People like Tracy have "Current Needs" that can only be met using a Medicaid waiver. If a waiver is not available when the assessment is complete, they will be added to a waiting list until a waiver becomes available. As always, they can request a new assessment any time their needs change by contacting their county board.
Frequently Asked Questions
If I have a "Current Need" in the next 12 months, does that mean I am guaranteed to get a waiver in the next 12 months?
No. County boards can only enroll people if there are waivers available. However, be sure to talk with your county board about other ways some of your needs may be met while you are waiting.
OAC 5123-9-04(E)(3) and (F)(2)
My assessment says I have needs in the next 12 months that cannot be met without a waiver. How are these not "Immediate Needs"?
The rule defines "Immediate Needs" as needs that require action within 30 days to prevent harm. "Current Needs" are needs that will arise in the next 12 months, or needs that exist now that may require waiver funded supports in the next 12 months. If your assessment finds you will have needs in the next 12 months, you have "Current Needs," and if you need a waiver when one isn't available, you will be placed on the waiting list. However, if your situation changes and your needs will come up in the next 30 days, you should ask your board for a new assessment.
OAC 5123-9-04(B)(5) and (B)(9)
If my "Current Needs" become "Immediate Needs," can I get services to meet my "Immediate Needs"?
Yes! It is important for you to contact your county board as soon as possible when your needs change. The county board will review and update your waiting list assessment to confirm your "Immediate Needs." If you have "Immediate Needs," then the county board must take action to ensure they are met–either through alternative services or an available waiver–within 30 days.
OAC 5123-9-04 (D)(1) and (B)(9)
If a waiver becomes available in my county, who will receive it?
County boards use two factors to determine the order in which people on the waiting list will be enrolled on an available waiver. First, they consider how many needs a person has based on the results of their assessment. People with more needs are enrolled ahead of people with fewer needs. Second, they consider how long a person has been waiting for a waiver based on their status date (or original date of request, if the person was already on the waiting list before September 1, 2018). When two or more people have the same number of needs, the person with the older status date (or original date of request) will get the waiver first.
Will I know how many and what type of waivers my county board plans to enroll each year?
Yes. The county board will identify how many and what type of county-funded waivers they will enroll each year and will make that information available to anyone who requests it.
If there are two or more people who have an identical level of "Current Needs" as me, who would get the waiver first?
If two people have the same level of need and a waiver becomes available, the person who has been on the waiting list longest will receive the waiver.
Will I have a "number" on the new waiting list?
No. The old waiting list used to assign a "number" to people waiting for a waiver based on the date they were added. The new waiting list is organized based on each person's level of need and the date they were placed on the waiting list. There are no "numbers" in the new waiting list.
OAC 5123-9-04(B)(19) and (E)
If there are people who have an identical level of "Current Needs" as me, and we are both assessed on the same day, who can get an available waiver first?
If two people are assessed to have the exact same number of "Current Needs," and they both live in the same county, and they both are assessed on the same day, the person whose assessment is entered into the state's computer system with the earliest time would be the first to receive an available waiver.
If my county board offers an ICF as the only option to meet my "Current Needs" and I refuse it,can I still be put on the new waiting list?
Yes. Refusing the option of receiving services in an ICF does not disqualify anyone from being on the waiting list.
OAC 5123-9-04(H)(5) and (I)(2)(c)(ii)
What happens if I move to a different county after I am assessed and placed on a waiting list?
You can only be on the waiting list in one county. After you have notified your new county board once you move, your waiting list record will transfer from your old county to your new county and the new county board will review your waiting list assessment within 90 days. Your waiting list record will not automatically transfer to your new county, so contact them when you move!
If I am not eligible for Medicaid now because of my income or assets, can I be put on the waiting list in the new system?
Yes. You may still go on the waiting list because Medicaid eligibility is determined as part of the waiver enrollment process. When a waiver becomes available, your county board will discuss Medicaid requirements with you.
These are just a few of the questions that people like Tracy have after their assessments. Do you have a question that is not answered here? Contact your local county board of DD to learn more.