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Assisted Living Waiver

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.

Emergency Preparedness and Response the COVID-19

The Centers for Medicare and Medicaid Services (CMS) has approved the below Appendix K:  Emergency Preparedness and Response in response to the COVID-19 outbreak for the Assisted Living Waiver.

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
  • transportation
  • 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.

Long Term Care 1915(c) Waiver Training Requirements

Long term care waiver providers are required by Administrative Code to ensure all staff meet training requirements as defined by the Division of Medicaid.  The provider type specific memorandums linked below define the current training requirements for all direct care staff.

February 11, 2021 Update

In an effort to streamline and standardize procedures across waiver platforms, along with reducing the burden on Medicaid providers, the Division of Medicaid would like to confirm the removal of the forty (40) hour training requirement for Assisted Living (AL) Waiver direct care staff. The list of the required training topics to be covered in training can be located on the Medicaid website at Training Requirements for AL Waiver Direct Staff. The Division of Medicaid is in the process of updating the Administrative Code to reflect removal of the forty hour requirement.

Medicaid has partnered with the Person Centered Planning Institute (PCPI) and is excited to offer training on Person Centered Planning/Person Centered Thinking. If they have not already done so, PCPI will be reaching out to your agency with a schedule of courses offered and dates they are available. All AL case managers have attended this training and PCPI does an outstanding job presenting the material. You are strongly encouraged to avail yourself of this outstanding resource.

Thank you for all you do to serve our Medicaid population.

Assisted Living Waiver Renewal Information

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