Federal, exists in every state
Medicaid home-care programs (waivers)
Approved services at home, such as nursing or personal care, depending on the program and the child’s assessed needs.
What it is
Approved services at home, such as nursing or personal care, depending on the program and the child’s assessed needs.
In Washington, nursing at home for a child on Apple Health runs through the Medically Intensive Children’s Program; the state’s other home-care waivers require developmental-disability eligibility and an institutional level of care, which leukemia alone does not establish. This questionnaire cannot assess either; the care team can.
Rules
- Developmental-disability waivers: developmental-disability eligibility, disability, care level and an approved service plan; funded enrollment must be available.
- An approved waiver can use the child’s finances rather than parental income; that is not a general cancer-only exemption.
What you get
- Approved home services for children who meet a program’s criteria.
Detail
- Do not assume your child must join a waiting list before requesting covered Apple Health services.
If you decide to apply
- Ask whether the discharge or home-care team should assess the actual tasks, their frequency and the skilled-care needs; your answers here cannot settle the care level.
Discharge planner or care manager
If it becomes relevant
- Ask the discharge team to identify the Washington service matching the assessed needs.
Good to know
A note of the tasks you do at home and how long they take helps any assessment; it is not a requirement.
Other details
- Related Washington card: Skilled nursing at home.
Related Washington card: Skilled nursing at home (Medically Intensive Children’s Program).
Official sources
“If our child’s care at home becomes heavier, which Washington program would you ask the care team to assess for, and what should we note down?”
Why I’m asking: We want to be ready if home care needs change.
More background and detailed requirements
How this works
A Medicaid waiver is a particular state program with a defined group of eligible people and care requirements. Cancer alone does not establish eligibility, and not every home-care service requires a waiver.
In Washington, a child needing skilled nursing should be assessed for the Medically Intensive Children's Program when appropriate. The discharge team can also check other Apple Health services based on the actual care required.
Washington DDCS waivers can cover qualifying children without first requiring a long hospital stay, but developmental-disability eligibility, disability, care-level, financial and funded-enrollment requirements apply. Medically intensive children's nursing requires Apple Health eligibility first; nursing approval does not itself create an income exemption.
- Ask the discharge team to assess the nursing and other care your child will need at home and identify the right Washington service.
Before you start
- A waiver application, service authorization and finding an available nurse are separate steps.
- Do not assume your child needs to join a waiting list before requesting covered Apple Health services.
A waiver application, service authorization and finding an available nurse are separate steps.
Do not assume your child needs to join a waiting list before requesting covered Apple Health services.
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Register the child on the list, keep the task log, and answer the assessment call when it comes.
Your social worker
Names the waiver that takes medically fragile children in this state and helps with the registration form.
The care team
Documents the nursing-level tasks and the risk if care stops.
- Who decides
- The state waiver agency after a level-of-care assessment
- Ask your social worker
- “Which home-care program fits my child, and can we register today? Can Medicaid start home-nursing hours while we wait?”
How to apply
First step: Ask the discharge team which state home-care service or waiver fits your child's assessed needs, and how to apply.
- Register on the list this week.
- Ask the Medicaid plan for EPSDT nursing hours while you wait.
- Keep a two-week task log for the assessment.
Where it starts: State application or interest list. Assessment when a slot opens
What to gather
- A two-week log of daily tasks: what, how often, how long
- Doctor's letter naming nursing, equipment or safety needs
- Medicaid ID if the child has one
How long: Application steps, assessment timing and waiting-list availability depend on the specific state program. Ask for its current process.
What a yes looks like
A service plan with approved hours and a case manager's name.
What a no looks like, and the next move
“Does not meet level of care” or “no slot”: ask for Medicaid's rule that a child under 21 gets what is medically needed nursing through the Medicaid plan instead, and stay on the list.
Watch out
- If a suitable waiver has a waiting list, ask how and when to register and how priority is determined.
- For a child already on Medicaid, Medicaid's rule that a child under 21 gets what is medically needed home nursing can start long before a waiver slot opens. Ask for both.
- The assessment considers the child's actual care needs under the specific program's rules. No diagnosis or item of equipment guarantees approval.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 7, 2026.
What it is worth
Nursing hours, respite, personal care, equipment, home changes and a case manager. The value is the approved hours.
Covers: Case management · Respite · Personal care · Nursing (some waivers) · Adaptive equipment · Home and vehicle modifications · Caregiver training
What it costs the family: Medicaid-delivered. Patient liability depends on the state.
The eligibility facts, as published
- State specific
- yes
- Institutional level of care
- yes
- Target population
- medically fragile or technology-dependent children in most states
Decisions this site cannot make: Level of care · Service-plan necessity · Financial eligibility (child-only in institutional-deeming waivers)
Expect friction on: Interest lists · Provider shortages · Reassessment
The trap: Ask which waiver, if any, serves your child's needs and whether it has a waiting list. Request covered Medicaid services separately while any waiver application is reviewed.
What changes by state: Which waiver takes medically fragile children, the list length (Texas runs years), and whether parents' income is ignored.
Where I read this
- Home and Community-Based Services 1915(c) — Centers for Medicare & Medicaid Services, read August 27, 2026
- Full List of Medicaid Waivers and Programs — Kids’ Waivers, read August 27, 2026
- Early and Periodic Screening, Diagnostic, and Treatment — Centers for Medicare & Medicaid Services, read August 27, 2026