MEDICAID and Waiver Services
for People with Mental Retardation
and/or Developmental DISABILITIES

 

 

What is Medicaid?

Medicaid is a federal program allowing eligible Ohioans with low incomes to receive needed health services. Services available for payment by Medicaid are unique to each state and are approved under what is called a State Plan. Ohio’s State Plan covers services such as hospital stays, check-ups for children and for pregnant women, nursing services, medication coverage, and other services for people who are Medicaid eligible. Medicaid does not pay money to you; instead, it pays a provider that delivers healthcare services to you. Each month, you should receive a Medicaid card to show you are covered. To find out more about becoming a Medicaid recipient, please contact your local County Board of MRDD or your local county Department of Job and Family Services.

Waiver services, also known as "Medicaid waivers," are programs offered through the Ohio Department of Job and Family Services (ODJFS), the Ohio Department of Mental Retardation and Developmental Disabilities (ODMRDD), and the Ohio Department of Aging. Waivers provide community services to people who would otherwise be institutionalized. Currently, Ohio has several waivers and this section offers information about these programs. However, you should contact the agency that administers the waiver to verify the information provided and for more specific information about eligibility and services.

Names of the Waivers

Currently, Ohio has several waivers that are administered by either the Ohio Department of Job and Family Services, the Ohio Department of Mental Retardation and Developmental Disabilities, or the Ohio Department of Aging. The following lists the names of these waivers and the agency that administers them.

Individual Options Waiver -      Ohio Department of Mental Retardation and Developmental Disabilities

Level One Waiver -                  Ohio Department of Mental Retardation and Developmental Disabilities

Ohio Home Care Waiver -       Ohio Department of Job and Family Services

PASSPORT Waiver -              Ohio Department of Aging

Transitions Waiver -                 Ohio Department of Job and Family Services

 

Eligibility Requirements

The following lists the eligibility requirements for each waiver. Because there are many factors that go into determining financial eligibility, such as the extent of the person's disability, the person's prognosis, and the person's assets, the term "specific financial criteria" is used for each waiver. Specific information about financial criteria can be provided by the agency that administers the waiver. For some of the waivers, an "ICF/MR" level of care is required. ICF/MR stands for "intermediate care facility for a person with mental retardation or a developmental disability" level of care.

Name of Waiver, Eligibility Requirements
 

Individual Options Waiver   

·        Specific financial criteria

·        ICF/MR level of care

·        All ages

 

Level One Waiver    

·        Specific financial criteria

·        ICF/MR level of care

·        All ages

 

Ohio Home Care Waiver      

·        Specific financial criteria

·        Intermediate level of care

·        All ages

 

PASSPORT Waiver  

·        Specific financial criteria

·        Intermediate level of care

·        Ages 60 years and older

 

Transitions Waiver   

·        Specific financial criteria

·        ICF/MR level of care

·        All ages

 

Services Provided

The following lists services that may be provided by the waiver. For most waivers, once a person is approved to receive services, they are allotted a certain amount of money. The Service and Support Administrator works with the person to determine which services would benefit the person the most and the money is allocated in a way to provide the services. So, although there may be a broad menu of services available through a specific waiver, that does not necessarily mean the person will receive all of the services.

Also, although the funding for services may be approved, the availability of providers for the services is an on-going issue with many people. The nationwide shortage of nursing and home health aids is having a direct impact on the delivery of services to people with disabilities.
 

Waiver Services According to Program Name of Waiver; Type of Services:

 

Individual Options Waiver   

·        Respite care

·        Supported employment

·        Adult Day Support

·        Vocational Habilitation

·        Environmental accessibility adaptations

·        Transportation

·        Specialized medical, adaptive equipment and supplies

·        Homemaker personal care

·        Social work

·        Home delivered meals

·        Interpreter

·        Nutrition

 

Level One Waiver    

·        Homemaker/personal care

·        Respite (institutional or informal)

·        Special medical equipment

·        Transportation

·        Supported employment

·        Adult Day Support

·        Vocational Habilitation

·        Environmental accessibility

·        Personal emergency response system

·        Emergency services

 

Ohio Home Care Waiver      

·        Respite care

·        Adult day health

·        Environmental accessibility adaptations

·        Transportation

·        Personal emergency response system

·        Adaptive and assistive devices

·        Daily living services

·        Nursing services

·        Home delivered meals

·        Therapies

 

PASSPORT Waiver  

·        Homemaker/Personal care

·        Adult day health

·        Environmental accessibility and adaptations

·        Transportation

·        Specialized medical, adaptive and assistive equipment, and supplies

·        Chore services

·        Social work and counseling

·        Nutritional consultation

·        Home-delivered meals

 

Transitions Waiver   

 

·        Respite care

·        Adult day health

·        Environmental accessibility adaptations

·        Transportation

·        Personal emergency response system

·        Adaptive and assistive devices

·        Daily living services

·        Nursing services

·        Home delivered meals

·        Therapies

 

How to Apply for Waiver Services

 

The following lists the agencies where you can apply for waiver programs. It is wise to call first to make an appointment and to verify what information you will need for the initial interview. The interview usually requires copies of lots of paperwork, such as financial, medical, and housing records.

 

Name of Waiver                     Where to Apply

Individual Options Waiver         Apply at your county board of MR/DD.

Level One Waiver                    Apply at your county board of MR/DD.

Ohio Home Care Waiver          Apply at your county department of Job and Family Services.

PASSPORT Waiver                 Apply at your county department of Job and Family Services or at your Area Agency on Aging.

Transitions Waiver                    This waiver is not open for enrollment. It is currently used for people who are on the Ohio Home Care Waiver, but who have an ICF/MR level of care.

 

A list of benefits from Ohio’s Medicaid program can also be found by visiting Job and Family Services Helping Ohioans at: http://jfs.ohio.gov/ohp/consumers/benefits.stm.