Connecticut ABI Waiver Eligibility in 2026: Understanding Waiver I and Waiver II Requirements
For a person living with an acquired brain injury, understanding whether they may qualify for Connecticut's Acquired Brain Injury (ABI) Waiver can be the first step toward accessing the supports necessary to remain safely and meaningfully engaged in community life.
But ABI Waiver eligibility is not determined simply by having a traumatic brain injury (TBI), stroke, anoxic brain injury, infection-related brain injury, or another acquired neurological condition.
Connecticut's ABI Waiver is a Medicaid Home and Community-Based Services program. Eligibility involves multiple components, including the nature of the brain injury, age, Medicaid eligibility, functional needs, institutional level of care, ability to participate in person-centered planning, and the need for waiver services.
In 2026, Connecticut has two ABI Waiver programs: ABI Waiver I and ABI Waiver II. Although they share many of the same fundamental eligibility concepts, they are not identical programs, and their practical availability is different.
This guide explains the major eligibility requirements and what individuals, families, clinicians, discharge planners, and advocates should understand when considering the Connecticut ABI Waiver.
Important: This article is educational information and is not a determination of eligibility. Final eligibility decisions are made by the Connecticut Department of Social Services (DSS), based upon the applicable Medicaid rules, waiver requirements, assessments, documentation, and available waiver capacity.
CT ABI Waiver eligibility
What Is the Connecticut ABI Waiver?
The Connecticut ABI Waiver is a Medicaid-funded Home and Community-Based Services program designed to provide non-medical supports to adults with acquired brain injury who would otherwise require care in an institutional setting.
The underlying purpose is straightforward: when a person has an acquired brain injury that creates significant cognitive, physical, behavioral, or functional limitations, appropriate community-based supports may allow that person to live outside an institution.
The ABI Waiver can support areas such as:
Independent living
Activities of daily living
Personal care
Cognitive and behavioral support
Community participation
Employment and vocational development
Transportation
Household management
Respite
Assistive technology
Home accessibility
Socialization
Safety and supervision
Development and retention of functional skills
The waiver is therefore not simply a medical program. It is designed around the functional consequences of brain injury and the supports necessary for community living.
Connecticut DSS describes the ABI Waiver as a person-centered program intended to maintain adults with acquired brain injury in the community rather than an institutional setting.
ABI Waiver I vs. ABI Waiver II in 2026
One of the most common sources of confusion is the assumption that ABI Waiver I and ABI Waiver II are completely separate eligibility systems.
They share many fundamental eligibility requirements.
Both programs are designed for adults with acquired brain injury who meet Medicaid requirements and an institutional level-of-care standard. The regulations also establish requirements concerning person-centered planning, community living, service needs, safety, and cost-effectiveness.
However, the two waivers have important operational differences.
ABI Waiver I
ABI Waiver I is the original Connecticut ABI waiver.
Historically, it has provided services including independent living skills training, supported employment, cognitive/behavioral programs, companion services, homemaker services, transportation, respite, assistive technology, environmental modifications, and transitional living services.
ABI Waiver I has been closed to new intake since the creation of ABI Waiver II in 2014. Connecticut's current public materials continue to identify ABI Waiver I as a closed-to-new-participants program.
DSS is nevertheless seeking to renew ABI Waiver I for another five-year period. The current renewal proposal identifies one substantive change: adding agency-based Personal Care Assistance, a service already available under ABI Waiver II.
The current ABI I authorization expires December 31, 2026, so the renewal process is an important development to monitor.
ABI Waiver II
ABI Waiver II was created to expand Connecticut's ABI waiver infrastructure and remains the principal pathway for new ABI Waiver applicants.
The current federal approval for ABI Waiver II runs from December 1, 2024 through November 30, 2029.
