Funding Sources - DefinitionsClick on the links to view the definitions of each Funding Source and Service.
Funding Sources:
Adult Day Services
Adult day services helps people get services when they are not at home. The new services include Adult Day Support, Vocational Habilitation, Supported Employment, and Non-Medical Transportation. Please see the "New Adult Day Services" handbook (DODD) for more information.
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Individual Options Medicaid Waiver Services
Commonly known as the I/O waiver, the Individual Options Waiver provides funding to individual waiver recipients that allows them to pay for services and supports without which the person would have to move into a long-term care facility or nursing home. With the waiver, Medicaid will allow people to stay in their homes and get support rather than requiring them to live in an Intermediate Care Facility for the Mentally Retarded (ICF/MR). The I/O Waiver currently provides the following services: Homemaker/Personal Care, Home Modifications and Adaptations, Transportation, Respite Care, Social Work, Home-delivered meals, Nutrition, Interpreter Services, Specialized Adaptive or Assistive Medical Equipment and Supplies, Supported Employment, Day Habilitation, Adult Day Services.
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Intermediate Care Facilities
Intermediate Care Facilities for the Mentally Retarded or ICFs/MR are facilities providing four (4) or more beds that are funded directly with Medicaid dollars. These are generally larger facilities that meet all of the standards outlined by the Centers for Medicaid and Medicare Services. Funding is attached to a "bed" (rather than a person) and is paid on a per diem basis. Intermediate Care Facility for the Mentally Retarded (ICFMR) is licensed by the ODMRDD, to be operated by a specific provider at a specific location. The Department of Health (DOH) certifies the licensed facility as meeting the Federal requirements for funding as an ICFMR. The provider is responsible for all aspects of care for the individual, including financial matters, transportation, habilitation, and medical needs.
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Level One Medicaid Waiver Services
The second of the two Home and Community Based Waivers administered through the Ohio Department of MRDD, the Level One waiver provides funding to individual waiver recipients that allows them to pay for services and supports without which the person would have to move into a long-term care facility or nursing home. The Level One waiver offers a variety of services with set spending limits. Recipients of Level One waiver funding choose from a list of certified Level One waiver providers for the services and supports they need. These fund limited services are generally provided to individuals living at home with their families.
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Supported Living Services
Supported Living is a non-Medicaid funding service that allows individuals with MRDD that are eligible for County Board services but not recipients of Medicaid waiver funds to live as independently as possible in their own communities, with support from public funds. These funds are managed by local County Boards and pay for services and supports provided by certified Supported Living providers. The only service available through this funding source is Supported Living defined as "the services and supports necessary to maintain as much independence as possible in a community setting." Supported Living is a way to assist individuals with MRDD to live as independently as possible in their own communities, with support from public funds. Services may be provided in the home of the individual, who lives on his/her own, or in the family home in which the individual resides. An individual may share supported living with up to three other individuals in a supported living arrangement. Service providers chosen by the individuals sharing services may not also be the landlord. Services and supports are identified on an Individual Service Plan (ISP).
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Services:
Adult Day Services
Adult day services helps people get services when they are not at home.
The new services include Adult Day Support, Vocational Habilitation,
Supported Employment, and Non-Medical Transportation. Please see the "New Adult Day Services" handbook (DODD) for more information.
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Adult Day Support
Adult Day Support services are provided separate from any home or facility in which an individualresides, focus on non-work activities, and include five components:
> Assessment -- may be formal or informal, for the purpose of developing an Individual ServicePlan (ISP)
> Personal care -- includes personal hygiene, eating, communication, mobility, toileting, and dressing
> Skill reinforcement -- includes implementing behavioral intervention plans, and help with the use of communication and mobility devices
> Training in self-determination -- includes developing self-advocacy skills and acquiring skills that enable an individual to become more independent
> Recreation and leisure -- includes supports identified in the ISP that are therapeutic, and help to develop and maintain social relationships and family contacts
Please see the "New Adult Day Services" handbook (DODD) for more information.
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Adult Day Support or Vocational Habilitation (Agency)
Adult Day Support or Vocational Habilitation (Agency) means non-vocational day services needed to assure the optional functioning of individuals who participate in these activities in a non-residential setting. Please see the "New Adult Day Services" handbook (DODD) for more information.
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Specialized Assistive Medical Equipment and Supplies
Specialized Medical Equipment and supplies - Specialized Adaptive or Assistive Medical Equipment and Supplies are devices, controls or appliances that allow people to do daily living activities or help them communicate; item necessary for life support and the supplies and equipment necessary for upkeep; and durable and non-durable equipment that is not paid for by the Medicaid State Plan.
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Day Habilitation
Day Habilitation is used when people go to workshops. It includes things like learning how to pack stuff in boxes so it doesn't get broken, or how to use a microwave oven to heat your lunch.
