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Home and Community-Based Services (HCBS) 
Medicaid HCBS provides services through various programs at home and in the community. Please click a link below to learn more about each program.
 
Transitioning from a nursing facility?
 
Need Resources in the Community? Visit the Maryland Access Point
 
Are you a Medicaid participant in need of medical equipment, supplies or transportation? Visit the Division of Community Supports Services.
 
Programs and Descriptions
·                        Community First Choice
·                        Community Options Waiver
·                        Medical Assistance Personal Care
The Medical Assistance Personal Care (MAPC), Community First Choice (CFC) and Community Options Waiver all offer a similar service package. Services vary based on eligibility. The core services are personal assistance, supports planning, and nurse monitoring. The Community Options Waiver also offers services in an assisted living.
Medical Day Care is a structured group program that provides health, social, and related support services to functionally disabled adults, age 16 and older.
·                        Medical Day Care Waiver Fact Sheet   
·                        Medical Day Care Waiver Application
The Rare and Expensive Case Management (REM) Program is a case management program for recipients with specified rare and expensive conditions.
Hopkins ElderPlus is a voluntary health program designed to provide and coordinate all needed preventive, primary, acute and long-term care services so that older individuals can continue living in the community.
Waiver for Individuals with Brain Injury
The program provides opportunities for community-based services to individuals who have experienced a traumatic brain injury after the age of 17. 
·                        Brain Injury Waiver Fact Sheet
·                        Brain Injury Waiver Application
 
This waiver targets medically fragile individuals including technology dependent individuals who, before the age of 22, would otherwise be hospitalized and are certified as needing hospital or nursing home level of care.
The EID Program provides Medical Assistance to working Marylanders with disabilities who meet the program’s eligibility criteria. 
The program targets populations with behavioral health needs who are at high risk for additional chronic conditions, including those with serious persistent mental illness, serious emotional disturbance, and opioid substance use disorders. 
The Community Pathways waiver provides services and supports to individuals, of any age, living in the community, meet the criteria for a developmental disability.
·                        Autism Waiver Fact Sheet
·                        Autism Waiver Application  

 
 
 
 
What is a waiver?

Under Section 1915(c) of the Social Security Act, Medicaid law authorizes the Secretary of the U.S. Department of Health and Human Services to waive certain Medicaid statutory requirements. These waivers enable States to cover a broad array of home and community-based services (HCBS) for targeted populations as an alternative to institutionalization. Waiver services may be optional State Plan services which either are not covered by a particular State or which enhance the State’s coverage. Waivers may also include services not covered through the State Plan such as respite care, environmental modifications, or family training. 
 
The four basic types of 1915(c) HCBS waivers available for states based on the target population’s level of alternative long-term institutional care are:
·         intermediate care facility-intellectual disability (ICF-ID) level of care for intellectually and/or developmentally disabled individuals;
·         chronic or rehabilitative hospital level of care for individuals who are medically fragile, chronically ill, or severely disabled;
·         psychiatric hospital level of care for individuals who are severely or chronically mentally ill; and
·         nursing facility level of care for individuals who are elderly, physically disabled, and/or cognitively impaired.
 
To be a waiver participant, an individual must be medically qualified, certified for the waiver’s institutional level of care, choose to enroll in the waiver as an alternative to institutionalization, cost Medicaid no more in the community under the waiver than he or she would have cost Medicaid in an institution, and be financially eligible based on their income and assets.