TBI Waiver Application Process

1.     All referrals must go to regional office at Headway of WNY. The RRDS, Ronald Fernandez or David Giordano or ARRDS Miranda Ward, conducts a personal interview that helps determine appropriateness and eligibility of participant for waiver services.  

2.    The potential participant signs the Freedom of Choice form, Application for Participation and Potential Participant Interview Applicant Acknowledgement Form.

3.    The potential participant is given both the provider list and the service coordinator list. The participant may indicate at this point a choice of Service Coordinator perhaps based on prior experience, or move on to the interviewing steps. The participant is asked to not call anyone on the list until step 5 is completed.

4.    The RRDS Office contacts all eligible Service Coordinators regarding their potential interest in providing services by sending them a general description and information regarding geographical area.

5.    The potential participant is contacted by the RRDS with who on the list would like to be interviewed and the participant is given their code # which identifies them to the possible providers.

6.    The participant schedules at their convenience interviews to pick a Service Coordinator.

7.     It is recommended that the participant meet with all of the Service Coordinators and then decide with whom s/he felt would work best. Although this is encouraged, the waiver participant may choose whomever s/he felt most comfortable with at the time. When you interview, please be sure the person you are interviewing, if picked, will be your Service Coordinator. 

8.    Once the Service Coordinator has been selected, the RRDS needs to be notified with appropriate forms and by e-mail by the selected Service Coordinator.

9.    With the Service Coordinator selected, a plan of services is developed within 60 days. The Service Coordinator works closely with the participant assisting with arranging services. The Service Coordinator will insure that there is a nursing assessment where a PRI/Screen will be done before an initial plan is submitted. Question 21 on the screen must not be 3 for the participant to receive waiver services. Services and number of hours of each service are determined based upon the individual needs, availability of services and wants of the waiver participant. The Service Coordinator reviews with the participant the rights of the participant on the waiver. The participant has the right to choose services from any approved provider agency, not just the agency the Service Coordinator represents.

10.  The service plan then requires the approval of the RRDS

11.  A Notice of Decision (NOD) is issued to the responsible social services district the participant and the Service Coordinator when the plan is approved at the time all specified services can begin.

12.  Services can be changed, either added or removed, at any time if need is justified with the approval of an addendum submitted by the Service Coordinator to the RRDS office.

13.   If not accepted on the TBI Waiver the participant will receive an official notification which includes fair hearing rights regarding the decision.

Other Service Coordinator responsibilities include, but are not limited to:

•         Being the main contact for the participant.

•         Revising/reviewing the Service Plan on a regular/6 month basis

•         Evaluating the services being provided and run a monthly clinical  team meeting with the participant and all the providers.

•         Have a monthly face to face meeting with the participant regarding their waiver services.

•         Reviewing the outcomes of the Service Plan with the participant

•         Maintaining records

•         Ensuring the desirability and appropriateness of community placement

If, for any reason, the participant is concerned about the work of the Service Coordinator, or wishes to change Service Coordinator, s/he may call the RRDS Office (716) 629-3633 for assistance.

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