Does this setting accept participants who are receiving day program services through a Medicaid program such as the MI Choice or the MI Health Link HCBS waiver programs? Yes: If marked, how many participants are currently enrolled in a Medicaid HCBS program? No Complete the below to indicate the population characteristics of participants within your setting. Each person should be listed only once in the most appropriate category. Number of people with this type of health need who are Type of health need receiving Medicaid funded services in this setting Alzheimer’s or Dementia Developmental Disabilities Mental Illness Physical Disabilities Traumatic Brain Injury Is the setting located in the same building or on the same campus as an institutional treatment option (as defined in the glossary on the last page of this survey)? Yes No Does the setting afford opportunities for individual schedules that focus on the needs and desires of an individual? Yes No: If marked, why? Do individuals participate in any of the following activities of his/her choosing in the community (check all that apply)? Individual shopping Religious or spiritual services Scheduled appointments (personal or medical) Meals with friends or family Recreation activities
Does this setting accept participants who are receiving day program services through a Medicaid program such as the MI Choice or the MI Health Link HCBS waiver programs? Yes: If marked, how many participants are currently enrolled in a Medicaid HCBS program? No Complete the below to indicate the population characteristics of participants within your setting. Each person should be listed only once in the most appropriate category. Type of health need Number of people with this type of health need who are receiving Medicaid funded services in this setting Alzheimer’s or Dementia Developmental Disabilities Mental Illness Physical Disabilities Traumatic Brain Injury Is the setting located in the same building or on the same campus as an institutional treatment option (as defined in the glossary on the last page of this survey)? Yes No Does the setting afford opportunities for individual schedules that focus on the needs and desires of an individual? Yes No: If marked, why? Do individuals participate in any of the following activities of his/her choosing in the community (check all that apply)? Individual shopping Religious or spiritual services Scheduled appointments (personal or medical) Meals with friends or family Recreation activities
Non-Residential_Survey_MI_Health_Link_HCBS_Waiver_482960_7.docx