Assessment to see if you qualify

After you call the HSD office, the next step is to see if your child or family member qualifies for Medicaid Waiver services.

What to expect:

  • Someone from the HSD office will call to schedule a face-to-face meeting. If it's hard for you to get to the office, they can meet you at your home or somewhere else. This should be done within 10 days after you call them. If it doesn't happen, call them again!

  • They might ask for medical records or results from any evaluations that have been done. If your child has an IEP, they will look at that as well.

  • They will do an assessment called a SUN: Screen for Urgency of Need. This is to see what needs your family member has, and how urgent these are. They will ask about your family member's disability, skills, medical needs, and ability to take care of basic personal needs.

  • They will give you a SUN Score, based on the assessment. A score of 0 means that the needs are not urgent and can wait. A score of 4 is the highest and means that there are urgent needs for support right away. The higher the score, the sooner you will get the services. (Click on the link at the bottom of the page to download a fact sheet about this.)

An image of an envelope representing a letter from your local HSD officer. If it is a statement of approval or SOA, then you will be put on the waitlist for services. If it is a Statement of Denial or SOD, then you can appeal or try again.

Here's what you can do:

  • Think about your family member's skills, habits, and ability to take care of basic needs. If your child lives at home, think about what kind of support you need to care for them. Be ready to speak up for what you think they need!

  • Write down your notes to share in the meeting. It will help to know exactly what they may need.

  • Gather any documents you have that relate to their disability. These include medical records, your child's IEP, test results, and notes from teachers or therapists.

  • Bring someone with you for support or just to help you listen.

  • Ask questions! Make sure you understand everything. Feel free to ask about other Waivers you've read about in this Guide, even if they don't mention them.

  • Ask what other services your family member could get.


Sources: LDH, OCDD