ASSISTED LIVING WAIVER PROGRAM
What is the Medicaid Assisted Living Waiver?
The Medicaid Assisted Living Waiver provides an alternative to home-based waiver programs and Medicaid-funded nursing home care for adults and persons with disabilities.
Where are the services provided?
Services are provided at assisted living facilities licensed by the Ohio Department of Health as residential care facilities. These facilities are also certified by the Ohio Department of Aging as a provider for the program.
What does the waiver pay for?
The Assisted Living Waiver pays for services provided to an individual in an assisted living facility. Facilities are reimbursed depending on the amount of services they provide to an individual. The individual must be able to pay a monthly room and board charge to the assisted living facility.
How do I know if I am eligible for the program?
A person may be eligible for the Assisted Living Waiver Program if he or she:
- Is 21 years of age or older
- Is currently receiving Medicaid-funded services in a nursing facility
- Is receiving services through a Medicaid Waiver Program (PASSPORT, Ohio Home Care or Choices) or has been residing in an assisted living facility and paying for their care privately for at least 6 months
- Has a documented need for unscheduled, hands-on assistance
- Meets relevant Medicaid financial requirements for income and assets (as determined by the Ohio Department of Job and Family Services)
- Requires a nursing home level of care (intermediate or skilled)
- Can be safely maintained in the assisted living facilities (the services available will provide sufficient care to the individual)
- Can pay the established room and board rate for the facility (an individual MUST have sufficient resources to pay the current room and board charge)
- The room and board charge changes each calendar year
- Agrees to participate in the program
How do I apply for the program?
Individuals interested in applying for the Medicaid Assisted Living Waiver should contact the Area Agency on Aging at 330-505-2300 or 1-800-686-7367. An in-person assessment will be scheduled to determine if the person is eligible and appropriate for the assisted living program. Individuals enrolled in the program will be evaluated to determine the type and level of services that are appropriate for their situation. Services available may vary from facility to facility, but may include:
- Social and recreational programs
- Personal care supportive services (laundry, housekeeping, maintenance)
- Coordination of three meals a day
- Non-medical transportation
- Nursing services
- Intermittent skilled nursing care
- 24-hour response capability
How is the Assisted Living Waiver funded?
The waiver is funded by Medicaid, the state’s health care system for low income individuals. It was designed to offer Medicaid eligible individuals an alternative to nursing home facility or home based waiver services. The waiver was a priority in the Ohio Access Initiative and its implementation was recommended by the Ohio Commission to reform Medicaid.
Area Agency on Aging, District 11
5555 Youngstown Warren Road
Suite 2685, 2nd Floor
Niles, Ohio 44446
Ph: (330) 505-2300
Fax: (330) 530-8862
The Aid and Attendance (A&A) Pension provides benefits for veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. Those also eligible for the program are blind individals, patients who are in a nursing home because of mental or physical incapacity and residents receiving assisted care in an assisting living facility.
To qualify for A&A, it needs to be established by a physician that the individual requires daily assistance by others to dress, undress, bathe, cook, eat, put on or take off of prosthetics, leave home, etc. A person does not have to require assistance with all of these. There simply needs to be adequate medical evidence that the individual cannot function completely on his or her own.
The A&A Pension can provide up to $1,788 per month to a veteran, $1,149 per month to a surviving spouse or $2,120 per month to a couple.
Eligibility must be proven by filing the proper Veterans Application for Compensation and/or Pension:
- Form 21-534: Surviving Spouse
- Form 21-526: Veteran
This application requires a copy of DD-214 (see below for more information) or separation papers, medical evaluation from a physician, current medical issues, net worth limitations, net income and out-of-pocket medical expenses.
A DD-214 is issued to military members upon separation from active service. DD-214s were issued to separated service members beginning in the 1950’s. The term “DD-214” is often used generically to mean “separation papers” or “discharge papers,” no matter what form number was used to document active duty military service.
If the VA has a copy of a DD-214, it is usually because the veteran attached a copy (or sometimes, the original) to his or her application for disability or education benefits.
If a veteran has lost his or her original DD-214 (or a copy) and is currently receiving disability or education benefits from the VA (or applied for benefits in the past), the VA may have the original or a copy on file, if it was given to them.
If the VA does not have the original DD-214 or a copy on file, the VA should be able to provide a Statement of Service, which can be used instead of a DD-214. To request a copy of a DD-214, visit www.vetrec.archives.gov.
For more general information about the Aid & Attendance Pension, please see our FAQ Section.