ABI II includes a broad array of services, including:
ABI Recovery Assistant services
Personal Care Assistance
Independent Living Skills Training
Supported Employment
Prevocational services
Cognitive/behavioral programs
Community Living Support Services
Companion services
Respite
Transportation
Assistive technology
Environmental accessibility modifications
Home-delivered meals
Personal Emergency Response Systems
Vehicle modifications
ABI group day services
Caregiver training and support
Remote supports and other approved services
The availability of a particular service is determined by the participant's approved person-centered service plan and applicable waiver requirements.
The Core Eligibility Requirements
Although individual circumstances matter, an applicant generally needs to satisfy several major eligibility components.
1. The applicant must generally be between ages 18 and 64
Connecticut's ABI Waiver eligibility requirements apply to adults ages 18 through 64 at the time of application.
The ABI II waiver documentation specifically states that applicants must be 18 through 64 and complete the eligibility assessment process before age 65.
This does not necessarily mean that turning 65 automatically ends services for an individual already participating in the waiver.
For individuals already enrolled who reach age 65, Connecticut provides options that can include remaining on the ABI Waiver, accessing institutional placement, or transitioning to the Connecticut Home Care Program for Elders, depending upon the individual's circumstances and applicable program rules.
The important distinction is between applying to the waiver and aging while already enrolled.
2. The person must have an acquired brain injury
A diagnosis must meet Connecticut's definition of acquired brain injury.
An ABI is a neurological dysfunction acquired after birth. Connecticut's definition encompasses brain dysfunction associated with circumstances such as:
Physical trauma
Traumatic brain injury
Oxygen deprivation
Infection
Toxic exposure
Surgical events
Vascular events that are not associated with normal aging
The definition specifically excludes conditions that are congenital, developmental, degenerative, associated with aging, or attributable solely to intellectual disability.
This distinction is important.
A person can have significant cognitive or functional limitations and still not meet the ABI definition if the underlying condition falls outside the waiver's definition of acquired brain injury.
Likewise, the presence of another diagnosis does not automatically exclude someone. The key question is whether the functional and cognitive difficulties being evaluated for the waiver are attributable to a qualifying acquired brain injury.
3. Medicaid eligibility is required
ABI Waiver services are Medicaid-funded.
An applicant must therefore satisfy the applicable Connecticut Medicaid eligibility requirements.
Connecticut's ABI regulations establish financial eligibility requirements using Medicaid rules applicable to institutionalized individuals. The ABI waiver regulations identify a special income standard based on 300% of the federal Supplemental Security Income benefit rate, together with applicable Medicaid rules concerning assets and other financial eligibility considerations.
There are also pathways involving Connecticut's Medicaid for Employed Disabled program.
This is important because employment does not automatically mean that a person cannot qualify for Medicaid or ABI Waiver services.
Financial eligibility can be complicated, particularly when an individual:
Works
Receives disability income
Has a spouse
Has substantial medical expenses
Has assets
Is using Medicaid for Employed Disabled
Has a conservator or other legal representative
For that reason, families should not assume that someone is financially ineligible without obtaining a formal Medicaid determination.
4. The person must meet an institutional level-of-care requirement
This is one of the most important parts of ABI Waiver eligibility.
Having an ABI is not enough.
The person must have functional needs significant enough that, without appropriate waiver services, they would otherwise require care at an institutional level.
Connecticut identifies several potential institutional levels of care, including:
Nursing facility level of care
Acquired Brain Injury nursing facility level of care
Intermediate Care Facility for Individuals with Intellectual Disabilities level of care
Chronic disease hospital level of care
The purpose of the level-of-care determination is to establish that the person's disability creates a level of need that rises to the threshold traditionally associated with institutional care.
This is why the ABI Waiver should not be understood as simply a "brain injury services program."
It is a Medicaid waiver designed to provide an alternative to institutional placement.
What Does "Level of Care" Actually Look Like?
For many applicants, this is where the process becomes more complicated.
The level-of-care assessment looks beyond the diagnostic label and considers what the individual actually needs help doing.
