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A waiver is a program that can waive, or set aside, some of the strict eligibility requirements, including income guidelines, benefits and health care delivery options required under federal Medicaid program regulations. A Home and Community Based Services Waiver can provide extra services that make living at home possible. This can include personal care, nursing, respite, adult day care, supported employment, home modifications, assistive technology and transportation. While waivers can differ substantially between states in eligibility and services, an important advantage is that they can expand services to cover individuals that may be over income for traditional Medicaid. However, because states have the discretion to choose the number of consumers to support in a waiver program, there are often long waiting lists for services.
The Complex Care Center at Cincinnati Children's provides information to help families and health care providers identify sources of financial assistance.
Medicaid Home and Community Based Services Waivers are programs of in home and community care that help eligible Medicaid consumers stay at home instead of in a nursing home, hospital or institution for people with mental retardation and / or developmental disabilities:
Nursing, aide and/or skilled therapy services must be provided by a Medicare-certified home health agency, accredited home health agency, or non-agency RN / LRN.
In addition to the usual Medicaid benefits, like doctor visits and prescriptions, a waiver can provide extra services that make living at home possible. This can include personal care, nursing, respite, adult day care, supported employment, home modifications, assistive technology and transportation, depending on the waiver. However, there are generally long waiting lists for waivers since they support a limited number of individuals.
In addition to the usual Medicaid benefits, like doctor visits and prescriptions, an Ohio Home and Community Based Waiver can provide extra services that make living at home possible. The following table is a brief overview of some helpful Ohio waivers that can pay for services for children and adults with special health care needs. Click on the waiver name to find more detailed information:
Home and Community-Based Waivers Medicaid Fact Sheet provides a comparison of all Ohio waivers.
Since waiver programs pay for services for a limited number of people, their openings can fill up quickly and there may be a waiting list. Children who have been hospitalized for more than 30 consecutive days will be given priority on the waiver waiting list, thereby significantly reducing their waiting time.
Ohio Department of Job and Family Services, Bureau of Home and Community Services oversees Medicaid's integrated program of home care services. The Ohio Home Care Waiver is administered through their county agencies. When an individual is approved, services are coordinated through a single case management agency, CareStar. CareStar provides information about services, resources and supports.
Ohio Department of Developmental Disabilities oversees the Individual Options Waiver and the Level One Waiver through their county boards.
Centers for Medicare & Medicaid Services provides information on Medicare, Medicaid and Waiver programs throughout the United States.
The Medicaid School Program is overseen by the Ohio Department of Education and the Ohio Department of Job and Family Services. It can reimburse participating schools for related services provided to Medicaid-eligible students. Services must be identified in the IEP and can include nursing, occupational therapy, physical therapy, speech therapy, specialized medical transportation and medical equipment and supplies for use only in school. This also covers students who receive the Ohio Home Care or Transitions MRDD waivers. It is possible for a family's current Ohio Home Care waiver provider to go to school with the child if the waiver team determines that the IEP is not adequate to ensure the child's health and welfare.
Kentucky Cabinet for Health and Family Services provides a variety of services and supports including:
Indiana Family & Social Services Administration provides comprehensive services to help the families of children with disabilities live, work, and remain healthy and safe in their communities. They oversee 5 Waiver Programs:
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