Nevada Assisted Living and In Home Care Medicaid Waiver Information and Rules 2017

Introduction

Nevada provides long-term care resources to seniors through its Department of Health and Human Services, Aging and Disability Services. The Community Options for the Elderly Program, or COPE, provides non-medical services to older persons to help them maintain independence in their own homes as an alternative to nursing home placement.

Nevada also provides anAging and Disability Resource Center(ADRC) which provides three types of services: 1) Options Counseling - a person centered approach to helping individuals know what services are available in their area. This is an interactive decision support process that helps Nevadans access the right services at the right time; 2) Care Transitions - a short-term service that helps individuals improve health and access services in order to reduce hospital admissions; and 3) Caregiver Support - Specialists work with unpaid caregivers (family or friends) to help them explore support options that are available to them. The ARDC provides these services infive different locations throughout the state.

In addition, you can access long-term care resources through local Area Agencies on Aging (AAAs) AAAs are local aging programs that provide information and services on a range of assistance for older adults and those who care for them. By contacting your local agency you get access to critical information including: Available services in your area; Mobility assistance programs, meal plans & housing; Assistance in gaining access to services; Individual counseling, support groups and caregiver training; Respite care; and Supplemental services, on a limited basis

Medicaid Waiver Program for Assisted Living and In-Home Care

Nevada Frail Elderly Medicaid Waiver (HCBS Frail Elderly Waiver)

The Nevada Aging and Disability Services Division's Home and Community Based Waiver (HCBS Frail Elderly Waiver) provides non-medical services to older persons to help them maintain independence in their own homes as an alternative to nursing home placement. It is available to seniors over the age of 65 who would otherwise require a nursing home level of care and choose to remain in their home or community setting, and meet certain financial criteria.

Services

Services include: Case Management (assistance by a licensed social worker in determining the needs of the client, arranging and monitoring services; Personal Care; Assistance with personal care, which includes such services as bathing, grooming, dressing and eating; Homemaker

Assistance with: Meal Preparation, Light Housekeeping, Laundry, Shopping; Social Adult Day Care; Adult Companion; Personal Emergency Response System (PERS); Chore Service (Heavy household tasks, which are intermittent in nature, and may be authorized as a need arises for the completion of a task, which otherwise left undone poses a home safety issue); Respite; Augmented Personal Care; Homemaker Services such as: chore Services, cocial and recreational programming, personal Care Services, companion Services, dedication oversight; and Services that will ensure that residents of the facility are safe, secure, and adequately supervised.

Eligibility

  1. Health: An applicant for the Frail Elderly waiver must require a Nursing Home Level of Care.
  2. Financial: An applicant for the Assisted Living waiver must meet certain income and asset limits. Nevada is a Special Income Limit (SIL) state, meaning there is a hard cap on the amount of income an applicant can earn every month to be financially eligible. For 2017, the individual income limit is $2,205 per month. In addition to the SIL, the waiver program has an asset limit of $2,000 for an individual (or $3,000 if applicants are married and both applying). In Nevada you can use a Miller Trust, or Qualified Income Trust, to divert some of your income if it is over the limit. For the non-applicant spouse (or, “community spouse”), a certain amount of assets and allowances are allowed without disqualifying the applicant. For 2017, the asset limit for a community spouse is $120,900 and the maximum monthly maintenance needs allowance (MMMNA), used for personal and other monthly expenses, is $3,022.50

Practical Considerations

The Personal Needs Allowance, or maintenance needs allowance, is equal to the individual's total income as determined under the post-eligibility process which includes income that is placed in a Miller Trust.

If you are interested in the Frail Elderly waiver, you must contact the Aging and Disability Services Division (ADSD) office nearest you. A listing of regional office is available here. Once a referral is made to the appropriate regional office, a social worker will contact the individual in need of services to determine which services are most appropriate for them. Once a person is determined eligible for services, a social worker will remain in close contact with the client to assure services are appropriate and are meeting the needs of the client.

Conclusion

Nevada’s Frail Elderly Waiver is a good option for seniors wishing to remain in their own home or community instead of a nursing home facility, while having Medicaid provide funding for the services received. The special income limit in Nevada means that the ability to use a Miller Trust to divert some income so it is not considered in the calculation is a big advantage.