Medically Intensive Children's Program (MICP)
MICP provides skilled nursing services to children ages 17 and younger with complex medical needs that require support from a registered nurse. Nursing services may be provided in the family home, foster homes, and contracted medically intensive children’s groups and staffed residential homes.
To be eligible, you must meet all of these requirements:
- Be age 17 or younger
- Have complex medical needs (example: ventilator dependent, require tracheostomy care)
- Enrolled in Washington Apple Health (Medicaid)
- Require at least four hours of continuous skilled nursing care per day
To learn more about this program, contact our Case Management department:
- Email us at cmrefwash@amerigroup.com
- Call toll free at 1-855-323-4688, ext. 33118
If you need extra help getting private duty nurses, call the Health Care Authority Medical Assistance Customer Service Center at 1-800-562-3022 (TTY 711).
The Americans with Disabilities Act (ADA) gives you or your child the right to receive Apple Health (Medicaid) services in your home or community instead of a hospital or institution, if possible. This federal law requires states and Medicaid managed care plans to help families receive skilled private duty nursing services if requested (directly or through referral). Families must receive timely access to these services. If you feel you are not receiving services in the time you need them or if you are not receiving all the services you are entitled to because you can’t find nurses, you have the right to ask us or the state to help you.
In September 2015, a group of children receiving Medicaid benefits filed a federal lawsuit against the state. The lawsuit claimed that the state was violating federal Medicaid law and the Americans with Disabilities Act in provision of in-home nursing care. In January 2016, a federal judge issued a preliminary injunction against the state, ordering the state to take all actions necessary to provide required in-home nursing care to the plaintiffs.
In December 2016, the plaintiffs and the state reached a settlement of the lawsuit. The settlement requires the state to take certain actions to increase the level of in-home nursing care for eligible Medicaid clients, including sharing this fact sheet with families. For more information, contact the Northwest Justice
Project either:
- By phone at 206-707-7205
- Online at Northwest Justice Project
Amerigroup & the Health Care Authority (HCA)
This program is run by Amerigroup in partnership with the Washington State HCA.
Amerigroup:
- Determines eligibility once the application is complete
- Assesses the child and determines medically needed services, including the specific number of hours required and authorized
- Arranges for timely access of medically needed services
- Sends the written authorization letter
HCA:
- Provides oversight of how Amerigroup delivers MICP services
- Helps families who experience difficulty getting private duty nursing services
- Ensures children enrolled in Apple Health (Medicaid) get the nursing services they need
Developmental Disabilities Association (DDA):
- Determines eligibility for Developmental Disabilities (DD) waiver services
- Provides the DD waiver services
This program is also supported by:
- DSHS Children’s Administration
- DSHS Home and Community Services Division
- Health Care Authority
- Service providers
- Families of clients
- Community organizations
- Hospitals
Medically Intensive Children’s Program flier
