Department of Medical Assistance Services
TECHNOLOGY ASSISTED (Tech) WAIVER
TECHNOLOGY ASSISTED (Tech) WAIVER IMAGE
OVERVIEW OF TECHNOLOGY ASSISTED WAIVER
The Technology Assisted Waiver is designed to afford individuals who meet the age appropriate waiver and financial eligibility criteria a choice of home and community based care services rather than reside in an acute care hospital, long stay hospital or specialized care nursing facility. Eligible individual’s are both children and adults who are chronically ill or severely impaired, needing both a medical device to compensate for the loss of a vital body function and require substantial and ongoing skilled nursing care to avert further disability or to sustain their lives.
WAIVER ENROLLMENT
Regardless of age, the request for consideration for enrollment into the waiver may originate from acute care hospitals, skilled nursing facilities, through the local department of social services or the health department in which the individual lives or from the community. All individuals must have a Virginia Universal Assessment (UAI) Instrument completed by the local preadmission screening team in the community, nursing facility or hospital discharge planner. The Department of Medical Assistance Services completes the final waiver eligibility determination and enrollment as well as the authorization for skilled private duty nursing services.
CRITERIA
Waiver applicants must meet the following age appropriate medical and functional specialized care nursing facility criteria:
  • Children under the age of 21 must require daily dependence on device-based respiratory or nutritional support, including mechanical ventilators, tracheostomy care, oxygen, tube feedings, prolonged intravenous medication administration or peritoneal dialysis and need substantial and ongoing nursing care as indicated by a score of 50 or greater on the Pediatric Scoring Tool;
  • Adults 21 or older must require ongoing and substantial nursing care and be dependent on mechanical ventilation or meet all of the complex tracheostomy criteria as indicated on the Adult Scoring Tool;
  • Individuals under the age of 21 who meet certain criteria based on various methods of respiratory or nutritional support;
  • Individuals who meet Medicaid eligibility criteria as determined by the local department of social services. Parents’ income and resources are not considered by DSS when making a financial eligibility determination for a child under the age of 18 who is enrolling in the Tech Waiver;
  • Individuals enrolled in the waiver must have a backup plan which includes a primary caregiver who assumes responsibility for and provides skilled nursing care at least eight hours a day and when the skilled agency nurse is not available. All caregivers must be trained in the waiver individual’s care.
Applicants who are eligible for third-party payments for private duty nursing services are not eligible for enrollment into the waiver. When third-party coverage is voluntarily dropped, enrollment can not be considered until 365 days have passed since the discontinuance occurred.
AVAILABLE SERVICES:
  • Assistive Technology;
  • Environmental Modifications;
  • Personal care (Adults Only);
  • Skilled Private Duty Nursing;
  • Skilled Private Duty Nursing - Respite;
  • Transition Services;
WHO CAN INITIATE SERVICES?
There is no cost to be screened to determine eligibility for the waiver. There may be a patient pay for services based on the individual’s earned and unearned income. The local department of social services eligibility worker will determine if an individual has a patient pay.
WHO COORDINATES CARE ONCE THE SCREENING PROCESS HAS BEEN COMPLETE?
The screening team will forward the screening to the Department of Medical Assistance Services (DMAS) where a care coordinator is assigned and the final determination for enrollment based on state and federal criteria, policy and regulations is made. The care coordinator will assist with a smooth transition to waiver services communicating with your physician and the agency provider you have chosen and authorize skilled private duty nursing hours based on assessed needs.
OTHER VIRGINIA MEDICAID RESOURCES:
Individuals receiving waiver services may also be eligible for other supportive Virginia Medicaid services such as medication assistance, physician office visits, hospitalizations and certain therapies and should contact your local Department of Social Services in your area to obtain details and assistance.

Children under the age of 21 may receive services through The Early and Periodic Screening, Diagnosis and Treatment Services (EPSDT), click on the link below for more information http://www.dmas.virginia.gov/Content_pgs/mch-home.aspx.