| | Waiver and Nursing Home
Waiver / Nursing Home
Medicaid Home and Community-Based Services (HCBS) waivers allow people with disabilities and chronic conditions to receive care in their homes and communities instead of in long-term care facilities, hospitals or intermediate care facilities. These programs are called waiver programs because, under current law, eligible people with disabilities and chronic conditions are entitled to facility-based care, but home and community-based care is considered optional. Therefore, states must apply for “waivers” from the federal government in order for Medicaid to provide home and community-based services. Waivers allow individuals with disabilities and chronic conditions to have more control of their lives and remain active participants in their community.
Medicaid provides funding for and is ultimately responsible for all of Ohio’s eight waivers. In state fiscal year (SFY) 2011, waivers provided alternative access to long-term care to nearly 72,000 Ohioans.
What is level of care?
Level of care (LOC) is used to determine the appropriate types of long-term care for which Medicaid will pay, either in an institutional setting or in the home and community. People who want to enroll in a Medicaid Home and Community Based Services
(HCBS) waiver must meet the specific LOC requirements for that waiver. All individuals must meet and exceed the requirements of a Protective LOC, which includes a need for assistance with instrumental activities of daily living such as shopping, laundry and cooking. See Fact Sheet for the three Level of Care associated with waiver.
What long-term care services are available?
ABD Medicaid provides long-term care services in nursing facilities and ICF-MRs. Home and community-based services waivers provide home health care to individuals who wish to stay in their home but otherwise need institutional care. The number of consumers that can be enrolled in a waiver program at any one time is limited. See for the types of waivers available.