ID Waiver Overview
The ID Waiver is administered by Alabama Department of Mental Health (ADMH) and is Alabama’s oldest Home and Community Based Services (HCBS) waiver, created in 1981. It currently is able to serve 5,260 people in the state of Alabama. The ID Waiver offers a broad menu of services aimed at providing both medical care and training services to individuals over the age of three with intellectual disabilities who would have to be institutionalized in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) without waiver services. The ID Waiver does not place a cost limit on the services an individual waiver recipient can access in a year.
The ID Waiver is available to participants in all counties that do not participate in the Community Waiver Program (CWP) BB. New admissions to the ID Waiver in non-CWP counties will continue, and individuals who are already on the ID Waiver but live in CWP counties are permitted to remain on the ID Waiver. A list of counties that have moved to the CWP is included below, and an illustrated map of CWP counties is included as an appendix to this manual. Additionally, at the present time, ADMH has not made public any immediate plans to phase out the ID Waiver for individuals already on it. ID Waiver enrollees are also still entitled to all of the services available under the ID Waiver.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
Eligibility for the ID Waiver
Financial Eligibility for the ID Waiver
All 7 waivers have the same financial eligibility rules.
Medicaid waiver programs, including the ID Waiver, have more flexible financial rules than standard Medicaid. Here’s what you, the person with a disability, need to know:
- If you receive SSI benefits, you automatically qualify financially for a Medicaid waiver.
- An individual may also qualify if your income is up to 300% of the Federal Benefit Rate (FBR). In the calendar year 2025, the FBR is $967 per month, meaning you can have an income of up to $2,901 per month and still be financially eligible for a Medicaid waiver.
While income limits are more generous, there is a resource limit. This means an individual generally cannot have more than $2,000 in resources (like money in bank accounts) in one’sname on the first day of each month, or one could lose one’s Medicaid eligibility.
If you have questions about managing your money and resources to maintain your waiver eligibility, it’s a good idea to talk to an attorney, as everyone’s situation is different.
Important Note for Children: When a child under 18 applies for a Medicaid waiver, only the child’s income and resources are counted, not the parents’. Usually, a child will have no income, making them financially eligible. If a child receives SSI, they are also automatically financially eligible.
Example: A young man earning $1,000 per month at a part-time job would not qualify for standard Alabama Medicaid (which has an income limit of $963 per month in 2024). However, because his income is below the $2,829 per month limit for a waiver, he could be financially eligible for an ID Waiver. If he qualifies for the waiver, he can also receive all basic Medicaid services
Medical and Program Eligibility for the ID Waiver
To qualify, the person must meet all 3 of the following:
☐ IQ score of 72 or below (both before and after age 18)
☐ Formal diagnosis of Intellectual Disability (ID)
☐ Substantial limitations in at least 3 of these areas:
- Self-care
- Living independently
- Understanding or using language
- Learning
- Self-direction (making decisions)
- Mobility
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
Applying for the ID Waiver in Alabama
The ID Waiver is administered by Alabama Department of Mental Health (ADMH). ADMH divides its administrative responsibilities into the following regions, which administer ID Waiver services in the indicated counties:
| Region I | Cherokee, Colbert, Cullman, DeKalb, Etowah, Franklin, Jackson, Lauderdale, Lawrence, Limestone, Madison, Marshall, Morgan |
| Region II | Bibb, Choctaw, Fayette, Greene, Hale, Lamar, Marengo, Marion, Pickens, Sumter, Tuscaloosa, Walker, Winston |
| Region III | Baldwin, Clarke, Conecuh, Dallas, Escambia, Mobile, Monroe, Perry,Washington, Wilcox |
| Region IV | Autauga, Barbour, Bullock, Butler, Chambers, Coffee, Covington, Crenshaw, Dale, Elmore, Geneva, Henry, Houston, Lee, Lowndes, Macon, Montgomery, Pike, Russell, Tallapoosa |
| Region V | Blount, Calhoun, Chilton, Clay, Cleburne, Coosa, Jefferson, Randolph, Shelby, St. Clair, Talladega |
Follow this link for contact information for the region offices.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
Who Manages the Process?
The ADMH works with local agencies called 310 Boards. These boards help people apply for and access services through the ID Waiver.
Once you start an application, your local 310 Board will:
- Help collect required documents
- Do an intake interview
- Assign a Support Coordinator (your main contact during the process)
💡 Some counties may have more than one 310 Board. Contact information for the 310 Boards can be found here.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
Before Applying for the ID Waiver
1. Collect IQ Tests and Diagnosis
You’ll need:
- An IQ test taken before age 18 showing a score of 72 or lower
- An IQ test taken after age 18 (if applicable), also showing 72 or lower
- A doctor’s letter confirming an intellectual disability
Low IQ scores alone are not enough. You need a diagnosis in writing.
2. Gather Other Helpful Documents
Bring anything that shows the applicant’s needs. Examples:
- IEPs or 504 Plans
- Behavior Intervention Plans (BIPs)
- Police or hospital reports
- Vocational Rehab assessments
3. Have Identification Ready
Include:
- Medicaid card (if available)
- Social Security Number
- Birth certificate
- Immigration documents (if needed)
4. Optional: Pre-fill the 204/205 Form
You can complete the 204/205 form early. Talk with your case manager about this.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
Don’t Have an IQ Test?
