The Assisted Living Waiver Program is a specialized initiative designed to support seniors and individuals with disabilities who require assistance with daily living activities but wish to avoid institutionalized care. This program is a part of Medicaid, a joint federal and state program that provides health coverage to people with low income, including some low-income adults, children, pregnant women, elderly adults, and people with disabilities.
The waiver program specifically targets those who are eligible for nursing home care but prefer to reside in an assisted living facility. By doing so, it offers a more home-like environment and promotes independence, dignity, and choice for its beneficiaries.
Through the Assisted Living Waiver Program, eligible individuals can receive financial assistance to cover the costs of services in assisted living facilities. These services can range from personal care to medication management, recreational activities, and more. It’s important to note that while the program covers the cost of services provided within the facility, it does not typically cover the room and board expenses.
Each state has its own set of guidelines and eligibility criteria for the program, and the availability of waivers can vary. As such, it’s crucial for individuals and families to research and understand the specific requirements and offerings in their respective states.
Services Covered by the Assisted Living Waiver Program
The Assisted Living Waiver Program is designed to provide a comprehensive range of services to ensure that seniors and individuals with disabilities receive the care and support they need while residing in an assisted living facility. While the exact services covered can vary by state, the following is a list of services that are typically covered under the program:
- Personal Care Services: Assistance with daily living activities such as bathing, dressing, grooming, and toileting.
- Medication Management: Ensuring that residents take their medications as prescribed, including assistance with administering medications and monitoring for any side effects.
- Recreational and Social Activities: Organized events and activities to promote social interaction, mental stimulation, and overall well-being.
- Meal Preparation and Dietary Services: Providing nutritious meals tailored to the dietary needs and preferences of residents.
- Health Monitoring: Regular check-ups and monitoring of residents’ health conditions, including vital signs and other health metrics.
- Transportation Services: Assistance with transportation for medical appointments, shopping, and other essential outings.
- Housekeeping and Laundry Services: Regular cleaning of residents’ living spaces and laundry services for their personal clothing.
- Therapeutic Services: Physical, occupational, and speech therapy services to address specific health and mobility challenges.
- Emergency Response Systems: Installation and monitoring of emergency call systems to ensure residents can quickly get help in case of emergencies.
- Case Management: Coordination of care and services to ensure that residents receive the appropriate level of care based on their individual needs.
It’s essential to note that while these services are typically covered by the waiver program, the room and board expenses at the assisted living facility are usually not included. Additionally, each state may have its own specific list of covered services, so it’s crucial to consult with local Medicaid offices or related agencies to get a detailed understanding of what’s covered in a particular state.
Eligibility Requirements for the Assisted Living Waiver Program
To benefit from the Assisted Living Waiver Program, individuals must meet specific eligibility criteria. These requirements ensure that the program caters to those who genuinely need assistance and support in an assisted living setting. While the exact criteria can vary by state, the following are general eligibility requirements commonly found across the U.S.:
- Age and Disability: The program is primarily designed for seniors, typically those aged 65 and older. However, younger individuals with certain disabilities may also qualify.
- Medical Eligibility: Applicants must require a level of care equivalent to that provided in a nursing home. This means they need assistance with multiple daily living activities or have medical conditions that necessitate regular monitoring and care.
- Financial Eligibility: Since the program is a part of Medicaid, applicants must meet the financial criteria set by Medicaid. This typically involves having an income and asset level below a certain threshold. The exact figures can vary by state and are adjusted annually.
- Residency: Applicants must be residents of the state in which they are applying for the waiver program. Additionally, they must be U.S. citizens or qualified non-citizens.
- Preference for Community Living: The program is designed for individuals who prefer to live in a community setting rather than an institutional one. As such, applicants must express a desire to reside in an assisted living facility as opposed to a nursing home.
- Availability of Waivers: The number of waivers available can be limited. As a result, even if an individual meets all eligibility criteria, they might be placed on a waiting list until a waiver becomes available.
It’s important to note that each state may have additional or slightly different eligibility criteria. Therefore, individuals interested in the program should consult with their local Medicaid office or related state agency to get a comprehensive understanding of the eligibility requirements in their specific state.
Assisted Living Waiver Program by State
Alabama
The Alabama Community Transition (ACT) Waiver is the state’s program designed to assist seniors and individuals with disabilities.
- Services Covered: Personal care, case management, respite care, and environmental accessibility adaptations.
- Eligibility Requirements: Must be 65 and older or 21 and older with a disability, require a nursing facility level of care, and meet financial criteria set by Medicaid.
