What is a Waiver?

What is a Medicaid Waiver? 

Offered by The State of Ohio Medicaid program, a waiver allows for the provision of diversified medical and support services in the home, community, and places of employment.

What types of waivers are available? 

There are two types of waivers Gateways to Better Living serves: Level One and I/O.  Level One waivers are designed for limited or short-term supports and allow selection of services based on an annual budget.  I/O or Individual Options waivers are funded based on an assessment outcome for individuals requiring enhanced or more frequent supports.

What supports do Medicaid waivers provide?

 
Individuals with Medicaid waivers may select from various HPC and ADS support, as well as enhanced individualized supports based on funding and availability.

How is funding determined?

 

Funding and supports may be outlined using the Ohio Developmental Disabilities Profile, or ODDP.  The Department of Job and Family Services has final say in funding level determinations for each individual.  Funding is influenced by supports needed and available Medicaid budget.

 

What do I do first?

If eligible, they will assign you a Service and Support Administrator to help guide you through your options available.

HPC Services:

Homemaker/Personal Care services are supports designed to promote independence with home and personal care needs.  May include cleaning, hygiene, food preparation, and other supports based on individualized needs.

ADS:

Adult Day Services are designed to provide recreational activities and potential employment opportunities for individuals who are no longer eligible for educational services through state programs.

ODDP:

Ohio Developmental Disabilities Profile is the tool used to determine required individual supports based on need.

AAI: 

Acuity Assessment Instrument is a tool used to determine the percentage of staff time an individual requires during Adult Day Services.

DODD Ohio: 

Ohio Department of Developmental Disabilities is responsible for setting standards and regulations to be observed by county boards and providers.

DJFS:

Department of Job and Family Services is a social services agency that has final say in determining funding ranges for each individual.

SSA: 

Service and Support Administrators are county board employees that act as mediators between individuals and providers, assisting in provider selection.

NMT: 

Non-Medical Transportation includes transit services for purposes other than medical appointments.  Certified agency providers may offer this solution to individuals for work or recreational purposes.