Let’s be honest: Getting the proper medical care for people with disabilities is costly in both time and money, and difficult to locate and access. When your loved one requires the level of care provided to individuals in a nursing facility but wants to hold on to their independence, it can be hard to find and afford the proper services to help maintain independence. That’s where the CADI waiver comes in.
The Community Access for Disability Inclusion (CADI) Waiver provides home and community-based care to children and adults with disabilities requiring a high level of care equivalent to that of a nursing facility. However, instead of receiving these services in a nursing facility, individuals can receive these services in the community or within their own home through the CADI Waiver. Therefore, it’s vital to know how to qualify and apply for a CADI waiver at the appropriate time.
Determining CADI Waiver Eligibility
As we stated above, CADI waiver programs are for both children and adults (under the age of 65 in Minnesota at the time the waiver is opened) who have disabilities requiring a level of care provided in a nursing facility but are living outside of that setting. For example, they live at home, or with caretakers, or in a senior living community but need extra disability services such as transportation and companionship.
There are six key requirements that someone must meet in order to be eligible for a CADI waiver.
- Be eligible for Medical Assistance
- Be certified disabled by the State Medical Review Team or by the Social Security Administration
- Be under the age of 65 years when the waiver is opened
- Be determined to require the level of care provided to individuals in a nursing facility via a MNChoice Assessment
- Have an assessed need for supports and services over and above those available under other funding sources
- Choose care and services in the community instead of a nursing facility
There are income and asset requirements that affect one’s eligibility for a CADI waiver, and Medical Assistance as well. Therefore, working with a professional financial planner who specializes in Medical Assistance, Medicaid, and waivers is highly recommended to ensure you are receiving all of the benefits available for your specific situation. If your income exceeds that of the requirements, you may still be able to get Medical Assistance coverage using a “spenddown”. A spenddown lets you deduct certain medical expenses from your income. Medical Assistance will pay for covered services after your income is at or below the income limit after deducting these medical expenses. Again, working with a professional financial planner who specializes in Medical Assistance is recommended. You can also check with your County Health & Human Services office or assisted living facility for more specific details.
What Services Are Covered Under the CADI Waiver?
There are many services included under a CADI waiver for qualifying individuals. Below is a list of eligible services covered under the CADI waiver. For a service-specific policy page, we have included the link to the DHS CDCS webpage below. Settings covered under the CADI waiver include the applicant’s home, the home of their family member or caretaker, their assisted living facility, or an adult or child foster home (living costs are not covered under the CADI waiver, however).
Services covered under the CADI waiver program include:
- 24-hour emergency assistance
- Adult day service/Adult day service bath
- Caregiver living expenses
- Case management and case management aide
- Chore Services
- Community residential services
- Consumer-directed community supports (CDCS)
- Crisis respite
- Customized living (including 24-hour)
- Day support services
- Employment development | Employment exploration | Employment support
- Environmental accessibility adaptations
- Extended home care nursing
- Extended home health care services, including extended home health aide, and extended occupational, physical, speech and respiratory therapies
- Extended personal care assistance
- Family residential services
- Family training and counseling
- Home delivered meals
- Housing access coordination (service will discontinue June 30, 2021 and is replaced by the housing stabilization services state plan program)
- Independent living skills therapies
- Independent living skills training
- Individualized home supports, including 3 different options of support
- Integrated community supports
- Night supervision
- Positive support services (formerly behavioral support)
- Prevocational services
- Specialist services
- Specialized equipment and supplies
- Transitional services
(Policy specific information on each of these services can be found at: CBSM – Community Access for Disability Inclusion (CADI) Waiver (state.mn.us)
Individuals can view more information on applications, assessment, eligibility, and support planning here.
Also, Sunflower Communities accepts both the CADI and Elderly Waiver at both of our facilities. In fact, all of our accommodations are eligible for the Community Access for Disability Inclusion (CADI) waiver with no private pay eligibility period.
Our professional care team can perform a comprehensive assessment to determine the level of care needed and work on your behalf with case managers to ensure everything gets processed appropriately and costs get finalized and approved. We want to ensure you and your loved ones that need extra care are more than welcome here, and we will do everything in our power to make sure they maintain their independence and quality of life at Sunflower Communities. For more information, click here!