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Brain Injury (BI) Waiver Program

The Brain Injury (BI) waiver is a habilitative/rehabilitation and independent living program with an emphasis on the development of new independent living skills and/or re-learning of lost independent living skills due to an acquired or traumatic brain injury. Participants who have a medically diagnosed brain injury receive intensive therapies and services based on the goals of the participant, their providers and their Managed Care Organization (MCO). The participant's progress will be evaluated every six months until they are no longer in need of these services or they reach a plateau in their progress and are able to transition to another waiver for ongoing supports.

Brain injuries diagnosed as being a chromosomal or congenital condition do not qualify for the BI waiver. If a brain injury is obtained prior to the age of 22, the individual may be considered developmentally disabled and may be referred to the Community Developmental Disability Organizations (CDDOs) prior to BI screening. CDDOs are required to assess all persons with developmental disabilities for the I/DD Program.

Services

Assistive Services
Financial Management Services
Home-Delivered Meals
Medication Reminder Services
Personal Emergency Response System and Installation (PERS)
Personal Care Services (PCS)

Rehabilitation Therapies: Behavior Therapy, Cognitive Rehabilitation, Physical Therapy,Speech-Language Therapy, and Occupational Therapy
Enhanced Care Services (ECS)
Transitional Living Skills (TLS)

Eligibility

To be eligible for the BI waiver, an individual must meet the following criteria:

Be from the age of 0 up to and including 64 years of age;
Be a resident of the state of Kansas;
Be determined disabled or have a pending determination by the Social Security Administration;
Be financially eligible for Medicaid;
Have a documented medical diagnosis of a traumatic brain injury or acquire brain injury, signed off by an acceptable medical provider. Brain injuries due to chromosomal or congenital diagnoses do not qualify for the BI waiver. To be eligible under a BI diagnosis, the participant must meet the criteria for placement in a Traumatic Brain Injury Rehabilitation Facility. To qualify under a BI diagnosis for ages four years and older, the participant must meet the level of care required for hospital placement. For ages 0 to 3 years, the participant must submit current brain injury diagnostic and treatment recommendations from the treating physician;
Have active habilitation/rehabilitation need for BI therapies;
Participants between the ages of 4 through 64 years must meet the level of care criteria based on the state-approved Medicaid Functional Eligibility Instrument (MFEI) completed by the ADRC.

Enrollment

To apply for the BI waiver, contact your local Aging and Disability Resource Center. The ADRC will conduct a BI Medicaid Functional Eligibility instrument assessment to determine functional eligibility for the BI waiver. If functionally eligible, KanCare Clearinghouse will determine if the participant meets the disability and financial eligibility guidelines.

HCBS BI Attestation Form

The KDADS ADCSP HCBS BI Attestation Form may be completed by a qualified medical professional and submitted to the ADRC in place of medical records containing your brain injury diagnostic information.

Frequently Asked Questions

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What is the difference between an acquired and traumatic brain injury?

A traumatic brain injury (TBI) is an injury to the brain caused by an external force after birth. Common causes of a traumatic brain injury include gunshot wounds, motor vehicle crashes, assaults or falling and striking your head.

An acquired brain injury (ABI) includes brain injuries caused after birth by cerebral vascular accidents (commonly known as stroke) and loss of oxygen to the brain (hypoxic brain injury). Both types of brain injuries are now covered under the BI waiver.
What does supporting BI documentation mean?

Supporting BI documentation provided to the ADRC needs to be a medical documentation of brain injury completed by a qualified medical professional. If a medical documentation of brain injury is not available, the individual applying for waiver services must submit a Brain Injury Program Eligibility Attestation Form completed by a qualified medical professional. A Brain Injury Program Eligibility Attestation Form can be requested from ADRCs, MCOs or KDADS-HCBS Brain Injury Program Manager.
Is there a time limit on the BI program?

The BI program is a short-term rehabilitative program. You may participate in the program as you continue to make progress in your rehabilitation and transitional living skills, at least until you no longer show habilitative/rehabilitative needs or progress.

The participant will establish goals with their provider and the MCO that will be used to track habilitative and rehabilitative progress of their independent living skills. When the participant achieves their goals and services are no longer needed or reaches a plateau in their progress, they will have the opportunity to discontinue the BI waiver or transition to another long-term HCBS waiver program for ongoing supports.
Who do I call to get information when I need help?
- For help with authorized services call your Managed Care Organization (MCO) Care Coordinator.
- For help with your Medicaid eligibility contact the KanCare Clearinghouse. KDADS does not determine Client Obligation or Medicaid Spend Down. The KanCare Clearinghouse manages these items.
- For help with your waiver eligibility contact your ADRC.
What is self-direction?

Self-direction is an option that allows you to direct your own services. These services are determined by the MCO Care Coordinator and individual to be essential to the maintenance of their health and welfare. When you choose to self-direct you are responsible for multiple tasks, such as choosing, training, monitoring and dismissal of the worker. TA services that you may be self-direct include ECS and PCS.

Additional Information

For additional information or assistance you may follow the provided link to contact the KanCare Ombudsman.

Renewal Information

KDADS is seeking feedback from HCBS Stakeholders for the renewal of the Brain Injury (BI) Waiver. KDADS will host virtual meetings to share information and accept public comment. These meetings are an opportunity for you to learn about any planned changes to the BI Waiver and share feedback on what you think is going well and what could be improved. The renewal and documents including the following information can be found at https://kdads.ks.gov/kdads-commissions/long-term-services-supports/home-community-based-services-(hcbs)-programs/programs/tramatic-brain-injury. Please register for the times you plan to attend. We look forward to hearing from you!

March 13^th 2024 1p-3p

https://wichitastate.zoom.us/meeting/register/tJEtdeCspz4tHtxivsbbwU1ANpq_V7gucSVB#/registration

March 13^th 2024 6p-8p

https://wichitastate.zoom.us/meeting/register/tJEtdeCsrTwrGtSQZ6nXOzR_Wkf16mf1OzEI#/registration

March 14^th 2024 11a-1p

https://wichitastate.zoom.us/meeting/register/tJwpd-yqrTMiGNCndLPCNTZ1Kk4ITCD2hFlo#/registration