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Supports and Services for Acquired Brain Disorders
Through New Hampshire's Developmental Services System
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Residents of New Hampshire who have an acquired brain disorder may be eligible for the State's Bureau of Developmental Services (BDS) system. Laws and policies determine eligibility, which can be difficult to understand. Primarily, eligibility and the location of services are determined both by current age and age when the acquired brain disorder occurred. These are listed briefly below and described further within this Resource Directory.
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Injury or Brain Disorder from Birth to Age 3: Eligible for the Early Supports & Services program. Services are determined according to individual and family needs. Support provided in the areas of health and physical development, motor skills, cognitive/play skills, social/emotional skills, communication and self-help skills. Refer to "Area Agencies" section of this directory for the Early Supports & Services Coordinator nearest you.
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Injury or Brain Disorder from Age 3 to 21: Eligible for some services under BDS including family support, respite and case management. If there is no family involved, the survivor may be eligible for residential services. All education related services are provided by local school districts. Refer to the "Education" section of this resource directory for additional school district information. New Hampshire law (RSA 171-A) defines a developmental disability as one which is: a) attributable to mental retardation, cerebral palsy, epilepsy, autism, or specific learning disability or any other condition of an individual found to be closely related to mental retardation as it refers to general intellectual functioning or impairment in adaptive behavior or requires treatment similar to that required for individuals with mental retardation; b) originates before an individual attains age 22; c) has continued or can be expected to continue indefinitely; and d) constitutes a severe handicap to such individual's ability to function normally in society. There are people in New Hampshire with acquired brain disorders that meet the above criteria and are currently being served by the Bureau of Developmental Services. Refer to the "Area Agencies" section of this directory for additional information.
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Injury or Brain Disorder Acquired from Age 22 on: In recognition that many individuals with an acquired brain disorder do not meet the above criteria, the Department of Health and Human Services in 1993 instituted initiatives to serve persons with acquired brain disorders who were not otherwise eligible. The primary foundation of the program is the Community Care Waiver/Acquired Brain Disorder. Refer to the "Support Services Description" section for further information describing the options available.
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State of New Hampshire
Bureau of Developmental Services(BDS)
Home and Community-Based Care Waiver(HCBC)
For Persons with Acquired Brain Disorders(ABD)
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What is the Community Care Waiver? |
| It is a waiver from the federal government to provide Medicaid funding for community-based services for persons with brain injuries who need an extensive level of care and services, in lieu of having the services provided in a skilled nursing or long-term rehabilitation facility. The waiver was instituted in 1993. |
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Focus of the Waiver
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To improve the quality of life for eligible consumers.
- To provide for more cost effective use of existing Medicaid funds.
- To provide linkages between consumers and families to New Hampshire service providers and communities.
- To return survivors to New Hampshire.
- To reduce the future of out-of-state, high cost nursing facilities.
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Services Provided:
The services offered under this waiver include:
- Support Coordination/Case Management
- Supported Employment
- Combined Day/Personal Care Services
- Environmental Modification
- Day Programs
- Community Support Services
- Respite Services
- Personal Care Services
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Who Can Be Served?
Residents of New Hampshire who have an acquired brain disorder that is not congenital or caused by birth trauma which presents a severe and life long disabling condition which significantly impairs their ability to function in society and is attributable to one or more of the following reasons as manifested by significant decline in cognitive functioning and ability and/or deterioration in personality, impulse control, judgment, modulation of mood or awareness of deficits:
- External trauma to the brain as a result of a motor vehicle crash, fall, assault or other related traumatic incident or occurrence.
- Anoxic or hypoxic injury to the brain such as can result from cardiopulmonary arrest, carbon monoxide poisoning, airway obstruction, hemorrhage, near drowning.
- Infectious diseases such as encephalitis and meningitis.
- Brain tumor, intracranial surgery, cerebrovascular disruption such as stroke, toxic exposure.
- Other related neurological disorders such as Huntington's Disease or Multiple Sclerosis, which affect predominately the central nervous system.
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Eligibility is limited to persons:
- Who are 22 years of age or older
- Who are Medicaid eligible
- Whose disorder occurred before the age of 60
- Who meet the CCW definition for an acquired brain disorder
- Who meet the criteria for skilled nursing care or long term rehabilitation level of care
- Who are not eligible for the developmental services waiver (DD-CCW)
Individuals whose injury occurred prior to age 22 are eligible to apply to the Area Agency in their region to determine eligibility through the developmental services system.
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| How Are Services Provided? Services are provided under the Bureau of Developmental Services (BDS) comprehensive network of services for persons with developmental disabilities. This includes 10 developmental service Area Agencies with whom BDS contracts to serve consumers with ABD. The Area Agencies may, in turn, contract with other vendors to provide services.
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| Reimbursement: The rates for reimbursement are established as individually negotiated for each individual between BDS and the Area Agency and approved by the Medicaid office. The bottom line is that the overall costs of services to Medicaid under this waiver program must not exceed what the total Medicaid costs would be for the same individual if they were in a skilled nursing or long-term rehabilitation facility. Medicaid resources consist of an equally divided amount by the federal government and the State of New Hampshire.
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| How to Apply: Subsequent to determining Medicaid eligibility, an application is made through the Area Agency in the consumer's home region. For further information regarding the ABD Waiver contact your local area agency or the Brain Injury of New Hampshire.
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