Mental Retardation (MR) Waiver
Virginia Department of Medical Assistance Services
600 E. Broad St, Suite 1300
Richmond, VA 23219
(804)786-7933
dmasinfo@dmas.virginia.gov
The Mental Retardation (MR) Waiver is a Medicaid program that provides eligible individuals with services in their homes and communities. This waiver provides a variety of consumer and agency-directed services to individuals who choose to receive home and community based services as an alternative to care in an Intermediate Care Facility for the Mentally Retarded (ICF/MR). While assistance with the cost of room and board is not available through Medicaid waivers, waivers provide supports that help individuals to live as independently as possible in the community.
Who qualifies for services?
- Individuals who meet the criteria for ICF/MR placement and have a diagnosis of mental retardation, or are under the age of six and at developmental risk.
- Once a MR Waiver slot is available for an individual, financial eligibility (income and resources) must be determined by the local department of social services (DAA). Parents income and resources are not considered by DSS when making a financial eligibility determination for a child under the age of 18 who has an available MR Waiver slot.
Who can help initiate services?
All screenings for the Mental Retardation Waiver are conducted by the Community Services Boards (CSB's). A listing of CSB's can be found at http://www.vacsb.org or by contacting the Virginia Association of Community Services Boards, Inc. at (804) 330-3141.
Will there be a fee?
There is no cost to be screened to determine eligibility for the waiver.
There may be a monthly patient pay for services based on an individuals earned and unearned income. The local DSS eligibility worker will determine if an individual has a patient pay.
Is there a waiting list?
There is a waiting list for MR Waiver services.
Individuals on the MR Waiver waiting list who also meet criteria for another Medicaid Waiver can choose to receive those services while remaining on the waiting list for the MR Waiver.
If someone doesn't qualify for services, is there an appeal process?
Yes, individuals denied eligibility may appeal within 30 days to:
Recipient Appeals
Unit DMAS
Suite 1300
600 E. Broad St.
Richmond, VA 23219
More information on the appeal process can be found at http://www.dmas.virginia.gov/app-home.htm.
What type of services are available in the MR Waiver?
The following services are available based on the individuals needs and may be provided alone or in combination:
- Companion Services (Consumer or Agency-Directed)
- Crisis Stabilization
- Day Support (Center Based or Non-Center Based)
- Personal Assistance (Consumer or Agency-Directed)
- Personal Emergency Response Systems (PERS)
- Prevocational Services (Center Based or Non-Center Based)
- Residential Support Services (In-Home or Congregate)
- Respite (Consumer or Agency-Directed)
- Skilled Nursing
- Supported Employment (Individual or Group)
For individuals receiving at least one other MR Waiver service, the following services are available based on an individuals needs:
- Assistive Technology
- Environmental Modifications
- Therapeutic Consultation
Descriptions of these services can be found at www.dmhmrsas.virginia.gov by clicking on mental retardation waiver.
Individuals receiving MR Waiver services receive other services offered through Medicaid. Examples include medications, physician visits, hospital charges, Early Periodic Screening, Diagnosis and Treatment program (EPSDT), and certain therapies. In addition, the individual will have a case manager who will coordinate services.
Information on Choice
- Eligible individuals have the right to choose between institutional care or receiving waiver services at home and in the community.
- Services that are provided are supports that are needed, that the individual chooses, and that the individual agrees are needed.
- Individuals have the right to choose from among waiver service providers and change providers as needed.
- Â Individuals have the right to participate in service planning and choose others to assist in service planning if needed.
Who can be called for more information?
For more information contact the local CSB. A listing of CSB's can be found at www.vacsb.org or by contacting the Virginia Association of Community Services Boards, Inc. at (804) 330-3141.
Additional information on the MR Waiver is also available on the Department of Mental Health, Mental Retardation and Substance Abuse Services website at http://www.dmhmrsas.virginia.gov.
This document was developed under Grant No. 91599/3 from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. However, the contents herein do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not infer endorsement by the Federal government. Please include this disclaimer whenever copying or using all or any part of this document in dissemination activities.