To apply for Medical Assistance Only, contact your county Department of Family and
Children Services (DFCS) after your Intake and Evaluation Team has screened you for
eligibility for Medicaid waiver services. You will need to show DFCS that you are
eligible for MR waiver services. This can be accomplished by bringing a completed
“Level of Care” with you to your DFCS appointment. This form will be supplied to you
after you are seen by the Intake and Evaluation Team.