- Link to Alabama Medicaid Agency
Alaska
Alaska’s Alaskans Living Independently (ALI) Waiver aims to support those who prefer community-based care over institutional settings.
- Services Covered: Respite care, specialized medical equipment, environmental modifications, and chore services.
- Eligibility Requirements: Must be 65 and older or 21 and older with physical or developmental disabilities and meet the financial criteria set by Medicaid.
- Link to Alaska Department of Health and Social Services
Arizona
The Arizona Long-Term Care System (ALTCS) is the state’s program for seniors and individuals with disabilities requiring long-term care.
- Services Covered: Personal care, respite care, adult day health care, and home health services.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Arizona Health Care Cost Containment System
Arkansas
The Arkansas Living Choices Assisted Living Waiver supports seniors and individuals with disabilities in community-based settings.
- Services Covered: Personal care, case management, respite care, and environmental modifications.
- Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Arkansas Department of Human Services
California
California’s Assisted Living Waiver (ALW) Program aims to facilitate the provision of assisted living services to eligible Medicaid beneficiaries.
- Services Covered: Personal care services, nursing services, social recreational activities, and transportation.
- Eligibility Requirements: Must be 21 and older, require a nursing facility level of care, and meet the financial criteria set by Medicaid.
- Link to California Department of Health Care Services
Colorado
The Colorado Elderly, Blind, and Disabled (EBD) Waiver is designed to assist seniors and individuals with disabilities in accessing community-based services.
- Services Covered: Personal care, respite care, adult day services, and home modifications.
- Eligibility Requirements: Must be 65 and older or blind or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Colorado Department of Health Care Policy & Financing
Connecticut
Connecticut’s Home Care Program for Elders (CHCPE) supports seniors in accessing services that allow them to remain in their homes or communities.
- Services Covered: Personal care assistance, adult day care, home-delivered meals, and emergency response systems.
- Eligibility Requirements: Must be 65 and older, at risk of nursing home placement, and meet the financial criteria set by Medicaid.
- Link to Connecticut State Department of Social Services
Delaware
The Delaware Diamond State Health Plan Plus (DSHP Plus) offers long-term services and supports to eligible individuals.
- Services Covered: Personal care, case management, respite care, and adult day services.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Delaware Department of Health and Social Services
Florida
Florida’s Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program provides long-term care services to eligible individuals.
- Services Covered: Personal care, case management, adult day care, and home accessibility adaptations.
- Eligibility Requirements: Must be 65 and older or 18 and older with a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Florida Agency for Health Care Administration
Georgia
The Georgia Community Care Services Program (CCSP) offers services to seniors and individuals with disabilities to prevent institutionalization.
- Services Covered: Personal support services, emergency response services, and alternative living services.
- Eligibility Requirements: Must be 60 and older or have a disability, require an intermediate level of care, and meet Medicaid’s financial criteria.
- Link to Georgia Department of Community Health
Hawaii
Hawaii’s Med-QUEST Integration (MQD) program provides integrated health services to eligible beneficiaries.
- Services Covered: Personal assistance, respite care, skilled nursing, and environmental accessibility adaptations.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Hawaii Department of Human Services
Idaho
The Idaho Aged and Disabled (A&D) Waiver program supports seniors and individuals with disabilities in accessing community-based services.
- Services Covered: Personal care services, respite care, adult day care, and specialized medical equipment.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Idaho Department of Health and Welfare
Illinois
Illinois’ Supportive Living Program (SLP) offers an alternative to nursing home care for low-income seniors and persons with disabilities.
- Services Covered: Personal care, medication management, social and recreational activities, and laundry services.
- Eligibility Requirements: Must be 65 and older or 22 and older with a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Illinois Department of Healthcare and Family Services
Indiana
Indiana’s Aged and Disabled (A&D) Waiver provides services to seniors and individuals with disabilities to allow them to remain in their homes or communities.
- Services Covered: Personal care, respite care, home modifications, and transportation services.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Indiana Family and Social Services Administration
Iowa
Iowa’s Elderly Waiver (EW) program provides home and community-based services to seniors as an alternative to institutional care.
- Services Covered: Personal care, home health aide, respite care, and adult day care.
- Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Iowa Department of Human Services
Kansas
The Kansas Frail Elderly (FE) Waiver offers services to seniors to support them in community settings.
- Services Covered: Personal care, nursing evaluation visits, sleep cycle support, and assistive services.
- Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Kansas Department for Aging and Disability Services
Kentucky
Kentucky’s Home and Community Based (HCB) Waiver program provides services to seniors and individuals with disabilities to prevent institutionalization.
- Services Covered: Personal care, respite care, home adaptations, and adult day health care.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Kentucky Cabinet for Health and Family Services
Louisiana
Louisiana’s Community Choices Waiver (CCW) supports seniors and individuals with disabilities in accessing community-based services.
- Services Covered: Personal care, respite care, assistive devices, and environmental accessibility adaptations.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Louisiana Department of Health
Maine
Maine’s Elderly and Adults with Disabilities (EAD) Waiver program offers services to seniors and individuals with disabilities to allow them to remain in their homes or communities.
- Services Covered: Personal care, respite care, adult day services, and home modifications.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Maine Department of Health and Human Services
Maryland
Maryland’s Home and Community-Based Options (CO) Waiver provides services to seniors and individuals with disabilities as an alternative to nursing home care.
- Services Covered: Personal assistance, nurse monitoring, assisted living, and environmental assessments.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Maryland Department of Health
Massachusetts
Massachusetts’ Frail Elder Home and Community-Based Services (HCBS) Waiver program supports seniors in accessing community-based services.
- Services Covered: Personal care, adult foster care, respite care, and home modifications.
- Eligibility Requirements: Must be 60 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Massachusetts Executive Office of Elder Affairs
Michigan
Michigan’s MI Choice Waiver program offers services to seniors and individuals with disabilities to prevent institutionalization.
- Services Covered: Personal care, respite care, environmental modifications, and counseling.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Michigan Department of Health and Human Services
Minnesota
Minnesota’s Elderly Waiver (EW) program provides home and community-based services to seniors.
- Services Covered: Personal care assistance, adult day care, respite care, and home modifications.
- Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Minnesota Department of Human Services
Mississippi
Mississippi’s Assisted Living (AL) Waiver program supports seniors in accessing services in licensed personal care home settings.
- Services Covered: Personal care services, nursing services, therapeutic services, and medication administration.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Mississippi Division of Medicaid
Missouri
Missouri’s Aged and Disabled Waiver program offers services to seniors and individuals with disabilities to allow them to remain in their homes or communities.
- Services Covered: Personal care, respite care, advanced respite care, and environmental accessibility adaptations.
- Eligibility Requirements: Must be 63 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Missouri Department of Social Services
Montana
Montana’s Big Sky Home and Community-Based Services (HCBS) Waiver program provides services to seniors and individuals with physical disabilities.
- Services Covered: Personal assistance, respite care, environmental modifications, and specialized medical equipment.
- Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Montana Department of Public Health and Human Services
Nebraska
Nebraska’s Aged and Disabled (A&D) Waiver program offers services to seniors and individuals with disabilities to support them in community settings.
- Services Covered: Personal emergency response systems, home modifications, personal care, and respite care.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Nebraska Department of Health and Human Services
Nevada
Nevada’s Home and Community-Based Waiver for the Frail Elderly (HCBW-FE) supports seniors in accessing community-based services.
- Services Covered: Personal care, respite care, adult day health care, and home modifications.
- Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Nevada Division of Health Care Financing and Policy
New Hampshire
New Hampshire’s Choices for Independence (CFI) Medicaid Waiver program provides services to seniors and individuals with chronic illnesses.
- Services Covered: Personal care services, respite care, environmental modifications, and specialized medical equipment.
- Eligibility Requirements: Must be 65 and older or have a chronic illness, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to New Hampshire Department of Health and Human Services
New Jersey
New Jersey’s Managed Long-Term Services and Supports (MLTSS) program offers comprehensive services to seniors and individuals with disabilities.
- Services Covered: Personal care, respite care, home modifications, and adult day services.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to New Jersey Division of Medical Assistance and Health Services
New Mexico
New Mexico’s Centennial Care program provides a wide range of services to seniors, individuals with disabilities, and other eligible groups.
- Services Covered: Personal care services, respite care, adult day services, and environmental modifications.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to New Mexico Human Services Department
New York
New York’s Managed Long-Term Care (MLTC) program offers services to seniors and individuals with disabilities to support them in community settings.
- Services Covered: Personal care, adult day health care, home health services, and non-emergency transportation.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to New York State Department of Health
North Carolina
North Carolina’s Personal Care Services (PCS) program provides assistance to seniors and individuals with disabilities in their homes.
- Services Covered: Personal care services, home modifications, meal delivery, and case management.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to North Carolina Department of Health and Human Services
North Dakota
North Dakota’s Home and Community-Based Services (HCBS) program offers services to seniors and individuals with disabilities to support them in community settings.
