Most older Ohioans would prefer to remain in their homes and communities for as long as possible. The Ohio Department of Aging, through the aging network, provides many services and supports that can help elders who require a nursing home level of care get the assistance they need to remain in the setting of their choice. These services are funded by state, local and federal funding sources, such as the Older Americans Act, the Centers for Medicare and Medicaid Services and the Ohio Department of Medicaid.
For information about these and other programs, and to determine your eligibility (where applicable), contact the PASSPORT Administrative Agency serving your community.
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. 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 or other community settings, rather than enter nursing homes, when appropriate.
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.
Program Profile: PASSPORT
Eligible PASSPORT participants are:
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.
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.
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:
Your PASSPORT administrative agency can help you better understand self-directed care options.
Assisted living combines a home-like setting with personal support services to provide more intensive care than is available through home care services. Assisted living facilities provide older adults with an alternative to nursing facility care that is both less expensive and less restrictive.
Assisted living residences vary considerably, but most provide meals, housekeeping, laundry, transportation, and social activities. They also offer personal care, such as assistance with eating, bathing, grooming and personal hygiene. Some nursing care is also provided, including medication administration and dressing changes.
Costs for assisted living generally range from $2,000 to $4,000 per month and vary depending on the size of living area an older adult chooses, area of the state and the amount of care needed.
Ohio's Assisted Living Waiver Program pays the costs of care in an assisted living facility for certain people with Medicaid, allowing the consumer to use his or her resources to cover "room and board" expenses. Individuals who meet certain service and care needs and meet established financial criteria may be eligible for Ohio's Assisted Living Waiver Program.
To find out if assisted living is a good option for you, contact your Area Agency on Aging and request a free assessment. To determine if you may be eligible for Medicaid, visit Ohio Benefits.
The Long-term Care Consumer Guide is an online tool that can help you find and compare nursing and residential care facilities, including assisted living, in your area.
Program Profile: Assisted Living
Program of All-Inclusive Care for the Elderly, or PACE, is a managed care model that provides participants with all of their needed health care, medical care and ancillary services in acute, sub-acute, institutional and community settings. Services include primary and specialty care, adult day health services, personal care services, inpatient hospital, prescription drug, occupational and physical therapies and nursing home care.
Ohio's PACE site is in Cleveland, managed by McGregor PACE Center for Senior Independence, who receives full capitation from both Medicare and Medicaid. They have an inter-disciplinary team that directs and provides the care of their participants. The site pools its resources to pay for whatever services an individual needs, including services not otherwise covered by Medicare or Medicaid. This flexibility enables them to be proactive in their care of participants.
To be eligible for PACE, participants must be age 55 or older, live in the Cleveland area and, if seeking Medicaid assistance, qualify for coverage under the institutional financial eligibility standards (participants can be private-pay). To determine if you may be eligible for Medicaid, visit Ohio Benefits. Participants also must need an intermediate or skilled level of care and be willing to receive all of their care from PACE program providers. In addition, participants must be able to remain safely in a community setting at the time of initial enrollment.
Program Profile: PACE
To learn more about PACE and inquire about availability and eligibility, contact:
Serving Cuyahoga County
26310 Emery Road
Warrensville Heights, OH 44128
MyCare Ohio is a new coordinated approach to providing health care and long-term services and supports. The program is available in 29 Ohio counties and coordinates Medicare and Ohio Medicaid benefits into one managed care plan.
MyCare participants have a single point of contact for care and care management support 24/7 through the managed care plan that you select. MyCare offers vital preventive services and provides information to help you make choices about your health care. Your MyCare plan includes all benefits available through traditional Medicare and Medicaid programs, including long-term care services and supports (if applicable) and behavioral health services.
Learn more about MyCare Ohio from the Ohio Department of Medicaid.
Get help with your providers from a MyCare Ohio Ombudsman.
Effective October 2018, applicants not enrolled in Managed Care will no longer receive monthly fee for service (FFS) Medicaid or Qualified Medicare Beneficiary (QMB) cards on a monthly basis.
The FFS and QMB cards will no longer display dates or Medicare data. The following language will display: "Retain this card. This is your permanent card. You will not receive a new card every month."
Individuals will receive a new card only for:
Providers have access to the Medicaid Information Technology System (MITS) provider portal. Providers can log in to access eligibility information for individuals being served through PASSPORT and Assisted Living waivers. Providers should complete this verification action monthly to verify individuals have current Medicaid eligibility.
For more information on how to access the MITS provider portal, visit the Medicaid website and click "Providers" and then "MITS resources."
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