A&D Waiver Services: Definitions

01. A&D Waiver Services. Services for the elderly and physically disabled to maintain self- sufficiency, individuality, independence, dignity, choice, and privacy in a cost-effective home-like or community- based setting. It does not include participants in skilled, or intermediate care facilities, nursing facilities, ICF/IID or hospitals. When possible, services should be available in the participant’s own home and community regardless of their age, income, or ability and should encourage the involvement of natural supports. (7-1-26) 02. Employer of Record. An entity that bills for services, withholds required taxes, and conducts other administrative activities for a waiver participant. Such an entity is also called a PAA functioning as a fiscal intermediary (FI). (7-1-26) 03. Employer of Fact. A participant or representative of a participant who hires, fires, and directs the services delivered by a waiver provider. This individual may be a family member. (7-1-26) 04. Fiscal Intermediary. An entity that providing services allowing the participant receiving waiver services, their designee or legal representative, to choose their level of control to recruit, select, manage, train, and dismiss direct care staff regardless of the employer of record, and allows the participant control over their service delivery. (7-1-26)