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Children's Extensive Support (HCBS-CES)


Children’s Extensive Support (CES) – is a program that provides Medicaid-funded services and supports to children with developmental disabilities or delays who have the most intensive behavioral and/or medical needs and are at high risk of out-of-home placement.  Eligible children demonstrate a behavior or have a medical condition that requires direct human intervention, more intense than a verbal reminder, re-direction or brief observation of medical status, at least once every two hours during the day and on a weekly average of once every three hours during the night.  The behavior or medical condition must be considered beyond what is typically age appropriate and be due to one or more of the following conditions:


  1. A significant pattern of self-endangering behavior(s) or medical condition which, without intervention will result in a life threatening condition/situation.
  2. A significant pattern of serious aggressive behaviors toward self, others or property.
  3. Constant vocalizations (on average of fifteen (15) minutes of each waking hour), such as screaming, crying, laughing, or verbal.



HCBS-CES Waiver amended effective 12/1/11 as approved by the Centers for Medicaid and Medicare Services (CMS) on 10/31/11