Get Medicaid Home And Community-based Services: Results From A 50 ...

Filling out the Medicaid Home And Community-Based Services: Results From A 50 ... can seem complex, but this guide provides clear, step-by-step instructions to assist you in completing the form accurately. This document is essential for individuals seeking intensive behavioral services and will ensure that all necessary information is submitted correctly.

Follow the steps to fill out the Medicaid form thoroughly and accurately.

1. Click ‘Get Form’ button to obtain the application form and access it in the online editor.
2. Begin by entering the date and selecting whether this is an initial application or a reauthorization application. Be sure to provide details about your choice, including relevant dates if applicable.
3. In Section I, fill in your name, affiliation (such as agency name), phone number, and email address. This section identifies the person completing the application.
4. Proceed to Section II and provide the individual's name, date of birth, address, TABS ID, city, zip code, and phone number. Confirm whether the individual is enrolled in the waiver, check the appropriate box, and provide the individual's CIN Number. If applicable, list the individual's school.
5. In Section III, address question one by indicating the individual's living arrangement by selecting from the list provided.
6. For question two, list any OPWDD services the individual is currently receiving. Select all relevant services from the options available.
7. In question three, state any clinical services that the individual is currently receiving, marking all that apply.
8. Continue to question four and list any other services that the individual receives, particularly those from different governmental agencies.
9. For question five, specify any medications the individual is currently taking to provide important health information.
10. In question six, write a brief narrative detailing the individual's behavior that needs to be addressed through Intensive Behavioral Services, explaining the potential risks to their current living situation.
11. In question seven, indicate any additional supporting materials being submitted, such as clinical or educational records, and specify any other documents that may assist the application.
12. For question eight, provide documentation that supports the claim of the individual being at risk of being placed in a more restrictive living environment due to behavioral episodes.
13. Finally, ensure that the form is signed and dated by the person completing the application before submission.
14. Review all completed sections for accuracy. Once verified, you can save changes, download, print, or share the form as needed.

Complete your applications online today for timely processing and the support you need.