What is a Medicaid Waiver?
The Medicaid Waiver program began in 1981, in response to the national trend toward providing Home and Community-Based Services (HCBS). In the past, Medicaid paid only for institutionally based long term care services, such as nursing facilities and group homes.
The goals of waiver services are to provide to the person meaningful and necessary services and supports, to respect the person's personal beliefs and customs, and to ensure that services are cost-effective. Specifically:
Waivers for individuals with a developmental disability assist a person to:
- Become integrated in the community where he/she lives and works
- Develop social relationships in the person's home and work communities
- Develop skills to make decisions about how and where the person wants to live
- Be as independent as possible
There are 3 Ohio Waivers, but a person can only be receiving one. In order to receive waiver services, an individual must be eligible for Medicaid.
Types of Ohio Waivers
* Self Empowered Life Funding (SELF Waiver)
* Individual Options Waiver (I/0 Waiver)
* Level One Waiver (L1 Waiver)
An application has must be completed with your County Board of Developmental Disabilities (DD). A staff from your Board of DD will assist you with the intake process.
Contacts at Ohio County Boards of Developmental Disabilities
A waiver must be renewed annually, which you will do with your County Board. It is important to know that if you are enrolled on a waiver, you must also meet Medicaid eligibility every month to continue with waiver services.
The waiting lists for waivers has changed. Please see below for more information about the waiting lists.
Fix the List • www.fixthelist.info
People with developmental disabilities and their families have repeatedly told us Ohio's waiting list for Home and Community-Based Services (HCBS) waivers is overly complex and in need of simplification. The previous waiting list confused people with developmental disabilities and their families, misled advocates, and hindered efforts by policymakers to direct resources to where they are needed most.
To better serve Ohioans with developmental disabilities, the organizations listed below have been collaborating for more than 22 months to modernize Ohio’s DD waiver waiting list. We believe by replacing the previous system will greatly improve the way Ohio’s DD waiting list for HCBS waivers operates.
There are roughly 49,000 people with developmental disabilities on Ohio’s waiting list for HCBS waivers. However, that number is misleading. Many people on the list receive some type of services because county boards have a variety of ways to meet people’s needs – a waiver is just one of them. Those who are eligible for county board services can have their needs met through local funds as well as other resources. Learn more
Waiting List Waiver Changes for Ohio by Jena Wells, DSAGC Advocate
The information provided below is an accumulation of information from various sources including, but not limited to…Hamilton Co DDS, Clermont Co DDS, Fixthelist.info, DODD.ohio.gov. For more specific information about your county, please visit your county board of developmental disabilities.
A few main points:
1. If you have a waiver, it will not be taken away, but there will still be an assessment process to make sure it fits your needs
2. These changes begin on September 1st, 2018
3. The “new rule” about waiver waiting lists is found here.
Reasons why a new rule was designed/problems with the old waiting lists:
1. It was confusing because your number on the waiting list would fluctuate. For example, you could be at number 150 this year, but your number could be 180 next year. There are multiple factors that played into your position on the waiting list and it wasn’t always clear.
2. The waiting lists across counties was not consistent. There was a lot of room for interpretation with the old rule.
Currently Michelle P Waiver services are being offered to individuals with urgent needs, and those on the "Supported for Community Living (SCL)" waiting list beginning with those who have been on the waiting list the longest.
NorthKey Community Care will conduct the assessments. Eligible individuals will receive a letter from the Department for Medicaid Services and their names will then be given to North Key.
Kentucky Department for Medicaid Services
Indiana applies for permission to offer Medicaid Waivers from the Centers’ for Medicare and Medicaid Services (CMS). The Medicaid Waivers make use of federal Medicaid funds (plus state matching funds) for Home and Community-Based Services (HCBS), as an alternative to institutional care, under the condition that the overall cost of supporting people in the home or community is no more than the institutional cost for those people.
DDRS oversees two waiver programs, the Community Integration and Habilitation Waiver and the Family Supports Waiver.
Community Integration and Habilitation (CIH) Waiver
CIH is a combination of the Autism and the Developmental Disability Waivers and provides services that enable persons to remain in their homes or in community settings and assists transitions from institutions into community settings. This is a needs-based waiver and is designed to provide supports for persons to gain and maintain optimum levels of independence and community integration while allowing flexibility in the provision of those supports.
Family Supports Waiver (FSW)
Formerly the Support Services Waiver, the FSW is designed to provide limited, non-residential supports to persons with developmental disabilities residing with their families, or in other settings with informal supports.
Home & Community Based Medicaid Waivers (CIH and FSW)
- Community Integration and Habilitation Waiver (CIH) Effective October 1, 2014
- Family Supports Waiver (FSW) Effective June 1, 2014
Who can receive waiver services?
To receive a Medicaid Waiver you must meet both the criteria for a developmental disability and ICF/ID-DD level of care. The criteria for a developmental disability is defined in state law and means that a qualifying developmental disability is evident and that it was diagnosed by a medical doctor prior to age 22. ICF/ID-DD Level of Care means that an individual qualifies as deficient in at three of the functional limitations designated in the Code of Federal Regulations.
How do I apply for a Family Supports Waiver?
The Bureau of Developmental Disabilities Services District Offices can provide an application for the Family Supports Waiver as well as assist in researching additional services. Once it has been determined that an individual meets the criteria for a developmental disability, that individual will be placed on the appropriate waiver waiting lists. Once a waiver slot becomes available the individual will be offered a waiver placement.
BDDS District Offices
The Bureau of Developmental Disabilities Services (BDDS) is a program of the Division of Disability & Rehabilitative Services,a division of the Indiana Family & Social Services Administration.
1452 Vaxter Avenue
Clarksville, IN 47129-7721
Toll Free: 1-877-218-3529 (V/VRS/711)
Toll Free Fax: 1-855-525-9376
- Counties: Bartholomew, Brown, Clark, Crawford, Dearborn, Decatur, Floyd, Harrison, Jackson, Jefferson, Jennings, Lawrence, Ohio, Orange, Ripley, Scott, Switzerland & Washington.