A new Medicaid 1915(c)(11) waiver authority (effective July 1, 2028) lets states serve people with brain injury who don't meet an institutional level of care — a population that often falls through the cracks of existing HCBS eligibility pathways. This resource outlines key factors states should weigh and how NASHIA can help with waiver design, stakeholder engagement, and preparation for the CMS application process.

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Medicaid community engagement requirements require certain beneficiaries to participate in qualifying activities, such as work, education, job training, or community service, or to qualify for an exemption.

This resource outlines considerations for states and partners in implementing these requirements in ways that recognize how brain injury may affect memory, communication, organization, behavior, and the ability to navigate complex systems.

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NASHIA is excited to join our partners with the Link Center, the National Association of State Directors of Developmental Disabilities Services (NASDDDS), and NADD, in announcing the release of a new groundbreaking publication, Cross-System Strategies to Support Children with Complex Behavioral Health Conditions, authored by Nancy Thaler with contributions from Stacy L. Nonnemacher, PhD. This important resource responds directly to one of the most urgent challenges facing states and families: how to better support children with complex behavioral health needs who are often served across multiple systems, including behavioral health, child welfare, Medicaid, developmental disabilities, acquired brain injury, education, and juvenile justice.

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