To qualify for the ID Waiver, you must have at least one IQ test score of 72 or below.
Ways to get tested:
- Under 21? Contact your school district’s special education coordinator to discuss.
- Using Vocational Rehab? Testing is included in their assessment.
- Private Psychologist: Some insurance plans may cover testing.
- Ask ADMH to arrange testing when you apply.
In special cases, ADMH may accept a doctor’s letter diagnosing an intellectual disability instead. Contact your Regional Community Services Office to discuss this option.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
How to Apply for the ID Waiver
Step 1: Call ADMH Developmental Disabilities Call Center
📞 800-361-4491
You’ll have a short phone interview about:
- Diagnoses
- School history
- Past services (e.g., special education)
Be sure to mention intellectual disability during this call.
Step 2: Get Confirmation & Referral
ADMH will:
- Mail you a confirmation letter
- Refer your case to the local 310 Board
Step 3: Work with the 310 Board
They will:
- Contact you
- Ask for your documents
- Set up a meeting for an ICAP interview and a Family History form
Step 4: Regional Office Review
Your completed application goes to the Regional Office. If approved:
- You’re placed on the Statewide Waiting List if no slots are currently available.
Important Timeline – ID Waiver
By law, ADMH must respond to your application within 90 days.
You will either:
- Be approved for waiver services, or
- Receive a denial with instructions on how to appeal.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
ID Waiver Statewide Waiting List & Criticality Categories
What Is the Statewide Waiting List?
If there are no open spots, approved applicants are placed on a waitlist.
Your waitlist number does not reflect your priority. Placement is based on your Criticality Category, not when you applied.
🟥 Criticality Category 1: High Risk (Top Priority)
You may qualify if the person:
- Has no caregiver (e.g., caretaker passed away or abandoned them)
- Is homeless
- Is at serious risk of harm or harming others
You’ll need:
- Documentation like eviction notices, doctor’s statements, police reports
- A High-Risk Assessment
- A Medical & Behavioral Checklist
🚫 Day programs are not available in this category.
🟧 Criticality Category 2: Family Support
You may qualify if:
- The caregiver is sick, elderly, or recently passed away
- The caregiver lost a job or had a major life change
- Multiple family members need support
Must complete the Medical & Behavioral Checklist
🚫 Residential services are not available in this category.
🟨 Criticality Category 3: Daily Living Support
You may qualify if:
- The person needs help with daily tasks or will soon finish school
- Without help, they may need to move to a group home soon
Must complete the Medical & Behavioral Checklist
🟦 Criticality Category 4: Inclusion Support
You may qualify if:
- The person needs services to take part in community activities
🟩 Criticality Category 5: Long-Term Planning
You may qualify if:
- You’re planning for services 1–5 years ahead
- The person will finish school within that time and need job/day support
Must be at least 14 years old to qualify.
💬 Need Help?
Contact the ADMH Developmental Disabilities Call Center:
📞 800-361-4491
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
How to Handle the Wait for the ID Waiver
It’s a tough reality across the U.S.: more people need waiver services than there are resources available.
While you’re on the waiting list, here’s what you can do:
- Stay in touch with your 310 Board.
Let them know right away if your situation changes—especially if it becomes more urgent (like a new health risk or loss of housing). - Report emergencies.
If something happens that might move you into a higher priority category (like Criticality Category 1), reach out immediately. - Follow up regularly.
It’s okay to check in every so often. As the saying goes, “the squeaky wheel gets the grease.”
You are your best advocate. Don’t be afraid to speak up and ask questions.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
ID Waiver Services
The ID Waiver offers a wide range of services to help people with intellectual disabilities live more independently and be part of their communities.
Services you can self-direct (choose and manage yourself) are in bold below.
· Residential Habilitation Training Services
· Day Habilitation Services
· Day Habilitation Services with Transportation
· Prevocational Services
· Supported Employment Services
· Individual Assessment/ Discovery
· Individual Job Coach
· Individual Job Developer
· Supported Employment Transportation Services
· Employment Small Group 1:2-3, 1:4
· Occupational Therapy Services
· Speech and Language Therapy Services
· Physical Therapy Services
· Positive Behavior Support Services
· Personal Care on Worksite Services
· Crisis Intervention Services
· Benefits Counseling Services
· Benefits Reporting Assistance Services
· Community Experience Services
· Housing Stabilization Services
· Remote Supports
· In-Home Respite Care
· Out-of-Home Respite Care
· Personal Care Services
· Individual Directed Goods and Services
· Personal Emergency Response System Services
· Personal Care Transportation Services
· Environmental Accessibility Adaptations Services
· Assistive Technology
· Specialized Medical Supplies Services
· Skilled Nursing Services
· Companion Services
If you’d like help choosing or understanding these services, talk to your Support Coordinator at your local 310 Board. Follow this link for contact information for the 310 Boards.
For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.
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