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New York State Medicaid Waiver Program Application Guide

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  • New York State Medicaid Waiver Program Application Guide



    Waiver #1: Office for People with Developmental Disabilities (OPWDD) Comprehensive Waiver/ People First Waiver

    Who Can Apply?

    Circumstances/Diagnosis: Any kid or adult who has an either an intellectual and/or developmental disability (this includes autism). There are no age restrictions on this waiver and eligible applicants require an intermediate care facility level of care.

    Income: Eligibility is based solely on the child’s income so if they are not making any money they are eligible for the waiver.

    What do I get?

    The waiver provides a variety of services including: assistive technology-adaptive devices, intensive behavioral services (like ABA therapy), day habilitation, live-in caregiver, prevocational, residential habilitation, respite, supported employment, agency with choice/FMS, consolidated supports and services, support brokerage, community habilitation, community transition, environmental mods (home accessibility), family education and training, pathway to employment, plan of care support services.

    How do I apply?

    Call the OPWDD Info Line at 1-866-946-9733 to be connected to your Regional Office, they can provide you with information about the enrollment process.

    This link will take you to the the enrollment application you can fill out: https://opwdd.ny.gov/apply-home-and-...ervices-waiver

    Waiver #2: 1915(c) Children's Waiver

    Who Can Apply?

    Circumstances/Diagnosis: Any child with intellectual and/or developmental disabilities (this includes autism), physical or medical disabilities (this includes things like traumatic brain injury, HIV/AIDS, technology-dependent, and several other mental health concerns.

    Income: Eligibility is based solely on the child’s income so if they are not making any money they are eligible for the waiver.

    What do I get?


    The waiver provides a variety of services including: case management, community habilitation, day habilitation, prevocational services, respite, supported employment, adaptive and assistive equipment, caregiver/family supports and services, community self-advocacy training and supports, crisis intervention, environmental modifications, family peer support services, non-medical transportation, palliative care - expressive therapy, palliative care – bereavement service, palliative care – massage therapy, palliative care – pain and symptom management, vehicle modifications, youth peer support and training

    How do I apply?

    Call the Children and Youth Evaluation Service (C-YES) at 1-833-333-2937 and they will help you walk through the first steps of the process.

    You can visit the C-YES website to answer questions: https://www.nymedicaidchoice.com/con...based-services


    What does the Goally Team Think?

    New York has a good waiver program once you are able to get connected to the right place. Their website feels like a labyrinth and it is incredibly difficult to find the information you need at different times. We highly recommend that you rely on the info lines to get connected to people who can walk you through the process. Trying to figure it out with only their website is frustrating and time consuming.

    Which waiver should I apply for?


    Though it depends on your circumstances, we recommend that you apply for the OPWDD Comprehensive Waiver first. Both waivers provide similar services, but the OPWDD waiver is better suited for children with autism because of their behavioral services and due to the fact that your child can stay on the waiver for life if needed.


    Goally Waiver Scorecard

    Website clarity and ease of navigation: 1/5

    Access and requirements of qualification: 5/5

    Healthcare coverage: 4/5



    Additional Online resources

    Disability Rights New York provides free legal and advocacy services for people with disabilities: https://www.drny.org/index.php

    Parent to Parent Group of NY: http://parenttoparentnys.org/

    A brochure explaining New York HCBS services: https://omh.ny.gov/omhweb/bho/docs/h...re_english.pdf
    Telephone Resources

    Every relevant contact number in the OPWDD: https://opwdd.ny.gov/contact-us

    Additional Telephone Resources

    OPWDD Information Line 1-866-946-9733

    C-YES Information Line 1-833-333-2937
    Last edited by Brady; 07-10-2020, 10:39 AM.
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