Examples may include difficulties involving:
Bathing
Dressing
Eating
Toileting
Transfers
Medication management
Household management
Community safety
Supervision
Cueing
Problem solving
Memory
Executive functioning
Behavioral regulation
Mobility
Community navigation
Vocational functioning
Connecticut's regulations recognize that assistance can include physical assistance, supervision, and cueing.
That distinction is particularly important for people with cognitive disabilities.
A person does not necessarily need to be physically unable to perform a task independently in order to have a significant functional limitation.
Someone may physically be capable of completing a task but require repeated prompting, supervision, cueing, structured routines, environmental supports, or cognitive strategies because of brain-injury-related impairment.
This is one reason why the functional consequences of an ABI need to be documented carefully.
Invisible Disabilities Matter
Brain injury is frequently described as an "invisible disability" because a person may look physically well while experiencing significant cognitive, emotional, behavioral, or executive-function difficulties.
For example, a person may be able to walk, speak, dress, and physically prepare food while still experiencing substantial difficulty with:
Initiating tasks
Sequencing activities
Remembering appointments
Managing medications
Regulating emotions
Understanding social situations
Managing money
Planning
Multitasking
Recognizing danger
Navigating unfamiliar environments
Maintaining employment
Generalizing skills across environments
These difficulties can have major consequences for community safety and independence.
Peer-reviewed research on community integration following TBI has identified cognition, disability, mobility, mood, social support, and other environmental factors as important contributors to community participation.
In other words, independence after brain injury is not determined solely by whether someone can physically perform an isolated task.
5. The applicant must need waiver services
Connecticut's regulations also require an individual to demonstrate an actual need for ABI waiver services.
The current regulations specify that the individual must need at least two waiver services on a monthly basis in order to be considered to need waiver services.
This is an important distinction.
A person may have a qualifying brain injury and significant disability but still require an individualized assessment to determine whether ABI Waiver services are actually necessary and appropriate.
The question is not simply:
"Does this person have a brain injury?"
The more relevant question is:
"What disability-related supports does this person require to remain safely and meaningfully in the community?"
6. The individual must participate in person-centered planning
The ABI Waiver uses a person-centered planning model.
The individual is expected to participate in developing the service plan whenever possible.
Participation may include involvement in decisions concerning:
Services
Providers
Goals
Supports
Staffing
Community activities
Employment
Independent living
Safety strategies
If the person cannot independently participate in the planning process because of cognitive limitations, a legal representative may participate on the individual's behalf.
This is particularly important for individuals with significant cognitive impairment, impaired insight, executive dysfunction, or communication limitations.
A cognitive disability should not automatically be interpreted as an inability to participate in planning.
The relevant question is what level of support or representation is necessary for meaningful participation.
7. The person must choose community-based services
The ABI Waiver is designed for individuals who want to live in the community rather than receive institutional care.
The applicant must therefore choose to utilize community-based ABI services and participate in development of a service plan intended to support community living.
The plan must address identified risks and provide reasonable supports to promote health, safety, and community participation.
This is one of the fundamental principles of Home and Community-Based Services: the goal is not merely to relocate someone from an institution to a house or apartment.
The goal is to create an appropriate support structure that allows the individual to live in the community with meaningful choice and participation.
Neuropsychological Documentation and the ABI Waiver
Neuropsychological documentation can be particularly important in the ABI Waiver eligibility process.
Connecticut's current ABI II application materials describe the use of a neuropsychological examination report as part of the prescreening process.
The regulations provide that the neuropsychological examination report should generally have been completed within two years before the application date, although DSS retains discretion regarding this timeframe in individual circumstances.
The report may help document areas such as:
Attention
Memory
Executive functioning
Processing speed
Cognitive flexibility
Problem solving
Behavioral regulation
Emotional functioning
Functional implications of cognitive deficits
However, a neuropsychological evaluation should not be viewed as the only evidence of disability.
