If you are caring for a loved one with an acquired brain injury, you may wonder if any financial assistance is available to help you with the costs and challenges of caregiving. This article explores one of the Medicaid waivers that may offer some relief: the Acquired Brain Injury Non-Residential Habilitation (ABI – N) Waiver in Massachusetts. This waiver supports adults with an acquired brain injury who do not need 24-hour help and support and live with family or in their own homes. It also allows participants to design and direct services, including hiring and managing support workers like family members.
The ABI – N waiver is a Medicaid program that aims to help adults with an acquired brain injury remain in their homes and communities rather than being institutionalized in nursing facilities or other long-term care settings. An acquired brain injury is defined as a brain injury that occurs after birth, and that is not related to a developmental disability, substance abuse, or a degenerative disease. The waiver covers people between 18 and 64 years old, clinically eligible for a nursing facility level of care, and meeting the financial eligibility criteria for MassHealth Standard. MassHealth is the name of the Medicaid program in Massachusetts.
The ABI – N waiver offers various services and supports tailored to each participant's individual needs and preferences. The services are delivered through a person-centered planning process involving the participant, their family, and a case manager. The participant can choose between two service delivery models: agency with choice or participant-directed program.
To qualify for the ABI – N waiver, a person must meet the following criteria:
The ABI – N waiver provides various services and supports designed to help participants live independently and safely in their homes and communities. Some of the services and supports include:
One of the benefits of the ABI – N waiver is that it allows participants to design and direct their services in partnership with a qualified provider agency or to hire and manage their support workers. This means that participants can choose who provides their services, including family members, friends, or neighbors. The waiver pays for the wages and benefits of these support workers through either the agency with choice model or the participant-directed program model.
In the agency with choice model, the participant selects a provider agency that acts as the employer of record for their support workers. The agency handles the payroll, taxes, insurance, training, and supervision of the workers. The participant can hire, fire, schedule, and direct their workers in collaboration with the agency.
In the participant-directed program model, the participant acts as the employer of their support workers. The participant is responsible for recruiting, hiring, training, scheduling, supervising, and firing their workers. The participant must also comply with the labor laws and regulations that apply to employers. The waiver provides a fiscal intermediary service that helps the participant with the payroll, taxes, insurance, and reporting of their workers.
Both models allow participants to pay their support workers at a competitive rate determined by the waiver. The rate varies depending on the type and level of service provided. For example, as of 2021, the hourly rate for a personal care attendant was $15.75. The waiver also covers the costs of worker's compensation, unemployment insurance, and health insurance for support workers.
If you think you or your loved one may be eligible for this waiver, or if you want to learn more about other Medicaid waivers that may compensate family caregivers, please fill out this form, and we will get back to you as soon as possible. We are here to help you navigate the complex world of caregiving and find the best solutions for your situation.