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HPIO releases update to Ohio Medicaid Basics

Advocates push for changes to Ohio Medicaid wait list for home services

About 49,000 Ohioans are on the state’s waiting list for Medicaid waivers that pay for home- and community-based services for people with disabilities and advocates are promoting a proposed rule to address the issue (Source: “Proposal aimed at whittling down waiting list for Medicaid waiver program,” Columbus Dispatch, May 4, 2018)

State and county officials and many advocates say the waiting list has become more of a haphazard compilation than accurate representation of the children and adults who most need help. A “Fix the List” coalition has helped craft a proposed rule that spells out new waiver waiting-list requirements and procedures, including an assessment tool to determine eligibility. For years, individuals and families have been able to add names to the list on their own with little or no input from service coordinators.

The median wait time for a waiver in many Ohio counties exceeds six years. Most other states also have waiting lists for the highly sought waivers, which allow people with disabilities to get support such as personal care and homemaker services while living in their communities instead of the residential centers known as ICFs, or intermediate-care facilities.

Not all advocacy groups support the proposed changes. Disability Rights Ohio submitted testimony that said the proposed rule misses the mark by focusing on managing the list instead of broad changes to the system, such as better pay and training for direct-support workers, expanded funding for waivers and making sure people have “real choice” about the services they receive. Addressing those problems, executive director Michael Kirkman said, would eliminate the need to “fix the list.”