Home & Community-Based Services Waivers
Home and Community-Based Services (HCBS) waivers, like the TEFRA State Plan Option, allow states to disregard family income for children with severe disabilities who are eligible for institutional placement, but who are cared for at home. In contrast with the TEFRA State Plan Option, the HCBS waivers usually provide an enhanced package of services designed to support families in keeping their children in the community rather than in institutions. However, waiver programs restrict eligibility to a pre-determined number of slots, and can limit enrollment to children with specific diagnoses or disabilities such as AIDS, autism, developmental disability, or traumatic brain injury. Although 48 states offer services through HCBS waivers, only a very small number of waiver recipients and waiver expenditures are linked to HCBS waivers that serve only children. Children are often served under general waivers for people with mental retardation, developmental disabilities, or physical disabilities.