- Services Covered: Personal care, adult day care, respite care, and environmental modifications.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to North Dakota Department of Human Services
Ohio
Ohio’s Assisted Living (AL) Waiver program provides services to seniors in licensed residential care settings.
- Services Covered: Personal care, nursing services, emergency response systems, and medication administration.
- Eligibility Requirements: Must be 60 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Ohio Department of Medicaid
Oklahoma
Oklahoma’s Advantage Waiver program offers services to seniors and individuals with disabilities to prevent institutionalization.
- Services Covered: Personal care, adult day health services, case management, and specialized medical equipment.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Oklahoma Health Care Authority
Oregon
Oregon’s Aged and Physically Disabled (APD) Waiver program provides home and community-based services to seniors and individuals with physical disabilities.
- Services Covered: Personal care, respite care, home-delivered meals, and assistive technology.
- Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Oregon Department of Human Services
Pennsylvania
Pennsylvania’s Community HealthChoices (CHC) program offers long-term services and supports to seniors and individuals with physical disabilities.
- Services Covered: Personal care, respite care, home health services, and adult day services.
- Eligibility Requirements: Must be 21 and older with a physical disability or be 60 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Pennsylvania Department of Human Services
Rhode Island
Rhode Island’s Global Consumer Choice Compact Waiver program provides comprehensive services to seniors and individuals with disabilities.
- Services Covered: Personal care assistance, adult day services, shared living, and assistive technology.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Rhode Island Executive Office of Health and Human Services
South Carolina
South Carolina’s Community Choices Waiver program offers services to seniors and individuals with disabilities to support them in community settings.
- Services Covered: Personal care, respite care, adult day health services, and meal delivery.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to South Carolina Department of Health and Human Services
South Dakota
South Dakota’s HOPE Waiver program provides home and community-based services to seniors and individuals with disabilities.
- Services Covered: Personal care, adult day services, respite care, and emergency response systems.
- Eligibility Requirements: Must be 60 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to South Dakota Department of Social Services
Tennessee
Tennessee’s CHOICES in Long-Term Services and Supports program offers comprehensive services to seniors and individuals with disabilities.
- Services Covered: Personal care, adult day care, in-home respite, and assistive technology.
- Eligibility Requirements: Must be 65 and older or have a physical disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Tennessee Bureau of TennCare
Texas
Texas’ STAR+PLUS program provides long-term services and supports to seniors and individuals with disabilities as part of the state’s Medicaid managed care system.
- Services Covered: Personal care, nursing services, respite care, and emergency response services.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Texas Health and Human Services
Utah
Utah’s Aging Waiver for Individuals Age 65 or Older program offers services to seniors to support them in community settings.
- Services Covered: Personal care, respite care, adult day services, and home modifications.
- Eligibility Requirements: Must be 65 and older, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Utah Department of Health
Vermont
Vermont’s Choices for Care program provides long-term services and supports to seniors and individuals with disabilities.
- Services Covered: Personal care, respite care, home modifications, and assistive devices.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Vermont Department of Disabilities, Aging and Independent Living
Virginia
Virginia’s Commonwealth Coordinated Care Plus (CCC Plus) program offers comprehensive services to seniors and individuals with disabilities.
- Services Covered: Personal care, adult day health care, respite care, and private duty nursing.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Virginia Department of Medical Assistance Services
Washington
Washington’s Community First Choice (CFC) program provides home and community-based services to seniors and individuals with disabilities.
- Services Covered: Personal care, relief care, skills acquisition training, and assistive technology.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Washington State Department of Social and Health Services
West Virginia
West Virginia’s Aged and Disabled (A/D) Waiver program offers services to seniors and individuals with disabilities to support them in community settings.
- Services Covered: Personal care, respite care, case management, and environmental modifications.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to West Virginia Department of Health and Human Resources
Wisconsin
Wisconsin’s Family Care program provides long-term care services to seniors and individuals with disabilities.
- Services Covered: Personal care, adult day care, home modifications, and supportive home care.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Wisconsin Department of Health Services
Wyoming
Wyoming’s Community Choices Waiver (CCW) program offers services to seniors and individuals with disabilities to prevent institutionalization.
- Services Covered: Personal care, respite care, home modifications, and specialized medical equipment.
- Eligibility Requirements: Must be 65 and older or have a disability, require a nursing facility level of care, and meet Medicaid’s financial criteria.
- Link to Wyoming Department of Health
