Waiver Services Coordinator Referrals

Services Coordinators for the Home and Community Based Medicaid Waivers make referrals to ATP for assistive technology and modifications for home and vehicles.

► Referrals are submitted electronically.

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Changes to the referral form were made on January 6, 2020. Please read carefully as you complete the form. Thank you.


  Make a referral   ►​ Service Coordinators: Please hold off sending in a referral if the consumer or their family is currently experiencing flu like symptoms.                         

 Waiver Guidelines

If you have questions contact:
May Faith, Program Supervisor
(402) 471-1369