Eligibility for the Connecticut ABI Waiver is determined through a combination of factors, including an individual's diagnosis, functional needs, financial eligibility, and ability to safely benefit from community-based services.

While eligibility decisions are made by the Connecticut Department of Social Services (DSS), individuals typically must meet several key requirements.

These may include:

1. The Individual Must Have an Acquired Brain Injury

The ABI Waiver is intended for adults who have experienced an acquired brain injury after birth.

Examples of qualifying acquired brain injuries may include:

• Traumatic brain injury (TBI) caused by:

  • Motor vehicle accidents

  • Falls

  • Sports injuries

  • Assaults

  • Other traumatic events

• Non-traumatic brain injuries caused by:

  • Stroke

  • Brain tumors

  • Oxygen deprivation (anoxic or hypoxic injury)

  • Certain infections affecting the brain

  • Other neurological events

An acquired brain injury does not only refer to physical damage. Many individuals experience ongoing cognitive, behavioral, emotional, and executive functioning challenges that significantly impact daily life.

2. The Individual Must Demonstrate Functional Support Needs

A diagnosis alone does not determine ABI Waiver eligibility.

The ABI Waiver is designed for individuals who require assistance due to the impact of their brain injury on their ability to function independently.

Support needs may include challenges with:

• Managing daily routines

• Organizing and initiating tasks

• Memory and learning new information

• Problem solving and decision making

• Safety awareness

• Medication management

• Emotional regulation

• Community navigation

• Maintaining employment or education goals

• Managing relationships and social interactions

• Completing household responsibilities

Many individuals with brain injuries experience what are often referred to as invisible disabilities. A person may appear physically independent while still requiring significant support due to cognitive or behavioral changes.

3. The Individual Must Require a Level of Support That Can Be Provided Safely in the Community

The ABI Waiver is a community-based alternative designed to help individuals remain outside institutional settings when appropriate supports are available.

Eligibility considerations may include whether an individual:

• Can benefit from community-based services

• Requires ongoing supports to maintain independence

• Has goals that can be addressed through waiver services

• Can safely participate in an individualized service plan

The purpose of the waiver is not simply to provide assistance—it is to help individuals develop skills, maintain independence, and participate meaningfully within their communities.

4. Financial Eligibility Requirements Must Be Met

Because the Connecticut ABI Waiver is a Medicaid-funded program, applicants must meet financial eligibility requirements established by the Connecticut Department of Social Services.

Financial eligibility requirements may include considerations related to:

• Income

• Assets

• Medicaid eligibility status

Because Medicaid rules can be complex and individual circumstances vary, applicants and families are encouraged to work directly with DSS or qualified professionals familiar with Connecticut Medicaid programs.

5. The Individual Must Be Age Eligible

The Connecticut ABI Waiver is designed for adults with acquired brain injuries.

Specific age requirements and program criteria are determined by DSS and may change over time. Individuals and families should confirm current eligibility requirements directly through official DSS resources or through knowledgeable ABI Waiver professionals.