TBI Waiver Program
Philosophy
The HCBS/TBI Medicaid Waiver was developed based on the philosophy that:
- An individual with a TBI has the same right to be in control of his or her life as anyone else in our society.
- An individual with a TBI must be able to choose where he or she wants to live, with whom he or she will live, and who will provide any needed services.
- The individual with a TBI has the right to learn as a member of society, by encountering and managing risks, and through experience learn from related failures.
Services to enable you to stay at home or return home if currently living in a nursing home facility.
Eligibility
- Be authorized to receive NYS fee-for-service Medicaid.
- Nursing home level of care as supported by the UAS assessment.
- Be able to live safely with the help of the waiver and available community resources.
- Be 18 years old and less than 65 years of age.
- Have clear medical documentation of a traumatic brain injury or acquired brain injury.
All Services must be pre-approved and are paid for by Medicaid.
Available TBI Waiver Services - Buffalo Region
Service Coordination
- A manager of your services.
- An aide that helps you live in your home by helping with personal care and reminders. This service has additional eligibility requirements.
- A goal-oriented trainer who helps you develop skills to be more independent. ILST is not intended to be a long-term support.
- Changes in your home to help you be more independent such as installing ramps or modifying bathrooms.
- Equipment to help a person live at home and be more independent such as special cooking equipment.
- A counselor to help you deal with the problems that brought you to the program.
- A program you go to safely develop social skills and take part in activities.
- A therapist who works with you to change things that you do that cause you and others problems.
- Funds to help you set up a home after being in a Nursing Home.
- Home and Community Support Services
- Independent Living Skills Training
- Environmental Modifications
- Assistive Technology
- Community Integration Counseling
- Structured Day Program
- Positive Behavioral Interventions and Supports
- Community Transition Services
- Social Transportation
- Some service providers offer transportation if you can transfer into a car, are unable to use public transportation, and do not possess your own transportation vehicle.
The Home and Community-Based Services Medicaid Waiver for Individuals with Traumatic Brain Injury (HCBS/TBI) is one component of a comprehensive strategy developed by the New York State Department of Health to assure that New Yorkers with traumatic brain injury may receive services within New York in the least restrictive setting.
TBI Waiver Application Process
- The TBI Referral Form must go to regional office at Headway of WNY (Fax TBI referral forms to: 716-817-2531). Headway of Western New York conducts a personal interview that helps determine appropriateness and eligibility of participant for waiver services. All referrals must go through this process.
- The potential participant signs the Freedom of Choice form, Application for Participation and Potential Participant Interview Applicant Acknowledgement Form.
- The potential participant is given both the provider list and the service coordinator list. The participant may indicate at this point a choice of Service Coordinator perhaps based on prior experience or move on to the interviewing steps. The participant is asked to not call anyone on the list until step 5 is completed.
- The RRDS Office contacts all eligible Service Coordinators regarding their potential interest in providing services by sending them a general description and information regarding geographical area.
- The potential participant is contacted by the RRDS with who on the list would like to be interviewed and the participant is given their code # which identifies them to the possible providers.
- The participant schedules at their convenience interviews to pick a Service Coordinator.
- It is recommended that the participant meet with all of the Service Coordinators and then decide with whom s/he felt would work best. Although this is encouraged, the waiver participant may choose whomever s/he felt most comfortable with at the time. When you interview, please be sure the person you are interviewing, if picked, will be your Service Coordinator.
- Once the Service Coordinator has been selected, the RRDS needs to be notified with appropriate forms and by e-mail by the selected Service Coordinator.
The Service Coordinator will guide you through the rest of the process.
Other Service Coordinator responsibilities include, but are not limited to:
- Being the main contact for the participant.
- Revising/reviewing the Service Plan on a regular/6 month basis
- Evaluating the services being provided and run a monthly clinical team meeting with the participant and all the providers.
- Have a monthly face to face meeting with the participant regarding their waiver services.
- Reviewing the outcomes of the Service Plan with the participant
- Maintaining records
- Ensuring the desirability and appropriateness of community placement
If, for any reason, the participant is concerned about the work of the Service Coordinator, or wishes to change Service Coordinator, s/he may call the RRDS Office 716-408-3120 for assistance.
TBI Referral
All referrals must go to regional office at Headway of WNY, Inc. The RRDS conducts a personal interview to fully determine eligibility of participant for waiver services.
Headway Virtual Connection - #1
Individuals who have appointments scheduled by phone with Headway/Headway Waiver Programs can access video or auditory conferencing by simply CLICKING HERE.
This connection will allow you to enter a virtual waiting room where you will be called into a virtual meeting with a staff member of Headway. Please be patient during this process.
Please note: If you are using an Apple Device (IPAD, Smart Phone or Apple Computer) you will need to use Safari 11 or greater. If you have Android or a Microsoft computer, your default browser must be Chrome or Firefox in order to make the connection. If your default browser is not set up as one of these, you will need to paste the link https://doxy.me/supportheadway in an acceptable browser (as noted above).
These meetings are to provide communication for TBI/NHTD intake, as well as Headway support groups and other related functions.
If you are having difficulty with this link, please call 716-408-3120, during regular business hours.
Please read the Message from the Director for more information during this Covid-19 pandemic.
Headway Virtual Connection - #2
Individuals who have appointments scheduled by phone with Headway/Headway Waiver Programs can access video or auditory conferencing by simply CLICKING HERE.
This connection will allow you to enter a virtual waiting room where you will be called into a virtual meeting with a staff member of Headway. Please be patient during this process.
Please note: If you are using an Apple Device (IPAD, Smart Phone or Apple Computer) you will need to use Safari 11 or greater. If you have Android or a Microsoft computer, your default browser must be Chrome or Firefox in order to make the connection. If your default browser is not set up as one of these, you will need to paste the link https://doxy.me/headway2 in an acceptable browser (as noted above).
These meetings are to provide communication for TBI/NHTD intake, as well as Headway support groups and other related functions.
If you are having difficulty with this link, please call 716-408-3120, during regular business hours.
Please read the Message from the Director for more information during this Covid-19 pandemic.
Become a TBI Provider
If your agency does not currently provide TBI Waiver Services and you would like to find out about becoming a provider, please click here to review all the New York State requirements.
Once you have reviewed this information and you're still interested, you may contact Ronald Fernandez RRDS at 716-408-3120. He will help you with the rest of the process.
RRDC at Headway reviews all submitted forms and Policy and Procedures.
Final review by RRDC at Headway with submission to Department of Health (DOH).
Final determination is made by DOH.