HI HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver Explained

The HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver in Hawaii is a Medicaid program that provides home and community-based services for individuals with intellectual and/or developmental disabilities who are eligible for Developmental Disabilities Division services, Medicaid and meet the level of care criteria. 

Overview of HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver

The HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver is a Medicaid waiver program authorized under Section 1915c of the Social Security Act. This program allows Hawaii to provide an array of home and community-based services that assist Medicaid beneficiaries with intellectual and/or developmental disabilities to live in the community and avoid institutionalization. The program is administered by the Department of Human Services, Med-QUEST Division (MQD), and the Department of Health, Developmental Disabilities Division (DDD). The waiver serves individuals who are eligible for DDD services, Medicaid, and who meet the level of care criteria for an intermediate care facility for individuals with intellectual disabilities (ICF/IID). The waiver is meant to implement creative person-centered alternatives to long-term institutionalized care.

Eligibility requirements

To be eligible for the HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver, an individual must meet the following requirements:

• Be a resident of Hawaii
• Be eligible for Medicaid under one of the following categories: Supplemental Security Income (SSI), 300% of SSI, or Medically Needy
• Be eligible for DDD services, which means being diagnosed with an intellectual disability or a related condition before age 22 that results in  functional limitations in three or more areas of  life activity
• Meet the level of care criteria for an ICF/IID, which means requiring active treatment and 24-hour supervision due to severe physical, behavioral, or medical needs
• Have a person-centered plan that identifies the need for waiver services and supports
• Choose to receive waiver services instead of institutional care

Services and supports

The HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver offers a variety of services and supports that are intended to help individuals live as independently as possible in their homes or community settings. Some of the services and supports available under the waiver are:

• Personal Assistance/Habilitation: This service assists with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). It also provides training and support to help individuals acquire, maintain, or improve self-care, communication, socialization, recreation, and community integration skills.
• Residential Habilitation: This service provides 24-hour supervision and support in a licensed or certified residential setting, such as a group home or foster home. It includes assistance with ADLs, IADLs, health care needs, behavioral needs, and community participation.
• Additional Residential Supports: This service provides additional support to individuals who live in residential habilitation settings but need more intensive or specialized assistance due to complex medical or behavioral needs.
• Adult Day Health: This service provides structured day activities in a licensed or certified facility that promotes health maintenance, socialization, recreation, and community integration. It includes nursing services, personal care services, therapeutic services, and transportation services.
• Community Learning Service: This service provides opportunities for individuals to learn new skills and participate in meaningful activities in integrated community settings. It includes vocational training, volunteer work, educational classes, cultural events, leisure activities, and transportation services.
• Discovery and Career Planning: This service provides individualized planning and exploration activities that help individuals identify their strengths, interests, preferences, and goals related to employment or other meaningful activities.
• Individual Employment Supports: This service provides ongoing support to help individuals obtain and maintain competitive integrated employment in the community. It includes job development, coaching, retention, benefits counseling, and transportation services.
• Respite: This service provides temporary relief to unpaid caregivers responsible for an individual's primary care. It can be provided in the individual's home or another setting approved by DDD.
• Chore: This service includes assistance with household tasks essential to an individual's health and safety. It includes cleaning, laundry, yard work, minor home repairs, pest control, and trash removal.
• Non-Medical Transportation: This service provides transportation to and from waiver services or other community activities not covered by Medicaid state plan transportation or other sources.
• Private Duty Nursing: This service provides skilled nursing care to individuals who have complex medical needs that require more individualized and continuous care than can be provided by a licensed nurse under the Medicaid state plan.
• Training and Consultation: This service provides education and guidance to individuals, family members, caregivers, or providers on topics related to the individual's needs, such as health care, behavior management, communication, assistive technology, or self-advocacy.
• Waiver Emergency Services: This service provides immediate and short-term assistance to individuals who experience a crisis that poses a risk to their health or safety or jeopardizes their waiver eligibility or services

Compensation for caregivers

One of the benefits of the HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver is that it offers a self-direction option for some of the waiver services, such as personal assistance/habilitation, respite, chore, and non-medical transportation. This means that eligible participants have the flexibility to choose their caregivers, and in some cases, they can select a family member to provide the needed care and support. This option gives participants more control and autonomy over their care and supports family caregivers who dedicate themselves to caring for their loved ones.

Family caregivers hired under the self-direction option are paid by a fiscal intermediary agency that contracts with DDD. The payment rates vary depending on the type and amount of service provided, but they are generally based on the prevailing wage rates in the state. Family caregivers interested in becoming paid providers under the self-direction option must meet specific requirements, such as completing a background check, attending an orientation session, obtaining a tax identification number, and submitting timesheets and invoices.

Learn more about Medicaid self-directed care >>

A note from Givers

If you are a family caregiver in Hawaii caring for a loved one with intellectual and/or developmental disabilities, you may be eligible for compensation under the HCB Services for People with Intellectual and Developmental Disabilities (I/DD) Waiver. To determine if you qualify, please fill out this form, and we will get back to you as soon as possible.