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Training Downloads

•    ABI Employer Manual-Appendix.pdf
•    Appointment Weekly Schedule.pdf
•    DSS Provider Information Manual - Acknowledgement Form.pdf
•    DSS Provider Information Manual.pdf
•    Employee Training Documentation Form-Spanish.pdf
•    Employee Training Documentation Form.pdf
•    Employer OPT-OUT Form.pdf
•    Employer Orientation Certification.pdf
•    Job Description -Chore Services.pdf
•    Job Description -Companion Services.pdf
•    Job Description -Homemaker Services.pdf
•    Job Description -Personal Care Assistance Services.pdf
•    Weekly Schedule (large format).pdf
•    ABI Service Description for Manual.pdf
•    DSS Provider Information Manual-Spanish translation.pdf

Employment Downloads

•    ABI Employment Packet Sample.pdf
•    DSS Provider Directory Application.pdf
•    Transportation Application Packet.pdf
•    Transportation Services Application Supplement.pdf
•    ILST Application Packet.pdf
•    Rapid Paycard FAQs.pdf
•    DSS Employment Application checklist.pdf
•    Employment Packet Checklist.pdf
•    Employment Status Form.pdf
•    DSS Provider Agreement.pdf
•    Form I-9.pdf
•    DSS Employment Packet.pdf
•    2023 CT W-4.pdf
•    2023 W-4.pdf
•    Employment Forms Packet.pdf
 

General Information Downloads

•    Agency-Vendor Information Update.pdf
•    Discrimination is Illegal Poster (distributed to Employer at the time of home visit).pdf
•    Discrimination is Illegal Poster-Spanish (distributed to Employer at the time of home visit).pdf
•    Emergency Contact & Medical Information Form.pdf
•    Participant-Employer WC Information Booklet (for distribution at the home visit or by mail upon request to DSS program participants).pdf
•    Sexual Harassment is Illegal Poster (distributed to Employer at time of home visit).pdf
•    Spanish Signature Verification Form Sample.pdf
•    Web B Poster to Work English Version.pdf
•    ACR Consent and Acknowledgement Form.pdf
•    Sample Signature Verification Form-Spanish.pdf
•    Sample Signature Verification Form.pdf
•    Grievance Form.pdf
•    Authorized Representative Documentation Packet.pdf
•    Signature Verification Packet.pdf
•    Authorized Representative Document.pdf
•    Authorized Representative Document Instructions with Sample.pdf
•    Participant-Representative Personal Information Update Packet.pdf
•    Personal Information Update Form.pdf
 

Payroll Downloads

•    CT Universal Time Sheet Sample.pdf
•    DSS Vendor Billing Invoice Form (Sample).pdf
•    MFP Realtor Billing Invoice Form.pdf
•    Billing Form for Pre-Approved Services.pdf
•    Pre-Approved Service Payment Authorization.pdf
•    Billing Form for Pre-Approved Services-Sample.pdf
•    CT DSS Universal Time Sheet.pdf
•    Payroll Notice.pdf
•    Direct Deposit Authorization.pdf
•    EVV Telephony Instructions English.pdf
•    EVV Telephony Instructions Spanish.pdf
•    DSS Pay Schedule v2023.pdf
 

Form Links

•    Employee termination Form
•    Non-Payment Inquiry Form
•    Personal Information Update Form
•    Request for Information Form
 
ABI Basic Information Sessions

ABI Basic Informational Session Quiz – 
Handouts – Here
Spanish (Española):
Informacion Basica De La Prueba De Las Sesiones – 
Handouts – Here
 
 
There are two Acquired Brain Injury (ABI) Waivers, known as ABI Waiver I and ABI Waiver II, which are administered by the Department of Social Services (DSS). These waivers provide a person-centered plan of care for an array of non-medical, home and community-based services to individuals with an acquired brain injury who currently receive or would otherwise require services in an institutional setting.

Both waivers are functionally similar, however ABI Waiver II includes new services, has a lower cost cap and does not have Transitional Living Services.

Note: ABI Waiver I is currently closed to new participants.

Eligibility Criteria
To be eligible for the ABI Waiver II, individuals must be:

•    Eligible for Medicaid
•    Between ages 18 and 64 with an acquired brain injury
•    Meet the DSS “Level of Care Requirement” which means that without the waiver services the individual would otherwise receive services in an institutional setting
•    Able to participate in the development of a service plan in partnership with a DSS social worker or have a conservator to do so.
An ABI is an injury to the brain that has occurred after birth which results in improper brain function. The condition cannot be congenital, developmental, or degenerative to be considered for the ABI Waiver II.
Med-Connect applicants may also meet the financial eligibility rules for the program through the Medicaid for Employed Disabled coverage group. Under the program, working individuals can have income up to $75,000 per year, $10,000 in assets and receive Medicaid subject to payment of a monthly premium.

Individuals who cannot afford the cost of care, but are over Medicaid’s limits may still qualify. The state has a spend down program that evaluates an individual’s care costs and their income. If it is calculated that an individual cannot meet their care costs, they can qualify for Medicaid by spending-down their income over the limit on their medically-necessary care costs.

Types of Services & Supports that can be used for Acquired Brain Injury (ABI) Waiver
Services may include assistance with Activities of Daily Living (ADLs) such as eating, bathing, dressing, transferring and toileting.

