Disease Management and Medicaid Waiver Services for HIV/AIDS Patients. Appendix A


Approved Medicaid Waivers Offering Services Targeted to Individuals with HIV/AIDS

State Waiver Date Services
Alabama 1915(c) 03/16/2004 Personal care, respite, skilled nursing, and companion services to individuals with HIV/AIDS.
1915(c) 10/01/2004 Case management, homemaker, personal care, respite, companion, skilled nursing for HIV/AIDS age 21 with no maximum age.
California 1915(b) 12/20/1982 Primary Care Case Management (PCCM) plans are contractually responsible for the primary care, ambulatory care, case management, utilization review, and prior authorization through the fee-for-service (FFS) Medi-Cal program. The goal of PCCM plans is to reduce the over utilization of high-cost FFS inpatient hospital services through early intervention, preventive care, and outpatient referrals. Medical case management and two Disease Management programs are available (a DM pilot program beginning in January 2009 for HIV/AIDS and a DM program for six other chronic diseases).
1915(c) 03/07/2002 Case management, homemaker, environmental modifications, skilled nursing, transportation, specialized medical equipment and supplies, attendant care, psychosocial counseling, Medi-Cal supplement for infants and children in foster care, nutritional supplements, home delivered meals and nutritional counseling.
Colorado 1915(c) 01/01/2004 Nursing facility and hospital level of care for homemaker, personal care, adult day health, transportation and personal care to adults with HIV/AIDS.
Delaware 1915(c) 01/01/1991 Case management, personal care, respite, mental health services and nutritional supplements to children and adults with HIV/AIDS.
District of Columbia 1915(c) 01/01/1997 Water purification systems and replacement filters to persons with HIV/AIDS who would otherwise require institutionalization in a hospital.
1115 01/19/2001 Medicaid benefits to HIV-positive individuals who otherwise would be ineligible for Medicaid.
Florida 1915(b) 01/01/1990 Disease management for individuals with chronic illnesses, including HIV/AIDS.
1915(c) 01/01/1990 Case management, homemaker, personal care, environmental access adaptations, skilled nursing, specialized medical equipment and supplies, day health, education and support, specialized personal care for foster care children, home delivered meals, therapeutic management, adult dental and nutritional risk reduction for individuals diagnosed with AIDS.
Hawaii 1915(c) 06/01/1992 Case management, personal care, respite, adult day health, environmental access adaptations, non-medical transportation, specialized medical equipment and supplies, personal care, private duty nursing, counseling and training, moving assistance, home delivered meals, and home maintenance to aged and disabled individuals with a diagnosis of AIDS.
Illinois 1915(c) 10/01/1993 Personal care, homemaker, home health, emergency home response, respite, foster care, supplemental payment and environmental modifications to persons diagnosed with AIDS, AIDS-related complex (ARC), or HIV infection.
    Disease management is available as an additional voluntary service for Medicaid and other Illinois health program enrollees with complex medical conditions, including HIV/AIDS.
Indiana 1915(b) 09/13/1993 The full package of Medicaid benefits is available to beneficiaries enrolled in the waiver program. Care coordination/targeted case management is available as a self-referral service for Medicaid enrollees with HIV infection.
Iowa 1915(c) 07/1/1995 Counseling, Home Health aide, homemaker, nursing, respite and hospice, consumer directed attendant care, adult day care and home delivered meals to persons with AIDS or HIV.
Maine 1115 02/24/2000 Early treatment of HIV disease – a limited but comprehensive package of services, including antiretroviral therapies for individuals who are HIV-positive and at or below 250% FPL.
Missouri 1915(c) 07/01/1992 Personal care, specialized medical equipment and supplies, private duty nursing, and attendant care.
New Jersey 1915(c) 03/01/1991 Case management, private duty nursing, medical day care, personal care, narcotic and drug abuse treatment at home, intensive supervision to eligible children who reside in division of youth and family services supervised foster care homes, pediatric community transitional home services and hospice care to persons with AIDS and children up to age 13 who are HIV+ who would otherwise require the level of care provided in a nursing facility.
New Hampshire 1915(b) 2004 Disease management for individuals with chronic illnesses, including HIV/AIDS.
New Mexico 1915(c) 07/01/1994 Case management, homemaker/personal care, and private duty nursing for patients with HIV/AIDS.
North Carolina 1915(c) 10/01/1995 Case management, respite, adult day health, personal emergency response services (PERS), in-home aids, delivered meals, waiver supplies and home mobility aids for individuals with AIDS diagnosis (if ages 13 and older); HIV seropositivity and a CDC classification of category A, B or C (children ages 2-12); and HIV seropositivity (children up to age 2).
Pennsylvania 1915(c) 04/01/1995 Homemaker, specialized medical equipment and supplies, home health aide, skilled nursing, nutritional consultations, and community transitions services to individuals 21 and over with symptomatic HIV or AIDS. Targeted case management is available for Medicaid clients with HIV (not a waiver service).
South Carolina 1915(c) 10/01/1991 Case management, personal care aide, private duty nursing, home delivered meals, foster care, counseling services, and modified hospice care for persons with HIV/AIDS.
Virginia 1915(c) 07/01/1994 Case management, personal care, respite, private duty nursing, extended state plan services (nutritional supplements) to disabled individuals at the hospital or Nursing Facility level of care who have HIV and are symptomatic or who have AIDS. This waiver also provides consumer-directed personal care and respite care.

Disease Management is available to waiver enrollees.

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