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Acquired Brain Injury (ABI)

The Acquired Brain Injury (ABI) Waiver program provides intensive services and supports to adults with acquired brain injuries working to re-enter community life. Services are provided exclusively in community settings.

What services are available?

The following 14 services are funded:

  • case management
  • personal care
  • companion services
  • respite care
  • environmental modifications
  • behavior programming
  • counseling and training
  • structured day program
  • specialized medical equipment and supplies
  • prevocational services
  • supported employment
  • occupational therapy
  • speech and language services
  • community residential services (excluding room and board)

Upon completing the Map - 26 - ABI Program Application, clients will be transitioned to other community resources.

Note:  For members interested in Consumer Directed Option Services for ABI, visit the DMS CDO Web page.

How do I apply for Services?

To qualify for services, an individual must:

  • have an acquired brain injury
  • be between the ages of 21 and 65
  • meet nursing facility level of care
  • be expected to benefit from waiver services, and 
  • be financially eligible for Medicaid services

ABI Waiver program exclusions
The following conditions are not considered acquired brain injuries requiring specialized rehabilitation:

  • A stroke treatable in a nursing facility providing routine rehabilitation services
  • A spinal cord injury with no known or obvious injury to the intercranial central nervous system
  • Progressive dementia or other mentally impairing condition of a chronic degenerative nature such as senile dementia, organic brain disorder, Alzheimer's Disease, alcoholism or other addiction
  • Depression or psychiatric disorders with no known or obvious central nervous system damage
  • Birth defects
  • Mental retardation not associated with an acquired brain injury
  • A condition which causes an individual to pose a level of danger or aggression which cannot be managed and treated in a community setting

Note: Special financial eligibility criteria for Medicaid are applied for this program.

To apply, first complete the Map - 26 - ABI Program Application. When funding becomes available, an allocation letter will be sent directing you to choose a case manager who will help you with the admissions process and the development of a plan of care.

You may obtain a listing of ABI Enrolled Providers in your area or contact the Acquired Brain Injury Branch at (502) 564-5198.

 

Regulations, Billing Information, Letters, Forms and Publications
 

Regulations
907 KAR 3:090
907 KAR 3:100

Billing Information
Acquired Brain Injury Billing Manual

Provider Letters
Provider Letter #A-22 - Medicaid Waiver Assessment Process (05/07/09)
Provider Letter #A-21 - Map 95 Billing Process (4/27/09)
Provider Letter #A-19 - Operational changes for ABI Waiver Members with CDO (06/26/08)
Provider Letter #A-18 - Document Consideration(05/08/08)
Provider Letter # A-12 - Organizational Changes to ABI (11/30/06)

Forms:
MAP 10 - Waiver Services
MAP 24 C - Admittance, Discharge or Transfer of an Individual in the ABI/SCL Program
Map - 26 - ABI Program Application
Map 95 - Request for Equipment Form
MAP 109 - Plan of Care/Prior Authorization for Waiver Services
Map 351 - Medicaid Waiver Assessment
MAP 2000 - Initiation/Termination of Consumer Directed Option (CDO)

Publications
:
Acquired Brain Injury Brochure

 

Contact Information:
 

Department for Medicaid Services
Division of Community Alternatives
Acquired Brain Injury Branch
275 E. Main St.
6W-B
Frankfort, Ky. 40621

Phone: (502) 564-5198
Fax:  (502) 564-6568
Toll Free: (866) 878-2626

Contact us by e-mail:
CHFS DMS Webmaster

 

Last Updated 6/12/2009
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