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Other supports include, but are not limited to:

•    Case management (care plan development and monitoring)
•    Transportation
•    Vocational support
•    Independent Living Skills training
•    Personal Care Assistance (PCA) Services
•    Homemaker-Companion Services
•    Respite Services
•    Home Delivered Meals
•    Assistive Technology
•    Home Modifications
•    Personal Emergency Response Systems (PERS)

 

Connecticut Waiver Factsheet

CT ABI Waiver II (1085.R01.00)

Provides ABI group day, adult day health, homemaker, personal care, prevocational services, respite, supported employment, ABI recovery assistant II, ABI recovery assistant, assistive technology, chore, cognitive behavioral programs, community living support services, companion, consultation services, environmental accessibility modifications, home delivered meals, independent living skills training, personal emergency response systems, substance abuse programs, transportation, and vehicle modification services to individuals with brain injury ages 18 or older who meet a hospital, nursing facility, or ICF/IID level of care.

CT Acquired Brain Injury (ABI) Waiver (0302.R05.00)

Provides homemaker, pre-vocational service, respite, supported employment, ABI group day, assistive technology, chore, cognitive behavioral programs, community living support services, companion, environmental accessibility adaptation, home-delivered meals, independent living skills training, personal emergency response systems, substance abuse programs, transitional living services, transportation, and vehicle modification services to individuals with brain injury ages 18 or older who meet a hospital, nursing facility, or ICF/IID level of care.

CT Comprehensive Supports Waiver (0437.R03.00)

Provides adult day health, blended supports, group day supports, group supported employment,  live-in caregiver, prevocational services, respite, independent support broker, assisted living, assistive technology, behavioral support services, community companion homes, community living arrangements, companion supports aka as adult companion, continuous residential supports, customized employment supports, employment transitional services, environmental modifications, health care coordination, home delivered meals, individual directed goods and services, individual supported employment, individualized day supports, individualized home supports, interpreter, nutrition, parenting support, peer support, personal emergency response system, personal support, remote supports service, senior supports, shared living, specialized medical equipment and supplies, training/counseling/support services for unpaid caregivers, transportation, and vehicle modification services to individuals with developmental disabilities ages 18 or older and individuals with intellectual disabilities ages 3 or older who meet an ICF/IID level of care.

CT Employment and Day Supports Waiver (0881.R02.00)

Provides adult day health, blended supports, group day supports aka community based day support options, individual supported employment, prevocational services, respite, independent support broker, peer support, assistive technology, behavioral support services, customized employment supports, employment transitional services, environmental modifications, group supported employment, home delivered meals, individual direct goods and services, individualized day support, interpreter, personal emergency response system, remote supports, specialized medical equipment and supplies, training/counseling/support services for unpaid caregivers, transportation, and vehicle modification services to individuals with developmental disabilities ages 18 or older and individuals with intellectual disabilities ages 3 or older who meet an ICF/IID level of care.

CT HCBS for Elders Waiver (0140.R07.00)

Provides adult day health, care management, homemaker, personal care assistant, respite, adult family living, assisted living, assistive technology, bill payer, care transitions, chore, chronic disease self-management program, companion, environmental accessibility adaptations, home delivered meals, mental health counseling, personal emergency response systems, recovery assistant, and transportation services to individuals ages 65 or older who meet a nursing facility level of care.  This waiver operates with a concurrent 1915(b)(4) authority.

CT Home and Community Supports Waiver for Persons with Autism (0993.R02.00)

Provides live-in companion, respite, assistive technology, clinical behavioral support services, community mentor, individual goods and services, interpreter, job coaching, life skills coach, non-medical transportation, personal emergency response system, social skills group, and specialized driving assessment services to individuals with autism ages 3 or older who meet an ICF/IID level of care.

CT Individual and Family Support Waiver (0426.R04.00)

Provides adult day health, blended supports, community companion homes, group day supports, individual supported employment, live-in companion, prevocational services, respite, independent support broker, assistive technology, behavioral support services, companion supports aka adult companion, continuous residential supports, customized employment supports, employment transitional services, environmental modifications, group supported employment, health care coordination, home delivered meals, individualized day supports, individualized home supports, individually directed goods and services, interpreter, nutrition, parenting support, peer support, personal emergency response system, personal support, remote supports services, senior supports, shared living, specialized medical equipment and supplies, training/counseling/support services for unpaid caregivers, transportation, and vehicle modification services to individuals with developmental disabilities ages 18 or older, and individuals with intellectual disabilities ages 3 or older who meet an ICF/IID level of care.

CT Katie Beckett Waiver (4110.R08.00)

Provides case management services to individuals with physical disabilities ages 0-22 years who meet a hospital, nursing facility, or ICF/IID level of care.

CT Mental Health Waiver (0653.R03.00)

Provides adult day health, community support program, supported employment, assisted living, assistive technology, brief episode stabilization, chore services, home accessibility adaptations, home delivered meals, interpreter, mental health counseling, non-medical transportation, overnight recovery assistant, peer supports, personal emergency response systems, recovery assistant, specialized medical equipment, and transitional case management services to individuals with mental illness ages 22 or older who meet a nursing facility level of care.

CT Personal Care Assistance Waiver (0301.R05.00)

Provides adult day health, agency-based personal care assistant, care management, meals on wheels, adult family living, mental health counseling, and personal emergency response system services to individuals with physical disabilities ages 18-64 years who meet a nursing facility level of care.  This waiver operates with a concurrent 1915(b)(4) authority.