What are Medicaid Waivers?
Medicaid waivers are funding streams that pay for a variety of services depending on the type of waiver and the needs of the person who is enrolled. In Ohio, there are three waivers for people with developmental disabilities.
1. Individual Options Waiver (IO)
The Individual Options (IO) waiver is a comprehensive waiver that allows people to live in community settings of their choice with supports instead of living in an institution. The IO waiver has a higher funding range and more robust level of service options than the Level 1 Waiver or SELF Waiver, though all three waivers have been developed to meet a person’s individualized needs. People must meet Medicaid eligibility criteria and have an ICF (institutional) level of care – there are no age requirements for the IO Waiver, but most enrollees tend to be adults.
Services provided by the Individual Options Waiver include: Homemaker/Personal Care, Ohio Shared Living, Residential and Informal Respite, Transportation, Personal Emergency Response Systems, Specialized Medical Equipment, Environmental Accessibility Adaptations, Emergency Assistance, Supported Employment, Day Habilitation, and Community Respite.
2. Level One Waiver
The Level 1 waiver allows for minimal paid support and relies heavily on natural supports to help people live in community settings of their choice with supports instead of living in an institution. Pre-approved budget amounts may be adjusted by the county board to meet health and welfare
needs, but must not exceed a combined benefit of $5,000 per enrollment year for all services. To be eligible, a person must be Medicaid-eligible and have an ICF (institutional) level of care -there are no age requirements.
Services provided by the Level 1 Waiver include: Homemaker/Personal Care, Residential and Informal Respite, Community Respite, Transportation, Personal Emergency Response Systems, Specialized Medical Equipment, Environmental Accessibility Adaptations, Emergency Assistance, and Supported Employment (Day Habilitation).
3. Self-Empowered Life Funding Waiver (SELF)
The Self-Empowered Life Funding (SELF) waiver is Ohio’s first participant-directed waiver. It lets people direct where and how they receive services- this is known as “self-direction.” People must be willing and able to self-direct at least one waiver service, be able to have their health and welfare needs met through the SELF waiver, need at least one SELF waiver service, be Medicaid eligible, and have an ICF (institutional) level of care. There are no age requirements for eligibility. The cap on annual expenses is $40,000 for adults and $25,000 for children.
Services provided by the SELF Waiver include: Support Brokerage, Remote Monitoring and Equipment, Community Inclusion (Personal Assistance/Transportation), Integrated Employment, Residential Respite, Functional Behavioral Assessment, Community Respite, Clinical/Therapeutic Intervention, Adult Day Supports, Participant-Directed Goods and Services, Vocational Habilitation, Participant/Family Stability Assistance, Supported Employment (Enclave), and Non-Medical Transportation.