All HCS programs can get adaptive aids for your loved one through the HCS waiver. What separates a quality program from the rest is how long your loved one has to wait. The process has many steps, and many providers aren’t sufficiently experienced to know how to make the system work quickly for your loved one. Our programs employ knowledgeable and experienced case management staff who know the steps well, and are supervised by even more qualified leaders who have years of experience in getting adaptive aids approved, purchased, and made available without delay. There’s really no secret to it…the key is stay organized, communicate daily with all parties, be persistent, and make the effort necessary every day to keep all others involved on task and your loved one’s needs on top of everyone’s to-do list.
Definition: Adaptive aids are devices, controls, or appliances that enable persons with intellectual disabilities to retain or increase their abilities to perform activities of daily living or control the environment in which they live. Adaptive Aids furnished through the HCS Program provide a direct medical or remedial benefit to the person and are in addition to any medical equipment and supplies furnished under the State Medicaid Plan. HCS approved adaptive aids fall into the categories of:
- Mobility aids
- Control switches
- Positioning devices
- Environmental control units
- Medical supplies
- Communication aids (including batteries)
- Adapted Equipment for Activities of Daily Living
- Safety restraints and safety devices
- Some prescribed medications not covered through Medicare. For a more comprehensive list of specific adaptive aids available in the HCS program listed on the HHSC website, please click the following link, and scroll down to view the "List of Billable Adaptive Aids". Comprehensive Adaptive Aids List.
Process: The following steps are a simplified workflow of how adaptive aids are obtained for your loved one by our agency:
- The need for a specific piece of equipment is identified by a team members, and discussed in a Service Planning Team meeting.
- The Local Authority Service Coordinator is notified to add Adaptive Aids to the Person Directed Plan (PDP), if such is not already included.
- Our Case Manager will modify the Individual Plan of Care (IPC) Implementation Plan (IP) to include the specific equipment needed, justification, cost, and all other necessary information.
- A professional assessment is conducted indicating the need for equipment, how it is to be used, and other relevant information. A previous assessment can be used for this purpose if it includes all necessary information and was completed within the last year.
- The Physician’s order and/or professional recommendation from a specific therapist is obtained for the equipment.
- A Medicaid (and Medicare, if applicable) denial is obtained.
- Three bids are obtained, and one is selected with supporting rationale.
- The item (s) are ordered and purchased by our agency and delivered expeditiously to your loved one.
- Our agency is reimbursed by the HCS program.
Adaptive Aids is a state-managed reimbursement program under the HCS Program (Medicare/Medicaid) and apply to HCS programs. We work closely with these funding programs to assure your loved one has a safe and comfortable living environment at all times.