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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

  1. Be authorized to receive NYS fee-for-service Medicaid. 
  2. Nursing home level of care as supported by the UAS assessment. 
  3. Be able to live safely with the help of the waiver and available community resources.
  4. Be 18 years old and less than 65 years of age.
  5. 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 process of application to the TBI Waiver program in the Buffalo Region Counties starts with the TBI Referral Form

This can be submitted by the person wanting to go on the program or anyone else. You can fill the TBI referral form found at this link TBI Referral Form, or call Headway and a staff member can take the referral. The form needs to be either faxed to Headway (716-817-2531) or mailed to Headway. The more information regarding the brain injury and current information you can put on the referral the better. Names and phone numbers of individuals who support the referral are very helpful.

Headway will review the referral form and check that there is active Medicaid for the person referred. Headway will contact the referred ensuring that they want the referral to go through. Basic eligibility criteria will be reviewed with the person such as age, diagnosis, and Medicaid.

Headway staff will send by mail initial release forms, an introduction letter and a list of helpful information requested to process the referral.

If the referred wants to continue the process, they will be contacted within ten business days by a Headway Nurse Evaluator or RRDS to schedule an interview. Interviews are conducted through telehealth unless there are special circumstances. Instructions on how to access telehealth will be discussed.

After the interview the Nurse Evaluator or RRDS will present the case at the weekly Headway Program Case Conference to determine if the referral can go ahead to application, or more information is needed for a determination. The person who conducted the interview will contact the referred or their designate to discuss the results, and the next step to the process. Applicants are mailed a list of approved Service Coordinator agencies or independents to contract with to develop a service plan. It is up to the applicant to contact these agencies and contract with them to develop a service plan.

The applicant becomes a participant on the TBI waiver when their service plan is approved by Headway and a notice is sent to the county with a start date of services.

 

 

 

 

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.  

TBI WAIVER REFERRAL FORM

Power of Attorney Form

Health Care Proxy

Freedom of Choice Form

Application Interview Acknowledgement

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.