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Environmental Accessibility Adaptations
Individual Provider "Environmental accessibility adaptation(s)" means those physical adaptations to the home, required by the individual's plan of care, which are necessary to ensure the health, welfare and safety of the individual, or which enable the individual to function with greater independence in the home, and without which, the individual would require institutionalization. Such adaptations may include the installation of ramps and grab bars, widening of doorways, modification of bathroom facilities, or installation of specialized electric and plumbing systems that are necessary to accommodate the medical equipment and supplies that are necessary for the welfare of the individual. Excluded are those adaptations or improvements to the home that are of general utility, and are not of direct medical or remedial benefit to the individual, such as carpeting, roof repair, central air conditioning, etc. Adaptations that add to the total square footage of the home are excluded from this benefit. All services shall be provided in accordance with applicable state or local building codes. The benefit limitation for this service, personal emergency response systems, and specialized medical equipment and supplies combined shall not exceed six thousand dollars over a three- year period.
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Home Modifications and Adaptations
Home Modifications and Adaptations are changes to a home that enable a person to function with greater independence. Examples of Home Modifications are: installing ramps, doorways, wheelchair accessible bathrooms etc.
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Home-delivered meals
Home-delivered meals means the preparation, packaging and delivery of one or more meals to people who are unable to prepare or get nourishing meals. The waiver will provide two meals a day, seven days a week.
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Homemaker/Personal Care
Homemaker/Personal Care is provided in a person's home and helps a person with daily living activities such as personal hygiene, dressing and eating. The service include: Basic personal care and grooming, helping the person to and from the bathroom, help with medications, household services, light cleaning, shopping, laundry and other activities.
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Informal Respite-Limited Provider
Informal Respite-Limited Provider is support on a short term basis for the person who receives the waiver to give family members a break.
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Institutional Respite-Agency Provider
Institutional Respite-Agency means the care is provided in a Medicaid -certified ICFMR or a facility licensed by the State of DODD. Respite Care is support on a short term basis for the person who
receives the waiver to give family members a break.
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Interpreter Services
Interpreter Services helps a person communicate. People who provide this service help the individual with a disability convey his message as well as his attitude. The interpreter is an unbiased third party who can help the person with disability when asked.
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Non-Medical Transportation
Non-Medical Transportation includes transportation services necessary for an individual to participate in Adult Day Support, Vocational Habilitation, and Supported Employment, as specified in an Individual Service Plan (ISP).
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Nutrition
Nutrition services is used when people need directions to ensure they are eating the right types of food to be healthy. The service can provide a nutrition care plan that could include an outline of foods to be eaten, conversations about the importance of the food and counseling about the need for proper nutrition. The service can be used to teach the person with disabilities, their family, guardian or others who helps with meals.
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Personal Emergency Response Systems
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Respite Care
Respite Care is support on a short term basis for the person who receives the waiver to give family members a break. Institutional Respite means the care is provided in a Medicaid -certified ICFMR or a facility licensed by the DODD.
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Social Work
Social Work helps a person and their family with emotional problems or social needs tha twill allow them to live in the community. The counselor or social worker may work on problem solving, help a person to develop self-help or adaptive skills, or arrange for counseling, or other support services to help ease stress that may be caused by such things as work, families or living situations.
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Specialized Adaptive or Assistive Medical Equipment and Supplies
Specialized Medical Equipment and supplies - Specialized Adaptive or
Assistive Medical Equipment and Supplies are devices, controls or
appliances that allow people to do daily living activities or help them
communicate; item necessary for life support and the supplies and
equipment necessary for upkeep; and durable and non-durable equipment
that is not paid for by the Medicaid State Plan.
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Supported Employment
Supported Employment helps people work successfully who might not be able to work without a lot of supervision. It includes things like a job coach or special piece of equipment that lets the person with a disability perform a job. The support is available in a variety of places, including work sites where people without disabilities work.
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Supported Employment Services (Adult Day Services)
Supported Employment services are intensive, ongoing supports that help people to perform work in a regular employment setting, including self-employment. Supported Employment does not include sheltered
work or other vocational services furnished in specialized facilities. There are two types of Supported Employment services:
> Enclave -- provided to individuals who work as a team at a single work-site (community business or industry) with ongoing support provided by on-site staff
> Community -- provided to individuals who work in an integrated community work setting, along side employees without disabilities, and performing same or similar tasks
Please see the "New Adult Day Services" handbook (DODD) for more information.
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Transportation
Transportation enables people on the waiver to travel to waiver and community services, activities, and resources. Services can be provided by Public Bus Transportation Provider, County Board, Taxi, Non-Medical, Agency Provider, and Individual Provider.
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Vocational Habilitation
Vocational Habilitation services teach and reinforce concepts related to work such as:
> Responsibility
> Attendance
> Task completion
> Problem solving
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