Infants, Toddlers & Families Medicaid Waiver (ITF)

The Pennsylvania Department of Public Welfare has received approval from the Federal government to provide early intervention services funded under a Medicaid Waiver for infants, toddlers and families. As a condition of federal financial participation and in accordance with Office of Child Development and Early Learning Bulletin Number 00-98-07, Eligibility and Freedom of Choice in Medicaid Waiver for Infants, Toddlers and Families; the County and agencies providing services to infants and toddlers who receive services funded with these dollars must satisfy a certain level of care, as well as specific financial eligibility requirements.

Eligibility

To be eligible for ITF Waiver funded services, a child must:

Be determined to need early intervention services, which meet the definition of waiver habilitation
Be eligible for Medical Assistance as determined by the County Assistance Office
Be under the age of three years

Requirements

A 50% delay in at least one or a 33% delay in at least two of the following developmental areas:

Cognitive
Physical, including hearing and vision
Communication
Social and Emotional
Adaptive or Self-Help

The child’s conditions are likely to continue indefinitely for a period of at least 12 months.

Have waiver funded services explained to and chosen by the child’s family or legal representative before waiver funded services are provided
Be receiving services in the natural environment
Be receiving services with the presence and participation of the child’s caregiver

Every child will continue to receive services regardless of whether parents choose to participate in the waiver or other funding sources.

In Accordance With Office of Child Development & Early Learning Bulletin

Number 00-98-07, Eligibility and Freedom of Choice in Medicaid Waiver for Infants, Toddlers and Families Renewal; each child’s level of eligibility must be recertified at least once annually for the child to continue to be eligible for waiver funded IFSP services. This recertification process will be conducted in conjunction with the child’s annual IFSP, whenever possible.

Families are assured of certain information and due process rights under the waiver in accordance with OCDEL Announcement: EI-08 Number 06, IDEA EI Complaint Procedures and OCDEL Announcement: EI - 07 Number 3, Mediation Procedure for Early Intervention, Pt C ITF Waiver Operating Agreement. These rights are in addition to rights afforded under other federal and state funding streams, including EPSDT and Act 212. The County MH/MR program is responsible for notifying the family regarding their rights under the various programs and funding streams and will provide assistance to families in filing due process, fair hearings, and appeals. The families will be informed that they are still entitled to all safeguards, under IDEA Part C, regardless of their choice to obtain waiver funding or the determination of their child’s eligibility for waiver funded services.

View the Parent Guide to Due Process Hearings.

Interim Payments

When necessary to prevent a delay in the receipt of early intervention services by an infant or toddler with a disability or the infant or toddler’s family, State early intervention funds may be used to pay the provider of services pending reimbursement from the funding source that has ultimate responsibility for the payment. Wayne County Behavioral and Developmental Programs and Early Intervention shall seek reimbursement from the responsible funding source to cover the interim payments made for early intervention services.

Documentation of Other Funding Sources

The service coordinator shall maintain written documentation that attempts have been made to exhaust all other private and public funding sources available to an infant or toddler with a disability and the infant or toddler’s family, as required by § 4226.13, in the infant or toddler’s record. Specific procedures relating hereto are found in the Service Coordination section of this policy and procedure manual.