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my name is Linda Walcott Im with the division of aging I will be talking about waiver 101 what is a waiver the waiver actually came from the Social Security Act which permits States to offer an array of services for people to avoid institutionalization and the term waiver refers to waiving of certain federal requirements for example home and community-based services or waivers are not Medicaid entitlement programs now states have flexibility in design as you can see on this slide they can determine the target group of beneficiaries they can specify the services that are furnished they can incorporate opportunities for participants to direct and manage their waiver services they can also determine the qualifications of the providers and they can design strategies to assure the health and welfare of waiver participants they can also manage a waiver to promote the cost effective delivery of services they can link delivery of waiver services to other programs and other associated service