Long Term Care (LTC): Waivered Service Programs – Living Choice Waiver

317:35-23-1.

317:35-23-2.

The Living Choice waiver allows people who are institutionalized to move into the community with the necessary supports. To categorically relate to this program the person must be:

  • Aged (65 or older) or
  • Blind (per SSA rules)
  • Physically or Intellectually Disabled (per SSA rules)

To be eligible the person must be:

  • At least 19 years of age
  • In an institution (nursing facility or public ICF/ID) for at least 60 consecutive days prior to transition, and
  • Financially eligible for long-term care (Appendix C-1, Schedules VIII.B.1 and D)

This program is administered by OHCA. Amy King in AFS/HRMS is notified that a person has been approved for this waiver she checks financial eligibility. If it appears client is eligible financially she closes the nursing home authorization and the waiver eligibility is added. Codes are P1 for an elderly person and P3 for a disabled person. The address is also added at this time. Case notes are updated and an email is sent to the worker and supervisor notifying them of this change.

Clients are only eligible for this program for 365 days. These days are kept up with by the Living Choice unit at OHCA. Client must then transition to ADvantage Waiver if eligible. If AFS worker is notified that the person has returned to the nursing home, you must wait 30 days before reapproving the person for nursing home care since the person is allowed to remain in the Living Choice waiver for up to 30 days while in ICF care. Also, please contact Amy King in HRMS of the nursing facility placement so that OHCA can be notified.

Since this is a long-term care program, we recommend that these cases be maintained by a long-term care worker. Reviews must be done by the AFS LTC worker every 12 months just like any other long-term care case, and HRMS does not change the review date when the waiver codes are added. If the person has a MIPT, the worker must verify that the proper amount is in the account and that it continues to be funded properly. The AFS LTC worker will NOT close the case if unable to complete the review but will contact Amy King in AFS/HRMS.

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