Developmental disabilities are typically present at birth, and are life-long, incurable disabilities impacting individuals’ language, cognitive and behavioral development. Sometimes, Developmental Disabilities can affect fine/gross motor and adaptive functions, at times, having negative effects on other body parts, too. Typically, individuals with developmental disabilities need long-term support in the areas of life skills, self-care, self-direction, health, safety, mobility and many other areas. The support services individuals require are in the form of nursing assistance, medical and therapeutic services (services that are covered by Medicaid).
Autism, Behavioral disorders, Brain Injuries, Cerebral Palsy, Down Syndrome, Epilepsy, Hearing Loss, Intellectual Disability, Spina Bifida, Vision Impairment and others. Individuals that do not have a developmental disability, but are deemed medically fragile, also require long-term services and may be eligible for either Katie Beckett, or the NOW/COMP waiver programs.
No. It is not the individual's disability that makes them eligible for a waiver. Having Autism Spectrum Disorder, for example, is not enough to be eligible for a waiver. It is whether the individual's disability rises to an institutional level of care that makes them eligible for a waiver. This means that the care and treatment necessary must be comparable to that provided in a hospital, nursing home or intermediate skilled nursing facility. Individuals eligible for the Katie Beckett and NOW/COMP waivers must have been diagnosed with a developmental disability by qualified medical professionals before the ages of 18 and 22, respectively.
If an individual is approved for a waiver which allows them to remain in the comfort and security of their home while receiving medical and therapeutic support in their community, they must receive a minimum amount of care equivalent to what they would receive, if they were in fact institutionalized in a hospital, nursing home or skilled intermediate nursing facility. If your child receives services in school such as speech, occupational or physical therapy, school-based therapy counts toward your child's minimum of 5 weekly sessions, as long as your Pediatrician requests school-based therapy in their order (script) for total weekly sessions. In some circumstances a child may not be required to participate in 5 weekly therapy sessions based on the results from a Psychological Evaluation using intelligence and behavioral testing.
A Pediatrician is the primary provider responsible for managing the overall medical care your child receives. But, in areas where a child's development or behavior is a concern, it may be necessary that you and your child's Pediatrician work together to seek the services of a more specialized physician such as a Developmental Pediatrician. Developmental Pediatricians have attained more advanced training in all areas of child development. Depending on your child's disability, you may also need the services of even more specialized physicians such as an Endocrinologist, Neurologist or Gastroenterologist. Regardless of your decision, it is always best to seek the advice of your child's Primary Pediatrician in order to obtain the best medical care they need. These physicians will be necessary in attesting to your child's level of care when applying or reapplying for Medicaid waivers.
Yes! Easterseals of North Georgia's Champion for Children Program is an excellent option for children who are medically fragile, have developmental disabilities and are not eligible for Katie Beckett. The program provides financial assistance and support to families needing medical or therapeutic services for their children.
As disabled children experience transitions throughout their primary and secondary education the same will be the case for their healthcare needs . Typically children stop receiving medical services from their pediatricians and pediatric therapists around 20 years old. At that time It will be necessary to transition them to medical providers who treat, and understand the substantial medical needs of disabled adults. Sometimes families and caregivers begin transition to adult healthcare as early as 12 years old for their loved ones. The Adult Disability Medical Home (ADMH) is a service provider for disabled teens and adults providing primary healthcare. The ADMH also partners with hospitals and private practitioners who offer more specialized medical services when such treatment is necessary. To learn more about how the ADMH assists teens and adults with developmental disabilities, please visit their website at www.theadmh.org