The TBI/SCI Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services would require the level of care found in a nursing facility. This statewide waiver is administered jointly by the Division of Medicaid and the Department of Rehabilitation Services.
Emergency Preparedness and Response the COVID-19
The Centers for Medicare and Medicaid Services (CMS) has approved the below Appendix K: Emergency Preparedness and Response in response to the COVID-19 outbreak for the Traumatic Brain Injury/Spinal Cord Injury Waiver.
- Combined Addendum to 1915(c) Appendix K – CMS Approved October 30, 2022
- Combined Addendum to the 1915(c) Appendix K – CMS Approved June 16, 2022
- Combined Addendum to 1915(c) Appendix K – CMS Approved September 30, 2020
- TBI 0366 – 1915c Appendix K Final – CMS Approved on April 7, 2020
Who is Eligible for the Traumatic Brain Injury/Spinal Cord Injury Waiver?
Eligibility for the TBI/SCI Waiver is limited to individuals who have a traumatic brain injury or a spinal cord injury and are medically stable. The extent of the injury must be certified by the individual’s physician. Brain or spinal cord injury that is due to a degenerative condition, congenital condition, or that resulted from medical intervention is excluded. Beneficiaries of this waiver must be Medicaid eligible in one of the following categories of eligibility:
- Supplemental Security Income (SSI)
- Low Income Families and Children Program
- Disabled Child Living at Home
- Working Disabled
- Children Under Age 19 Under 100% of Poverty
- Disabled Adult Child
- Protected Foster Care Adolescents
- CWS Foster Children and Adoption Assistance Children
- IV-E Foster Children and Adoption Assistance Children
- Income level up to 300% of the SSI federal benefit rate
Traumatic Brain Injury/Spinal Cord Injury Services
Services provided under the TBI/SCI Waiver include:
- case management
- attendant care
- respite
- environmental accessibility adaptations
- specialized medical equipment and supplies
- transition assistance
Resources
- Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver-Approved by CMS June 26, 2023
- Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver-Submitted to CMS March 31, 2023
- Request for Public Input
- 1915(c) TBI/SCI Waiver Technical Amendment – Approved effective September 1, 2021
- 1915(c) TBI/SCI Waiver – Approved effective October 1, 2020
- TBI/SCI Waiver Renewal and 1915(b)(4) renewal application submitted to CMS
- 1915(c) TBI/SCI Waiver – Approved effective July 1, 2015
- 1915(b)(4) TBI/SCI Waiver – Approved effective July 1, 2015
- TBI/SCI Waiver brochure
- TBI/SCI Waiver Renewal Stakeholder Presentation – September 6, 2019
