Before the age of five, an individual can have a determination of Developmental Delay meaning that a child meets one or more of the following:
A child who is less than five years of age at risk of having a disability because of the presence of one or more of the following:
- Chromosomal conditions with delays in development
- Syndromes that begin at birth associated with delays in development
- Sensory impairments associated with delays in development
- Metabolic disorders associated with delays in development
- Prenatal infections and significant medical problems associated with delays in development
- Low birth weight infants weighing less than 1200 grams, or
- Postnatal acquired problems resulting in delays in development
A child less than five years of age who is significantly delayed in development in one or more of the following areas:
- Adaptive behavior (social skills, daily living skills such as bathing, dressing, safety, etc.)
A child less than three years of age who lives with one or both parents who have a developmental disability.
After the age of five, a person must have a determination of a disability.
An intellectual disability is a disability that starts before the person reaches the age of 22 that affects their ability to complete daily tasks, decision-making and problem-solving skills, and stems from a diagnosis or neurological condition. Examples of these conditions are cerebral palsy, epilepsy, autism, or other neurological conditions that result in impairment of intellectual functioning or adaptive behavior.
Disability Criteria Requires:
An IQ of 70 or below on a formal IQ test that looks at cognitive or intelligence functioning.
A score of 70 or below on a formal adaptive test. The adaptive test looks at the areas of communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work.
After the determination of a developmental delay/intellectual disability is completed, to access a Medicaid funded waiver, an individual must become eligible for Long Term Care Medicaid.
In order to enroll in one of our Medicaid waiver programs, the individual seeking services must enroll in and be approved for Medicaid. These include:
- Children’s Extensive Support Waiver (CES)
- Children’s Home and Community-Based Services Waiver (CHCBS)
- Children’s Habilitation Residential Program Waiver (CHRP)
- Children with Life Limiting Illness Waiver (CLLI)
- Brain Injury Waiver (BI)
- Complementary and Integrative Health Waiver (CIH)
- Community Mental Health Supports Waiver (CMHS)
- Developmental Disabilities Waiver (DD)
- Elderly, Blind, and Disabled Waiver (EBD)
- Supported Living Services Waiver (SLS)
The individual seeking services must meet the federal Social Security Administration’s definition of an individual with a disability (more information on the SSA’s definition of disability is available here), and they are encouraged to apply for social security benefits.