Functional information from family members, physicians, rehabilitation professionals, therapists, case managers, residential staff, employers, and others who understand the individual's day-to-day functioning may also be important.
The central issue is translating test findings and clinical observations into an accurate picture of how the brain injury affects everyday life.
Why Functional Documentation Matters
A diagnosis may explain what happened to the brain.
Functional documentation explains what happens in the person's life because of it.
For example:
A medical record might document a traumatic brain injury.
A neuropsychological evaluation might document impaired executive functioning and memory.
A family member might report that the person repeatedly forgets medications.
A provider might document that the person requires daily cueing to complete household tasks.
An occupational therapist might document safety concerns when the person attempts to prepare meals.
A vocational professional might document that the person requires structured support to initiate and complete employment-related tasks.
Taken together, these pieces of information can create a much more complete picture of the individual's actual support needs.
This matters because ABI Waiver eligibility is fundamentally connected to function, safety, and the need for community-based supports.
What Can Make an Application More Difficult?
Several circumstances can complicate ABI Waiver eligibility.
These may include:
The functional limitations are not clearly connected to the ABI
If the documentation does not establish that the cognitive, behavioral, or physical limitations are attributable to the acquired brain injury, eligibility may be difficult to establish.
The individual does not appear to require institutional level of care
A person may have substantial difficulties but not meet the specific level-of-care threshold required by the waiver.
Medicaid eligibility has not been established
The ABI Waiver is not a substitute for Medicaid eligibility.
The person needs only one waiver service
The regulations require a minimum need for two waiver services on a monthly basis.
There is insufficient functional documentation
A diagnosis alone may not communicate the extent of someone's day-to-day support needs.
The requested service plan is not cost-effective
The service plan must remain within the applicable program cost limits and funding requirements.
Community safety cannot reasonably be maintained
DSS must be able to determine that an appropriate and cost-effective plan can reasonably protect the individual's health and safety in the community.
ABI Waiver Eligibility Is Not the Same as Service Authorization
Another important distinction is that eligibility for the ABI Waiver does not automatically mean that every requested service will be authorized.
Once an individual is determined eligible, the person-centered planning process identifies the supports that are necessary to address the individual's specific needs.
The service plan may include some services but not others.
For example, two people with similar brain injuries may have very different service plans because their functional needs are different.
One person may primarily need:
Independent living skills training
Supported employment
Transportation
Another may require:
Personal care
Recovery Assistant support
Cognitive/behavioral services
Environmental modifications
Respite
The waiver is intended to be individualized rather than diagnosis-driven.
What Are the ABI Waiver Cost Caps?
ABI Waiver I and ABI Waiver II also differ in their individual service-plan cost limits.
Under Connecticut's current regulations:
ABI Waiver I: individual service-plan cost limit of up to 200% of the annualized alternative institutional care cost.
ABI Waiver II: individual service-plan cost limit of up to 150% of the annualized alternative institutional care cost.
These percentages do not mean that every participant receives a budget equal to those amounts.
The actual service plan must be based on documented needs and must remain cost-effective under the waiver's requirements.
This distinction is important when discussing ABI Waiver services with families.
Eligibility establishes access to the program.
The person-centered planning process determines what supports are appropriate.
The applicable cost limits then place boundaries on the total authorized plan.
What Happens After Someone Is Found Functionally Eligible?
ABI Waiver applicants can encounter a waiting list because the program is subject to available capacity and funding.
Connecticut's regulations establish a process through which completed applications are reviewed and individuals who meet the financial and programmatic requirements and the applicable level-of-care criteria can be placed on the waiting list.
When an opening is reasonably expected to become available, DSS can move forward with a comprehensive assessment and development of a proposed person-centered service plan.
This means that being determined eligible and actually beginning services can be two different points in time.
For families, that distinction is critical when planning for:
Hospital discharge
Rehabilitation discharge
Nursing facility transitions
Housing
Employment
Caregiver availability
Safety
Transportation
Long-term community supports
Why Community-Based Brain Injury Services Matter
Peer-reviewed research provides important context for understanding why community-based ABI services matter.
