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Home and Community Based Services Waiver Guidance Document Division of Children and Families Individualized Care Budget Date Budget was Prepared:
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How to fill out home and community based:

01
Gather all necessary personal information such as name, address, date of birth, and contact information.
02
Identify the specific type of home and community based services you or your loved one require. This can include services such as personal care, meal delivery, transportation assistance, or respite care.
03
Determine the eligibility criteria for the home and community based program you are applying for. Each program may have different requirements based on factors such as age, income level, or specific medical conditions.
04
Complete the application form accurately and thoroughly. Provide all requested information and ensure that it is current and correct. Common sections of the application may include personal information, medical history, and documentation of financial resources.
05
Attach any necessary supporting documentation to the application, such as medical records, income verification, or proof of residency.
06
Review the completed application for any errors or omissions before submitting it. It may be helpful to have someone else double-check the application to ensure its accuracy.
07
Submit the application according to the instructions provided. This may involve mailing it to a specific address, submitting it online, or delivering it in person.
08
Follow up on the application if necessary. This may include contacting the home and community based program to confirm receipt of the application or to inquire about the status of the application.
09
Prepare for any potential interviews or assessments that may be required as part of the application process. These may involve meeting with a social worker or healthcare professional to further evaluate care needs.
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Stay informed about additional resources and support services that may be available to you or your loved one. Consider reaching out to local organizations or agencies that specialize in home and community based services for guidance and assistance.

Who needs home and community based?

01
Individuals who require assistance with activities of daily living but wish to remain in their own homes or communities.
02
Older adults who may be experiencing limitations in mobility or have chronic health conditions that require ongoing care and support.
03
Individuals with disabilities who would benefit from a supportive environment that allows them to maintain independence and community integration.
04
Family caregivers who need respite or additional support in caring for their loved ones at home.
05
Individuals transitioning from a hospital or nursing facility back into the community and in need of continued care and assistance.
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Individuals with limited financial resources who may qualify for subsidized home and community based services to help meet their care needs.
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Home and community based services (HCBS) refer to a range of assistance provided to individuals with disabilities or chronic illnesses in their home or community instead of in an institutional setting.
Individuals or caregivers who are seeking HCBS for themselves or their loved ones may be required to file for these services in order to receive the necessary assistance.
To fill out HCBS forms, individuals or caregivers can contact their local department of social services or health department for assistance in completing the necessary paperwork.
The purpose of HCBS is to provide individuals with disabilities or chronic illnesses the necessary support to live independently in their home or community, rather than in an institutional setting.
Information that may need to be reported on HCBS includes the individual's medical history, current health status, type of assistance needed, and any other relevant information to determine eligibility for services.
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