CT Mental Health Waiver

Published on
July 24, 2023
Last updated
February 29, 2024
Written by
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Katie Wilkinson
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Connecticut's Mental Health Waiver is a Medicaid program that provides home and community-based services for individuals with serious mental illness, emphasizing recovery-oriented care and compensating eligible family caregivers through a self-directed option.
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Connecticut's Mental Health Waiver is a vital Medicaid program administered by the Department of Mental Health and Addiction Services (DMHAS) with oversight from the Department of Social Services (DSS). Designed to support individuals grappling with serious mental illness, this waiver offers an array of home and community-based services that enable Medicaid beneficiaries to lead fulfilling lives within their communities while avoiding institutional care.

The significance of this program in healthcare cannot be overstated. It bridges the gap between institutionalization and community living, providing essential services and support to those who need them most. By embracing a recovery-oriented approach, emphasizing wellness, and promoting person-centered planning, the Mental Health Waiver aims to enhance the lives of its participants and foster their journey toward recovery.

Overview of Connecticut's Mental Health Waiver

Connecticut's Mental Health Waiver is a crucial component of the state's Medicaid program, designed to address the unique needs of individuals with serious mental illness. Operated by the Department of Mental Health and Addiction Services (DMHAS) with oversight by the Department of Social Services (DSS), this waiver aims to provide a comprehensive array of home and community-based services to support Medicaid beneficiaries in leading fulfilling lives within their communities, while avoiding institutional care.

The primary purpose of the Mental Health Waiver is to promote community integration and recovery-oriented services for its participants. By offering intensive psychiatric rehabilitation within the participant's home and other community settings, the program ensures that individuals receive the necessary care and support tailored to their needs.

Furthermore, the program emphasizes a person-centered approach, empowering participants to develop their Individualized Recovery Plan actively. This plan guides the delivery of services and supports, considering both psychiatric and medical needs. Through a focus on wellness and recovery, the Mental Health Waiver aims to improve the overall quality of life for those facing severe psychiatric disabilities.

A key aspect of this waiver is the utilization of peer support provided by individuals who have undergone training and certification in rehabilitative care. These peer supports draw from their firsthand experience of recovery from mental illness, offering unique perspectives and understanding to participants and fostering a sense of connection and hope.

Connecticut's Mental Health Waiver's target population includes individuals diagnosed with severe mental illness and eligible for Medicaid. By complementing and supplementing services available through the Medicaid State plan and other public programs, the waiver seeks to ensure comprehensive and well-rounded care for its beneficiaries.


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Eligibility Requirements for Connecticut's Mental Health Waiver

Individuals must meet specific eligibility criteria to benefit from the support and services offered by Connecticut's Mental Health Waiver.

  1. The applicant must be 22 or older, ensuring that the program caters to the needs of adults facing severe mental illness.
  2. Eligibility for Medicaid is a fundamental requirement, as the Mental Health Waiver is an extension of the state's Medicaid program. Medicaid is a joint federal and state program that provides health coverage for low-income individuals and families, including those with disabilities and certain medical conditions.
  3. Applicants must have a documented diagnosis of a severe mental illness. This requirement is essential to ensure that those with significant mental health challenges receive the specialized care and assistance they need to lead fulfilling lives.
  4. The Mental Health Waiver caters to individuals either living in an institutional setting or meeting the level of care requirement for nursing home care. This criterion aims to support individuals who might otherwise face institutionalization and help them transition back into the community.
  5. Expressing an interest in transitioning into the community is a prerequisite for participation in the program. This requirement ensures that individuals actively seek community-based care and are willing to engage in recovery and community integration.

Services and Supports

The Mental Health Waiver in Connecticut offers a comprehensive range of services and supports to cater to the unique needs of individuals with serious mental illness. These services promote community living, enhance overall well-being, and facilitate recovery. Some of the services and supports covered by the waiver include:

  1. Residential-Based Services include the Community Support Program (CSP), which follows a team-based approach to community rehabilitation, fostering social integration and skill-building.
  2. Peer Support: Provided by trained and certified peer specialists, peer support offers an alternative or step-down option from CSP, focusing on personal connection and shared experiences to promote recovery.
  3. Recovery Assistant: This includes homemaker, companion, personal care, and in-home respite care services, aimed at helping care recipients maintain their homes and foster independence.
  4. Supported Employment: Participants receive a range of mental health supports to assist them in finding and sustaining competitive employment, empowering them with a sense of purpose and achievement.
  5. Transitional Case Management: Services provided during the transition from a nursing home to a community living arrangement, ensuring a smooth and successful shift.
  6. Brief Episode Stabilization: Designed to stabilize participants in crises or following discharge from institutional care, offering essential support during challenging times.
  7. Personal Emergency Response System: An electronic device worn by individuals to seek help in emergencies, including an electronic medication management system for added safety.
  8. Assisted Living Service Agency: Providing personal care and services within a licensed community care facility, ensuring 24-hour on-site response staff availability.

Other ancillary services include Specialized Medical Equipment, Home Accessibility Adaptations, Non-medical Transportation, Adult Day Health, Home-Delivered Meals, Chore Services, and Personal Care Assistance (PCA) Services.

These services and supports offered through the Mental Health Waiver empower care recipients with serious mental illness to live independently, engage in their communities, and work towards achieving their personal goals and aspirations. By addressing their diverse needs comprehensively, the program fosters a supportive and recovery-oriented environment for its participants.


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Compensation for Family Caregivers

Connecticut's Mental Health Waiver offers compensation for unpaid family caregivers through a self-directed option. This self-directed option allows eligible participants to choose and manage their caregivers; in some cases, family members can be hired and paid as caregivers. This is a significant and crucial aspect of the program as it recognizes the valuable role played by family caregivers in supporting individuals with serious mental illness.

By compensating family caregivers, the program acknowledges their dedication and hard work. It aims to provide financial assistance and support to those who often devote substantial time and effort to care for their loved ones. This self-directed approach empowers participants and their families to make informed decisions about their care, fostering a person-centered and family-centered approach to mental health support.

Learn more about Medicaid self-directed care >>

A Note from Givers

As we advocate for the recognition and support of family caregivers, we invite you to fill out this form to determine your eligibility for caregiver compensation.

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