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Applications Open for Medically Complex Children's Waiver

Sue Reeves

10/05/2015

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Applications for the Medically Complex Children's Waiver are open until October 29

The Medically Complex Children’s Waiver was authorized by the Utah State Legislature (details here) as a pilot program that will run through June 30, 2018. Authorized funding for the program will allow approximately 165 children to be served on an ongoing basis during the pilot period. Children enrolled in this program will have access to respite services, as well as traditional Medicaid services.

The Department will hold an open application period that will run from Oct. 1-29, 2015. Applications will be accepted online through this webpage, via fax or mail. The application process will require parents to answer some questions about their child’s medical conditions and services. In addition, parents will be required to provide a copy of the child’s most recent history and physical or Well Child Check by their Physician.

In order to qualify the child must:

  • Be 0 through 18 years of age; (the individual is eligible until turning 19)
  • Have 3 or more specialty physicians in addition to their primary care physician
  • Show medical complexity involving 3 or more organ systems
  • Demonstrate a level of medical complexity based on a combination of need for device-based supports, high utilization of medical therapies, treatments and frequent need for medical intervention
  • Have an SSI level of disability determined by the Social Security Administration or the State Medical Review Board. As part of the Medicaid eligibility determination process, the State will work with families to arrange to have a disability determination completed through the State Medical Review Board

Answers to frequently asked questions about the application process and other program details are now available on the Utah Department of Health website.

To receive updates on the MCCW open application period and other information, please enroll in the MCCW listserve by following the instructions found at http://health.utah.gov/ltc/mccw/listserv.html.

For more information, please contact the Utah Department of Health via phone at (800) 662-9651, option 5 or via e-mail at mccw@utah.gov.

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