Children Waiver

A Children’s Waiver is a program that allows states to receive federal funding to provide home and community-based services to children with disabilities, rather than institutional care. The program is intended to help children with disabilities live in the community and receive services that meet their needs, rather than being placed in institutions. The waiver allows states to use Medicaid funds to provide a wide range of services, including therapy, respite care, and case management. The program is designed to be flexible and responsive to the unique needs of each child and family.

EPSDT Waiver

EPSDT, or Early and Periodic Screening, Diagnostic, and Treatment, is a program under Medicaid that provides preventive and comprehensive healthcare services to children under the age of 21 who are enrolled in Medicaid. The program is designed to ensure that children receive necessary healthcare services to maintain their overall health and well-being.

In some cases, states may seek an EPSDT waiver from the federal government to provide additional or alternative services to eligible children. These waivers allow states to tailor their Medicaid programs to better meet the needs of their unique populations. For example, a state may seek a waiver to cover a specific service or treatment that is not typically covered under the EPSDT program.

It is important to note that while waivers can provide additional flexibility to states, they must still adhere to certain federal requirements, including ensuring that eligible children receive all required EPSDT services. Additionally, waivers must be approved by the Centers for Medicare and Medicaid Services (CMS) and are subject to ongoing monitoring to ensure that they continue to meet the needs of the population they serve.