Most older Ohioans prefer to live independently in their own homes, in their communities, surrounded by family and friends, for as long as they can. But, many need some help doing so. Before Medicaid waiver programs, older adults who needed any degree of long-term care typically entered nursing homes. Ohio's PASSPORT Medicaid waiver program helps Medicaid-eligible older Ohioans get the long-term services and supports they need to stay in their homes.
PASSPORT is a two-pronged program. The first part is a pre-admission screening during which interested consumers are screened by telephone to determine preliminary Medicaid eligibility and care needs. They are also provided information about the variety of long-term care options available.
The second part of PASSPORT is home care. Once a consumer is determined eligible a case manager works with him or her to develop a package of in-home services to be provided by local service providers. The case manager then monitors the care for quality and changes the care plan as necessary.
Eligible PASSPORT participants are:
- Age 60 or older;
- Financially eligible for Medicaid institutional care (For 2013, this means typically earning no more than $2,130 per month for one person and having no more than $1,500 in countable assets, though individuals above this limit may be eligible based on the extent of their medical and in-home needs);
- Frail enough to require a nursing home level of care; and
- Able to remain safely at home with the consent of their physician.
The cost of PASSPORT services needed at the time of application cannot exceed 60 percent of the cost of nursing home care. Some costs incurred by the state for PASSPORT care may be subject to estate recovery. Estate Recovery is required by the federal Omnibus Budget Reconciliation Act of 1993, and by Section 5111.11 of the Ohio Revised Code. All Medicaid services provided to persons age 55 or older are subject to recovery, including physician visits, outpatient visits and home- and community-based waiver services like PASSPORT and all medically related Medicaid services. For more information about estate recovery, contact your county Office of Job and Family Services.
For more information and to determine your eligibility, contact the PASSPORT Administrative Agency serving your area. To find out if you may be eligible for Medicaid, visit Ohio Benefits.
Consumer-Directed Services Options
PASSPORT: Consumer Direction Opportunities allows you, the PASSPORT consumer, more choice and control over the delivery of your home and community-based services. It puts you in the driver's seat! It also allows you or your authorized representative to hire your own direct service workers from a Choices-Home Care Attendant Service (C-HCAS) or Personal Care Service. You will receive training to assist with learning the necessary skills to direct your services.
Consumer Direction is optional, voluntary and not appropriate for everyone. With both service options, you or your authorized representative must exhibit the capacity and ability to: advocate for yourself; know your rights; monitor quality; verbalize your desire to direct the services; have open communication and use problem-solving skills.
With both options, you and your care manager agree that a consumer directed service plan is right for you. The two of you, then, develop your care plan. From there, you, the consumer do the recruiting, hiring, training and educating of your workers. You also manage scheduling, supervising and firing your workers, and are responsible for resolving worker or service issues with your worker directly. You and your care manager collaborate with the financial management service to track service hours and payroll. The care worker cannot be a parent, step-parent, spouse, guardian or power of attorney or DPOA.
The C-HCAS option offers this advantage: You train the worker on initial service tasks and provide ongoing training. Additional training can be required, if needed. You negotiate your worker's hourly pay rate with care manager input.
The Personal Care Service option offers this advantage: The worker must be certified as an STNA, HHA, or have completed a 60-hour ODA-approved training program and 12 hours of continuing education, annually. The worker works for the state-contracted hourly pay rate.
Is self-directed care right for you?
PASSPORT provides options for some participants to direct their own care. Self-directed care may be right for you if you agree with any of these statements:
- I am satisfied with the home and community-based services that help me so I can continue living in the community.
- I have special health needs (e.g., memory impairment, chronic health problem or disability) or cultural needs (e.g., language) that could be better met by a service where I can use workers that I know, like my family or friends.
- My life could be improved if I had more control over my services and could hire workers that I know and tell them what to do and when.
- I can describe how taking responsibility for my services will benefit me.
- I am interested in managing the help that I need so I can live in the community.
- I can write out a plan, on my own or with help, for the activities that help me stay in the community.
- I can take on the responsibility as an employer of finding, hiring, and managing workers myself or if someone helped me.
- I know someone who can help me with the responsibility of being an employer, if needed.
Your PASSPORT administrative agency can help you better understand self-directed care options.
Transitions Carve-Out Waiver
As part of its overall plan to improve individuals’ access to Medicaid services and create greater efficiencies within the State’s home and community-based services delivery system, the Ohio Department of Medicaid will phase-out and terminate the Transitions Carve-Out Waiver, effective June 30, 2015. This change will result in the transition of more than 1,300 individuals from the Transitions Carve-Out Waiver to the PASSPORT Waiver.
Transitions Carve-Out and PASSPORT Waiver Services Comparison