The Ohio Home Care Waiver aims to help individuals with physical disabilities to live independently and participate in their communities while reducing the cost of care and improving the overall quality of life.
Many people with physical disabilities prefer receiving care in their homes and communities rather than in institutional settings. However, the cost of home and community-based services (HCBS) can be prohibitive for many low-income individuals who rely on Medicaid for their healthcare coverage. Fortunately, there is a Medicaid program that can help them access the HCBS they need and want: the Ohio Home Care Waiver.
Overview of Ohio Home Care Waiver
The Ohio Home Care Waiver is a Medicaid program that provides HCBS to eligible individuals who need a hospital or nursing facility level of care. The waiver covers services such as:
- Adult day health center services
- Personal care aide services
- Community integration
- Community Transition
- Home care attendant
- Home delivered meal
- Home maintenance and chore
- Home modification
- Out-of-home respite
- Personal emergency response systems
- Supplemental adaptive and assistive device
- Supplemental transportation services
- Waiver nursing services
The waiver aims to help individuals with physical disabilities to live independently and participate in their communities while reducing the cost of care and improving the quality of life. The waiver is approved by the Centers for Medicare and Medicaid Services (CMS) under the authority of section 1915c of the Social Security Act.
Eligibility Requirements
To qualify for the Ohio Home Care Waiver, an individual must meet the following requirements:
- Be a resident of Ohio
- Be enrolled in Medicaid or eligible for Medicaid
- Be under 60 years of age at the time of application
- Have a physical disability that impairs their ability to perform activities of daily living (ADLs), such as bathing, dressing, eating, toileting, transferring, and mobility
- Need a hospital or nursing facility level of care, as determined by a standardized assessment tool called the Ohio Home Care Waiver Assessment Instrument (OHCWAI)
- Have an individual service plan (ISP) that identifies the HCBS they need and want
- Have a cost of care that does not exceed 60% of the average cost of care in a nursing facility
Services and Supports
The Ohio Home Care Waiver offers various services and supports to help individuals with physical disabilities live comfortably and safely in their homes and communities. The services and supports are based on the individual’s needs, preferences, and goals, as specified in their ISP.
Some of the services and supports available under the waiver are:
- Adult day health center services: These structured programs provide social, recreational, therapeutic, and health-related activities in a group setting during daytime hours.
- Personal care aide services: These services assist individuals with ADLs and instrumental activities of daily living (IADLs), such as household tasks, medication management, shopping, and transportation.
- Community integration: This is a service that helps individuals access and participate in community activities that are meaningful and enjoyable to them.
- Community transition: This service allows individuals to move from an institutional setting to a home or community setting.
- Home care attendant: This service provides personal care assistance by an individual hired and supervised by the waiver participant or their authorized representative.
- Home-delivered meal: This service provides nutritious meals delivered to the individual’s home.
- Home maintenance and chore: This service provides minor repairs and maintenance to the individual’s home or equipment.
- Home modification: This service provides physical adaptations to the individual’s home or equipment to enhance their safety, accessibility, and independence.
- Out-of-home respite: This service provides temporary relief to the primary caregiver by placing the individual in an approved facility or home for a short period.
- Personal emergency response systems: These devices enable individuals to summon help in an emergency.
- Supplemental adaptive and assistive devices: These are devices that improve the individual’s functioning, communication, mobility, or safety.
- Supplemental transportation services: These services include transportation to medical appointments or other essential activities.
- Waiver nursing services: These provide skilled nursing care to individuals with complex medical needs that other providers cannot meet.
Compensation for Caregivers
One of the benefits of the Ohio Home Care Waiver is that it allows individuals to self-direct their personal care services and hire their own providers, including family members or friends. This option is called Participant-Directed Personal Care.
Participant-Directed Personal Care gives individuals more flexibility and control over their care. They can choose who will provide their personal care services, how much they will pay, when they work, and what tasks they will perform.
Family members or friends hired as personal care providers must meet the qualifications and requirements set by the Ohio Department of Medicaid (ODM) and the fiscal intermediary agency that handles payroll and taxes. The state will pay the providers through the fiscal intermediary agency based on the hourly wage set by the individual within a specific range.
Participant-Directed Personal Care is an excellent way for family caregivers to receive compensation for their valuable work for their loved ones. It can also improve the quality of care and the relationship between the individual and the provider.
The Participant-Directed Personal Care service differs from the Participant-Directed Homemaker/Personal Care service, which is available under the OH Individual Options, OH Level One Waiver, and OH Self Empowered Life Funding (SELF) waivers.
The main difference is that the Participant-Directed Personal Care service is only for personal care tasks, such as bathing, dressing, grooming, eating, and toileting. In contrast, the Participant-Directed Homemaker/Personal Care service also includes homemaker tasks, such as cleaning, laundry, shopping, and meal preparation.
A Note from Givers
If you are interested in applying for this waiver or finding out if you may be eligible for compensation, please fill out this form, and we will get back to you as soon as possible.
