Medically Complex Children's Waiver (MCCW)
https://health.utah.gov/mccw/
This program provides medical assistance to children who are medically complex. This waiver serves the following population:
ï‚· Children ages 0-18
ï‚· Children who have 3 or more specialty physicians
ï‚· Children who have 3 or more organ systems involved in their disability
ï‚· Children who are not meeting age appropriate milestones for their activities of daily living; this includes eating, toileting, dressing, bathing and mobility
ï‚· Children who have an SSI Disability Designation through the SSA or
a disability determination by the State Medical Review Board, this will be
coordinated as part of the MCCW application process.
Required forms/documentation:
ï‚· Authorization to Disclose Health Information You must also provide a copy of the child's most recent history and physical by the Primary Care Provider completed within the last 24 months;
ï‚· a completed Authorization to Release Information form;
ï‚· a completed Medicaid Disability Addendum form;
ï‚· If the applicant has an Individualized Education Program (IEP) please include with the submitted application