The Assisted Living Waiver is a home and community-based waiver that provides services to beneficiaries who, but for the provision of such services, would require the level of care provided in a nursing facility. Qualified beneficiaries are allowed to reside in a Personal Care Home-Assisted Living (PCH-AL) facility that is licensed as a PCH-AL Facility by the Mississippi State Department of Health, and is approved as a Medicaid provider for Assisted Living services. Medicaid reimburses for the services received in the facility.
Public Notice for the Assisted Living Waiver Renewal
Pursuant to 42 C.F.R. Section 441.304(f), public notice is hereby given to the submission of a Medicaid Assisted Living (AL) Waiver Renewal. The Division of Medicaid, in the Office of the Governor, will submit this proposed renewal to the Centers for Medicare and Medicaid Services (CMS) for the AL Waiver effective October 1, 2018.
Who is Eligible for the Assisted Living Waiver?
Eligibility for Assisted Living is limited to individuals age 21 years old and older, who meet clinical eligibility requirements determined through screening the following areas:
- activities of daily living,
- instrumental activities of daily living,
- sensory deficits,
- cognitive deficits,
- client behaviors,
- medical conditions, and
- medical services.
Beneficiaries of this waiver must be Medicaid eligible either as a Supplemental Security Income (SSI) recipient or meet the income level up to 300% of the SSI federal benefit rate.
Assisted Living Waiver Services
Services provided under the Assisted Living Waiver are:
- case management
- personal care
- homemaker services
- attendant care
- medication oversight
- medication administration
- therapeutic social recreational programming
- intermittent skilled nursing services
- attendant call system
This waiver sets aside five waiver slots for participants with acquired traumatic brain injuries who are in a family/participant crisis or have behavioral issues that require 24 hour supervision and assistance to successfully thrive in a community or residential setting. If not for services provided in this waiver, these individuals would require institutionalization. The object for offering this service is to strengthen and support informal and formal services to meet the unique needs, cognitively and behaviorally, for these waiver participants in a specialized residential setting. Traumatic brain injury is defined as a traumatically acquired non-degenerative structural brain damage. This term does not apply to brain injuries that are congenital or due to injuries induced by birth trauma. There are specific training requirements for this service provider.