A systematic review of community-based interventions for adults with long-term acquired brain injury found a wide range of intervention approaches addressing functional capacity, participation, and quality of life. The review also emphasized the significant individual variability in outcomes following ABI.
Research on community integration following TBI similarly identifies cognition, disability, physical functioning, mood, social support, and environmental factors as important influences on participation.
Another systematic review found evidence that post-acute rehabilitation can improve community integration following TBI, particularly when interventions address real-world participation.
These findings are consistent with an important principle underlying ABI Waiver services:
Living in the community successfully often requires more than medical treatment.
A person may need ongoing support to translate rehabilitation gains into everyday functioning.
That may mean practicing skills in the actual home environment, developing compensatory strategies, supporting employment, improving community navigation, addressing behavioral barriers, or helping caregivers understand how to provide effective support.
ABI Waiver Eligibility Should Be Viewed Through a Functional Lens
One of the most important things families can do during the ABI Waiver process is describe the person's actual functioning rather than relying solely on diagnostic terminology.
Instead of simply saying:
"He has a traumatic brain injury."
Consider documenting:
"He requires daily cueing to initiate and complete household tasks because he loses track of multi-step activities."
Instead of:
"She has memory problems."
Consider:
"She forgets medication doses despite using a pill organizer and requires another person to provide reminders and verify completion."
Instead of:
"He has executive dysfunction."
Consider:
"He can complete individual tasks when prompted but cannot independently organize, sequence, and initiate the steps necessary to complete the activity."
Functional examples help demonstrate what the person's disability looks like in everyday life.
A Practical ABI Waiver Eligibility Checklist
Families and professionals preparing for an ABI Waiver application may want to consider the following:
Basic eligibility
Is the individual between 18 and 64?
Does the person have a qualifying acquired brain injury?
Is the individual eligible for Connecticut Medicaid?
Could the person qualify through Medicaid for Employed Disabled or another applicable Medicaid pathway?
Functional eligibility
What activities of daily living require assistance?
What instrumental activities require assistance?
Does the person require supervision or cueing?
Are there cognitive impairments?
Are there executive-function difficulties?
Are there behavioral concerns?
Are there safety concerns?
Does the person require structured support to remain in the community?
Clinical documentation
Is there adequate documentation of the ABI?
Is a current neuropsychological evaluation available?
Are the functional consequences documented?
Are relevant medical, rehabilitation, occupational therapy, speech-language, behavioral, or vocational records available?
Community support needs
What supports are currently being provided?
What supports are missing?
What would happen without those supports?
Would the person be at increased risk of institutional placement without community-based services?
What specific waiver services may be necessary?
Person-centered planning
Can the individual participate in planning?
Is a legal representative involved when necessary?
What does the individual want their life to look like?
What are the person's goals for housing, employment, relationships, community participation, and independence?
Frequently Asked Questions
Can someone qualify for the ABI Waiver if they have a traumatic brain injury but look physically independent?
Potentially, yes.
Physical independence does not necessarily mean cognitive or functional independence. The ABI Waiver assessment considers cognitive, physical, behavioral, supervision, cueing, and other functional needs.
The key question is whether the person meets the applicable institutional level-of-care criteria and other program requirements.
Can someone work and still qualify for the ABI Waiver?
Potentially, yes.
Employment does not automatically disqualify someone. Connecticut recognizes Medicaid pathways for working individuals with disabilities, including Medicaid for Employed Disabled.
Financial eligibility should be evaluated rather than assumed.
Does having a conservator prevent someone from receiving ABI Waiver services?
No.
A legal representative can participate in the planning process when an individual is unable to independently perform required planning functions.
Does everyone with an ABI qualify?
No.
A qualifying brain injury is necessary, but it is only one component of eligibility.
