The Assisted Living Waiver (ALW) is a program administered by the Ohio Department of Aging (ODA) that covers daily living services provided in an assisted living facility.
12/26/11- Consumers enrolled in an HCBS waiver (such as the Assisted Living waiver) will receive a letter from Medicare indicating that they no longer will have to pay a Medicare Part D co-pay for their drugs. The zero co-pay for Medicare Part D will apply for a full year. Even if a consumer changes their Part D plan that is all handled and updated by Medicare. Changing plans will not change the consumer's co-pay amount if the individual is a dual (Medicaid/Medicare) and on the Assisted Living Waiver waiver. Consumers who pay a Part D co-pay in January will be reimbursed for this expense. They should contact their plan to pursue. If a consumer is reimbursed for their Part D co-pays they will need to notify their CDJFS.
2012 Maximum Room and Board Payment- 2012 SSI benefit amount: $698.00- Maximum 2012 room and board payment: $648.00.
For a Fact Sheet on the State Funded Assisted Living Waiver, go to Fact Sheet
For Frequently Asked Questions on the State Funded Assisted Living Waiver, go to FAQ
For the Enrollment Agreement on the State Funded Assisted Living Waiver, go to Enrollment Agreement
For Medicaid Eligibility Information on the State Funded Assisted Living Waiver, go to ALW Medicaid Eligibility
For an overview of this waiver, you can go to AL Waiver
To view a complete listing of all the assisted living facilities that participate in the assisted living waiver, go to Assisted Living Map
The Medicaid consumer can be 21 years of age or older.
An interested Medicaid consumer can apply for the program by contacting their local Area Agency on Aging. To Find your local Agency, go to Area Agency on Aging. You can also download a form a Application and fax it to your local Area Agency on Aging intake department (Just check the Assisted Living box at the top of the page).
A worker from your local Area Agency on Aging will conduct an assessment to determine if the applicant meets the criteria for the program. If the applicant does qualify, the person will be placed in a facility certified by the Ohio Department of Aging. The applicant will be able to receive personal, on site care, 24-hour a day response capability, meals, transportation, social and recreational activities and some nursing care.
Recipients of the Assisted Living Waiver are able to keep a portion of their monthly income to pay for their room and board and personal needs. Other income remaining is the patient liability and is paid directly to the facility to help cover the cost of the applicant's care. Prescription copays are the responsibility of the participant.
A one time transition service of no more than $1,500 is available to help residents of nursing facilities purchase necessary items when moving into an assisted living facility. Some examples include dishes, clothing furniture, telephone, etc.
