Thursday, October 1, 2015

Medically Complex Children’s Waiver Now Accepting New Applicants

(Salt Lake City, UT) – The Utah Department of Health’s (UDOH) Medically Complex Children’s Waiver will open enrollment today for the first time after being authorized by the Utah State Legislature in the 2015 General Session (H.B. 199). The program will accept applications through Thursday, October 29. This program is intended to serve children with disabilities and complex medical conditions, providing them access to respite services, as well as traditional Medicaid services. The waiver was designed as a pilot program authorized to run through June 30, 2018 and serve approximately 165 children, from birth through age 18.

In order to qualify for the Medically Complex Children’s Waiver, the child must:
Be age 0-18
Have three or more specialty physicians
Have three or more organ systems involvement
Demonstrate a level of medical complexity based on a combination of need for device-based supports, high utilization of medical therapies, and treatments and frequent need for medical intervention
Have a disability determined by the Social Security Administration or the State Medical Review Board

Unlike traditional Medicaid, only the child’s income and assets are considered when determining the child’s eligibility for this program; the parent’s income and assets are not considered.  Children currently enrolled in traditional Medicaid will not be automatically eligible for the program and will also need to apply.

Applicants will not be selected for enrollment on a first-come-first-served basis. Once the application period ends, if more than 165 applications are received, UDOH clinical staff will review the applications and base entrance into the program on the highest medical complexity and critical needs of the family, as identified through the application process.  

To apply for the program, applications must be received by the end of day on Thursday, October 29. Applications can be submitted online at Parents may also print the application and submit it by fax (801-323-1593) or by mail (UDOH, Medically Complex Children’s waiver, Division of Medicaid and Health Financing, PO Box 143112, Salt Lake City, UT 84114-3112).

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Media Contact:
Kolbi Young, Utah Department of Health
(o) 801-538-6847
(m) 801-231-6350