Family caregivers are the backbone of the healthcare system, providing essential care and support to their loved ones with intellectual and developmental disabilities (IDD). However, many family caregivers face financial and emotional challenges, such as low income, high stress, and limited access to services and supports. That’s why Medicaid programs like the OPWDD Comprehensive Waiver in New York are so important. They offer family caregivers the opportunity to receive compensation and self-direction for their caregiving role and a range of services and supports for their loved ones.
The OPWDD Comprehensive Waiver is a Medicaid program that provides home and community-based services (HCBS) to individuals with IDD who meet an institutional level of care. The program is administered by the New York State Office for People With Developmental Disabilities (OPWDD) and the Department of Health (DOH), with approval from the federal Centers for Medicare and Medicaid Services (CMS).
The purpose of the OPWDD Comprehensive Waiver is to promote the health, safety, independence, and quality of life of individuals with IDD and to support their families and caregivers. The program aims to prevent or delay institutionalization, enhance community integration, increase individual choice and control, and reduce costs.
The OPWDD Comprehensive Waiver serves individuals with IDD of any age who live in New York State. As of July 2021, there were about 85,000 individuals enrolled in the program. The program is expected to undergo changes in October 2023, pending federal approval.
To be eligible for the OPWDD Comprehensive Waiver, an individual must meet the following criteria:
To apply for the OPWDD Comprehensive Waiver, an individual must contact their local Developmental Disabilities Regional Office (DDRO) to request an eligibility determination. If they are found eligible, they will be assigned a care manager to help them develop a person-centered care plan and enroll them in the waiver.
The OPWDD Comprehensive Waiver offers various services and supports tailored to the individual’s needs, preferences, and goals. Some of these services and supports include:
One of the most attractive features of the OPWDD Comprehensive Waiver is that it allows individuals to self-direct their services through employer and budget authorities. Employer authority means that individuals can hire, train, supervise, and dismiss their staff, including family members. Budget authority means individuals can manage a personal resource account to purchase goods and services that meet their needs.
Self-direction gives individuals more choice and control over their services, as well as the opportunity to compensate their family caregivers for the work that they do. Family caregivers can be paid for providing certain services under the waiver, such as community habilitation, respite, or supported employment. However, there are some limitations and restrictions on who can be paid and how much. For example, spouses and legally responsible relatives cannot be paid as caregivers. OPWDD determines the rates of pay and vary by service and region.
Individuals must work with their care manager and a fiscal intermediary to develop a self-directed budget and a circle of support to participate in self-direction. A fiscal intermediary is an agency that handles the payroll and taxes for the caregivers. A circle of support is a group of people who help the individual plan and monitor their services.
If you are interested in applying for this program or finding out if you might be eligible for compensation, please fill out this form, and we will get back to you soon.