The Independent Living Waiver is a Medicaid program that offers home and community-based services and supports adults with physical disabilities living in the community, usually with their families. The waiver aims to prevent or delay institutionalization and promote independence and inclusion. The waiver can serve individuals 18 or older and meet specific eligibility criteria. The waiver has an annual service cost limit of $40,000 per participant.
The Independent Living Waiver is one of the four waivers administered by the Missouri Division of Developmental Disabilities (D.D.). The waiver began in July 2003 and serves over 3,800 individuals as of 2023. The waiver is partly funded by federal dollars through the Centers for Medicare and Medicaid Services (CMS).
The purpose of the waiver is to provide an alternative to institutional care for adults with physical disabilities who are at risk of needing intermediate care facilities for individuals with intellectual disability (ICF/ID) services if waiver services are not provided. The waiver allows participants to receive services and support in their own homes or other community settings that are less restrictive and more integrated than institutional settings. The waiver also gives participants more choice and control over their services and supports through self-direction options.
The target population of the waiver is adults with physical disabilities who have a place to live in the community, usually with their families. A physical disability is a condition that impairs mobility or functioning and requires ongoing assistance or supervision. Such conditions include spinal cord injury, multiple sclerosis, muscular dystrophy, etc.
To be eligible for the Independent Living Waiver, an individual must meet the following requirements:
The Independent Living Waiver offers a range of services and supports designed to meet each participant's individual needs and preferences. The services and supports are intended to help participants achieve their personal goals and outcomes related to health, safety, independence, community participation, and quality of life. The services and supports include:
One of the benefits of the Independent Living Waiver is that it allows participants to choose self-directed support for some of the services they receive. Self-directed support gives participants more choice and control over their services and supports by hiring and managing their own workers. Participants can use a fiscal intermediary agency to handle the payroll and taxes for their workers.
Self-directed supports also allow participants to hire their family members as paid caregivers, as long as they are not legally responsible for the participant (such as a spouse) or living in the same household as the participant (unless an exception is granted). Family caregivers can be paid for providing personal care to the participant. The payment rates vary depending on the type and level of service provided, but they are generally based on the prevailing wage in the area.
Family caregivers who are interested in becoming paid workers for their loved ones must meet the following requirements:
Family caregivers who become paid workers must also comply with the rules and regulations of the waiver program, such as submitting timesheets, keeping records, reporting incidents, etc. They must also respect the participant's rights and preferences and provide quality care.
If you are a family caregiver of an adult with a physical disability who lives in Missouri, you may be eligible for this waiver program that provides valuable services and supports, including compensation for your caregiving work. To find out if you may qualify, please fill out this form, and we will contact you soon.