A Parent's Guide to Applying for The Medicaid Pediatric Hospice Waiver
First thing you'll need to do is call Longterm Care Options at (720)-974-0032.
"Longterm Care Options helps Medicaid-qualified individuals access services that range from Home and Community Based Services (HCBS) to supportive care. For individuals who are not qualified for Medicaid, but who are interested in applying for these long term care services, Longterm Care Options will assist with the Medicaid application process. The resource lists will also help any individual seeking services know what is available in the community." (http://www.ltcoptions.org/)
Let them know that you would like to apply your child for the Pediatric Hospice Waiver. They will set you up with a case manager for your child, and do an intake for your child.
You will need to fill out a Medicaid Application, which can be found at www.chcpf.state.co.us . Print off and complete applications part 1, 2, and the disability application. Fill out the application as if your child is filling it out. They are not looking at your income, or if your child could get on regular Medicaid. Once you've completed the forms, they will have you contact your county's department of human services. You will need to mail the application in to your respective county's dept. of human services case manager. (These are assigned by your child's last name.) If you don't understand how to fill out the forms contact your county case manager.
Once the application has been received by your county department of human services, they will contact Longterm Care Options, who will send your child's case manager to your home where they will ask you questions about the care of your child. They will ask if who administers most of the care,things like feeding, bathing, dressing, and giving medicines. They will line out the care under the Pediatric Hospice Waiver. And let you know your options for services under the medicaid hospice waiver.
At this point they will be waiting on the approval of the application from the county. They also will be waiting on a letter from your child's doctor verifying that the disease/illness they have is life limiting, and that your child should be granted medicaid services through the pediatric hospice waiver.
The whole process takes about 2 months from beginning, to receiving the approval letter and medicaid i.d. card from your county. You will have to take advatange of at least one service per month in order to keep your child on the waiver. And your child will have to be re-evaluated for the waiver each year.
If your child needs to be seen by a pediatrician who is familiar with children with special needs, contact the Special Care Clinic at the Children's Hospital.
"The Children's Hospital Special Care Clinic is a comprehensive and integrated program that offers both primary care and consultation services to children with chronic medical conditions and special health care needs. This clinic specializes in treating children with special health care needs, including children with genetic disorders, developmental disabilities, complex chronic medical conditions and high-risk newborns." (http://www.tchden.org)
They are more than helpful, and will be able to assist you with cordinating care between all of your children's doctors and therapists. You can contact them at (720)-777-6739.
Having just completed this process for my child, I am happy to share my experience with other parents.
Deana Watson
deanawatson@gmail.com
Contact Long Term Care Options for more information on the Medicaid Pediatric Hospice Waiver.
http://www.ltcoptions.org/medicaidservices.html
The following is from their webpage:
Purpose
The Pediatric Hospice Waiver program is designed for children/youth with
life limiting illnesses to continue to pursue curative care, while also being
able to receive services to relieve pain and to cope with pending death.
Services are provided in a community residence as authorized by the child’s
physician to eligible children who are at an institutional level of care.
Who is
Served?
Children/youth under 19 years of age with a life limiting diagnosis who are
at-risk for inpatient hospitalization if waiver services are not provided.
Life Limiting Illness: Means a medical condition that, in the opinion of the
medical specialist involved, has a prognosis of death that is highly probably
before the child reaches adulthood.
Is there a waiting
list? No
Program is
ideal for:
Children with a life limiting illness who have the ability to pursue curative
care.
What is the
Functional/Financial
eligibility criteria?
•Must be at risk of institutionalization into a hospital:
o Moderate or greater assistance with bathing, dressing, toileting,
mobility, transfers, eating and/or supervision as determined by
the SEP case manager
o Physician statement of a life limiting illness
• The child has not reached his/her nineteenth (19) birthday.
• Must meet the financial qualifications for Medicaid through the child’s:
o existing Family Medicaid status
o existing SSI status
o approved application for long term care Medicaid
• Exemption from a six-month until death prognosis
What services are
available?
• Respite Care – can be skilled or unskilled care
• Counseling – can be provided by a hospice, home health agency or an
individual therapist
• Expressive Therapy – provided by a hospice, home health agency or an
individual therapist
• Palliative/Support Care – provided by a hospice agency
Where do I apply?
In the County where you reside:
• County Departments of Social/Human Services
• Single Entry Point Agencies
County Dept. of Human Services
Adams County Human Services
Main Line: 303.287.8831
Adult Protective Services: 303.227.2553
Child Protection Services: 303.412.5212
Arapahoe County Human Services
Main Line: Aurora 303.636.1130 / Littleton 303.795.4850
Adult Protective Services: 303.636.1750
Child Protection Services: 303.636.1750
Denver County Human Services
Main Line: 720.974.3666
Adult Protective Services: 720.944.2994
Child Protection Services: 720.944.3000
Douglas County Human Services
Main Line: 303.688.4825
Adult Protective Services: 303.688.4825
Child Protection Services: 303.688.4825
Elbert County Human Services
Main Line: 719.541.2369Adult Protective Services: 303.621.3149
Child Protection Services: 303.621.3195
