with services in their home and community. This waiver provides a variety of services to individuals who need a medical device to compensate for the loss of a vital body function, who require ongoing skilled nursing care and who choose home and community based services as an alternative to institutional care in a specialized care facility. While assistance with the cost of room and board is not available through Medicaid waivers, waivers provide supports that help individuals to live as independently as possible in the community.

Who qualifies for services?

• Individuals who are dependent on a medical device and require ongoing skilled nursing care.
• Individuals 21 and older must spend at least part of each day on a mechanical ventilator or meet complex tracheotomy criteria.
• Individuals under the age of 21 may qualify based on various methods of respiratory or nutritional support.
• Individuals who meet Medicaid eligibility criteria as determined by the local department of social services (DSS). Parents income and resources are not considered by DSS when making a financial eligibility determination for a child under the age of 18 who is enrolling in the Tech Waiver.
• Tech Waiver services may be limited or denied for those individuals who are able to receive services through a third-party payment source.

Who can help initiate services?

The Department of Medical Assistance Services (DMAS) conducts the screenings for individuals under the age of 21 who request Tech Waiver services. A DMAS health care coordinator for the Tech Waiver can be reached at (804) 786-1465. If hospitalized, the hospital social worker or discharge planner can assist in coordinating a screening with DMAS.

Individuals age 21 and older must first be screened by the local department of social services (DSS) or if hospitalized, the hospital social worker or discharge planner.

Will there be a fee?

There is no cost to be screened to determine eligibility for the waiver. There may be a patient pay for services based on an individuals earned and unearned income. The local DSS eligibility worker will determine if an individual has a patient pay.

Is there a waiting list?

Currently, there is no waiting list for the Tech Waiver.

If someone doesn't qualify for services, is there an appeal process?

Individuals denied eligibility may appeal within 30 days to:

Recipient Appeals Unit
DMAS, Suite 1300
600 E. Broad St.
Richmond, VA 23219

More information on the appeal process can be found at http://www.dmas.virginia.gov/app-home.htm.

What type of services are available in the Tech Waiver?

The following services are available based on the individuals needs. Individuals may receive a combination of services as long as they are also receiving private duty nursing services:

Private Duty Nursing - Nursing care provided by a RN or LPN

Respite - Temporary skilled nursing services which allow an unpaid caregiver to receive breaks from care giving

Assistive Technology - specialized devices needed to make an individual more independent or promote an individual's health and safety

Environmental Modifications - adaptations to the individuals home

Personal Care - For individuals 21 and older, help with activities of daily living and instrumental activities of daily living provided by a qualified aide

Individuals receiving Tech Waiver services have their care coordinated by a DMAS Health Care Coordinator. Individuals receiving waiver services also receive other services offered through Medicaid. Examples include Early Periodic Screening, Diagnosis and Treatment program (EPSSDT), medications (for those individuals not covered under Medicare), physician visits, acute care hospitalizations, and certain therapies.

Information on Choice

• Eligible individuals have the right to choose between institutional care or receiving waiver services at home and in the community.
• Services that are provided are supports that are needed, that the individual chooses, and that the individual agrees are needed.
• Individuals have the right to choose from among waiver service providers and change providers as needed.
• Individuals have the right to participate in service planning and choose others to assist in service planning if needed.

Who can be called for more information?

For more information, contact DMAS at (804) 786-1465. If hospitalized, ask to speak to the hospital social worker or discharge planner.

 

This document was developed under Grant No. 91599/3 from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. However, the contents herein do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not infer endorsement by the Federal government. Please include this disclaimer whenever copying or using all or any part of this document in dissemination activities.