What is a Kaileigh Mulligan Waiver?

In the state of Massachusetts this is called the Kaileigh Mulligan Waiver. The Kaileigh Mulligan Program provides MassHealth services and benefits to certain children with severe special needs who are over the income standards for MassHealth eligibility and require the same level of ongoing nursing and medical needs as a child living in a pediatric nursing home or hospital. There are currently 198 children enrolled in this program in Massachusetts through DMA (as of December 20, 2001). Additional children, estimated to be 40-50 are enrolled each year through the Massachusetts Commission for the Blind. Total enrollment in the Kaileigh Mulligan Program (KMP) has averaged 250 children each year since it was established. This program was developed out of Section 134 of TEFRA 1982 (Tax Equity and Fiscal Responsibility Act) P.L.97-248 and Section 1902(e) of the Social Security Act. To be determined eligible, a child under age 18 years must:

• 1) meet Title XVI disability standards or were receiving SSI on August 22, 1996 and continue to meet the Title XVI standards that were in effect prior to August 22, 1996;
• 2) have $2,000 or less in countable assets;
• 3) have a countable income amount of $60 or less or if greater than $60 meet a deductible in accordance with 130 CMR 520.023 et seq; and,
• 4) require a level of care equivalent to that provided in a hospital or pediatric skilled nursing facility in accordance with 130 CMR 519.006(A)(3) and (4). Additionally, the care provided outside an institution must be determined appropriate by DMA and the estimated cost paid by MassHealth would not be more than the estimated cost if the child were in an institution. Children enrolled in the KMP receive the standard benefits package described above.

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