What is the Medically Dependent Children’s Program (MDCP) Waiver?

If you have STAR Kids patients, there’s a chance some of them receive the Medically Dependent Children’s Program (MDCP) waiver, which is a home and community based services program. The goal of this program is to support families and children by preventing institutionalization and hospitalization, while helping them remain safely in their homes with the appropriate services. Examples of these services include flexible family support service, respite, minor home modifications, adaptive aids, transition assistance services, employment assistance, supported employment, and financial management services. The purpose of enrolling a child into the MDCP waiver is to improve quality of life while decreasing cost of care, improving his or her health and psychosocial outcomes, and provide the most effective and appropriate in-home and community services.

For basic qualification, the MDCP waiver does not take into account the caregiver’s income, but it does consider the child’s income. To enroll in and receive services from this waiver, the caregiver has 2 options: enroll and be placed on the state’s interest list, or bypass the interest list –which can be at least a 10 year wait –and undergo the Money Follows the Person (MFP) process. The MFP process requires the family to be responsible for paying for an overnight nursing facility stay and a physician recommendation for that stay to occur. The caregiver is responsible for contacting the state to begin the enrollment process for either the Interest List or MFP process. Once the child has been released and undergone the Screening and Assessment Instrument (SAI) conducted by a Texas Children’s Health Plan Service Coordinator to gauge if he or she meets the medical necessity for the wavier, the MCO is then handed the responsibility of managing the services provided via the MDCP waiver. The member must use at least one (1) service a month in order to remain active with the waiver.

If you think one of your STAR Kids patients may qualify for the MDCP waiver, educate the family about it today!