Ohio Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Oct 31, 2024
- 2 min read
Ohio, known as The Buckeye State, has a well-developed Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.
Administered by the Ohio Department of Medicaid (ODM), in collaboration with the Ohio Department of Aging (ODA) and the Ohio Department of Developmental Disabilities (DODD), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings instead of institutional facilities.
Key waiver programs include the Ohio Home Care Waiver, which provides personal care, nursing, and assistive technology for individuals with physical disabilities, and the PASSPORT Waiver, which supports seniors with home-delivered meals, personal care, and transportation. The Individual Options (IO) Waiver, Level One (L1) Waiver, and Self-Empowered Life Funding (SELF) Waiver serve individuals with intellectual and developmental disabilities (IDD), offering residential, employment, and behavioral health services. Ohio also provides Self-Direction options, allowing waiver participants to manage their own services and hire caregivers of their choice.
Regulatory oversight in Ohio is managed through ODM, ODA, and DODD, with additional provider licensing and compliance enforcement by the Ohio Department of Health (ODH) and the Office of Health Assurance and Licensing (OHAL). The state operates under a Managed Care model, with HCBS services integrated into Ohio Medicaid Managed Care Organizations (MCOs) and MyCare Ohio, which coordinates care for individuals who are eligible for both Medicaid and Medicare.
Ohio has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring compliance and service integrity. Providers must navigate Medicaid enrollment, prior authorization requirements, and rigorous quality assurance measures to successfully participate in the state’s HCBS programs.
With a strong emphasis on community integration, person-centered planning, and cost-effective service delivery, Ohio’s Medicaid waiver system ensures that individuals receive high-quality, sustainable long-term care while maintaining independence, dignity, and full inclusion in their communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.
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