Age, Medicaid eligibility, level of care, service needs, person-centered planning, safety, cost-effectiveness, and other program requirements also matter.
Can a person with stroke qualify?
Potentially, yes.
A stroke can result in an acquired brain injury, depending upon the circumstances and the resulting functional impairments. The individual would still need to meet the ABI Waiver's other eligibility requirements.
Can someone with a brain injury and mental health diagnosis qualify?
Potentially.
The presence of a mental health diagnosis does not automatically exclude an individual. However, Connecticut's ABI criteria distinguish impairments attributable to an acquired brain injury from cognitive or behavioral dysfunction attributable solely to another condition.
Is ABI Waiver I available to new applicants?
ABI Waiver I has been closed to new intake since ABI Waiver II was established. As of 2026, DSS is seeking to renew ABI Waiver I, but the current practical pathway for new applicants is ABI Waiver II.
Does getting on the waiting list mean services begin immediately?
No.
A person can be determined functionally eligible and placed on the waiting list before a waiver opening becomes available and services are authorized.
The Bottom Line
Connecticut ABI Waiver eligibility is ultimately about much more than a brain injury diagnosis.
The central questions are:
Does the person have a qualifying acquired brain injury?
Does the person meet Medicaid requirements?
Does the brain injury create functional needs significant enough to meet an institutional level-of-care standard?
Does the person require waiver services to remain safely and meaningfully in the community?
Can an individualized, person-centered and cost-effective service plan be developed?
For families navigating ABI after hospitalization, rehabilitation, nursing facility care, or a major change in independence, understanding these requirements early can make the process much easier to navigate.
Brain injury recovery does not end when someone leaves rehabilitation.
For many survivors, the most important work begins when they return home: relearning routines, rebuilding independence, navigating employment, managing relationships, adapting to cognitive changes, and developing strategies that make community living sustainable.
That is where appropriately designed community-based ABI services can become an important part of the long-term recovery process.
Peer-Reviewed Research and Primary Sources
Connecticut Department of Social Services. Acquired Brain Injury Waiver information and eligibility requirements.
Centers for Medicare & Medicaid Services. Connecticut Acquired Brain Injury Waiver (0302.R05.00), current federal waiver documentation.
Centers for Medicare & Medicaid Services. Connecticut ABI II Waiver (1085.R02.00), current federal waiver documentation.
Hauger, S. L., et al. (2022). Community-Based Interventions After Acquired Brain Injury—A Systematic Review of Intervention Types and Their Effectiveness. Journal of Head Trauma Rehabilitation.
Reistetter, T. A., & Abreu, B. C. (2005). Appraising evidence on community integration following brain injury: A systematic review. Occupational Therapy International.
Kim, H., & Colantonio, A. (2010). Effectiveness of rehabilitation in enhancing community integration after acute traumatic brain injury: A systematic review. American Journal of Occupational Therapy.
Murad, M. H., et al. (2024). Home and Community-Based Services: A Systematic Review and Evidence Map. Journal of General Internal Medicine.
Dillon, E., Fortinsky, R., Barry, L., et al. (2024). Potentially Preventable Hospitalizations in a Connecticut Medicaid Home and Community-Based Services Population. Innovation in Aging.
Home- and Community-Based Services: A Comparison of Brain Injury Waivers Across the United States. Peer-reviewed analysis comparing brain injury waiver structures and eligibility across states.
A Note About 2026 Eligibility
Connecticut's Medicaid waiver policies can change through amendments, renewals, federal approvals, legislation, and administrative guidance. ABI Waiver I is specifically undergoing a renewal process in 2026, while ABI Waiver II has an approved waiver period extending through November 2029.
For that reason, individuals and families should confirm current eligibility requirements with Connecticut DSS before relying on this article for an application or appeal.
The Supported Living Group's Connecticut ABI Knowledge Center is intended to help survivors, families, professionals, and community partners better understand acquired brain injury services and the systems that support community living.