The Brain Injury Waiver provides funding for home and community-based services for children and adults who have an acquired or traumatic brain injury.
People may receive BI Waiver services in their home, in a biological or adoptive family's home, a relative's home (e.g. sibling, aunt, grandparent etc.), a family foster care home, a corporate foster care home, a board and lodging facility or in an assisted living facility. If married, a person may receive BI Waiver services while living at home with his or her spouse.
Who is eligible for BI Waiver services?
A screening process determines if you are eligible for the BI Waiver. You are eligible if you meet the following criteria:
- Are assessed at Level IV or above on the Rancho Los Amigos Levels of Cognitive Functioning Scale
- Are certified as disabled by the State Medical Review Team or by the Social Security Administration
- Are eligible for Medical Assistance
- Are under the age of 65 years when the waiver is opened
- Are determined to need the level of care available in a nursing facility or neurobehavioral hospital
- Choose services in the community instead of services in a nursing facility or neurobehavioral hospital
- Have a documented diagnosis of traumatic or acquired brain injury or degenerative disease diagnosis where cognitive impairment is present, provided the diagnosis is not congenital
- Experience significant/severe behavioral and cognitive problems related to the injury or disease
What else is important for participation in the BI Waiver?
Once your eligibility is determined for participation in the BI Waiver, certain questions must be asked about services including:
- Are the services necessary to ensure your recipient's health, welfare and safety?
- Have all options been assessed and does this option meet your needs and preferences?
- Is the cost of the service considered reasonable and customary?
- Is the service covered by any other funding source, for example, Medical Assistance state plan services, private health care coverage, Medicare, education or Vocational Rehabilitation Service funding?
How can persons apply for the BI Waiver?
You can apply for the BI Waiver at your local county agency or tribe. For more information, view the Brain Injury Waiver fact sheet (PDF).
