Medicaid Waiver Services

Services available to qualified Elderly and Disabled Waiver (EDW) recipients in Jefferson County.

Case Management is a waiver service available to all EDW clients. The objective of Case Management is to assist clients to make decisions regarding long term care. It also ensures continued access to waiver and non-waiver services that are appropriate, available, and desired by the client. Case Managers are responsible for ongoing monitoring of the provision of all services included in the individual’s Plan of Care.

Homemaker Service provides assistance with general household activities, meal preparation, routine housecleaning and tasks. Services include duties such as, changing bed linens, laundry, dusting, vacuuming, mopping, sweeping, cleaning kitchen appliances and counters, removing trash, cleaning bathrooms, and washing dishes. This service may also include assistance with such activities as obtaining groceries and prescription medications, paying bills, writing and mailing. Homemaker Services is not an entitlement, it is based on the needs of individual client as reflected in the Plan of Care.

Personal Care Services provides assistance with eating, bathing, dressing, caring for personal hygiene, toileting, transferring from bed to chair, ambulation, maintaining continence and other activities of daily living (ADLs). It may include assistance with independent activities of daily living (IADLs) such as meal preparation, using the telephone, and household chores such as, laundry, bed-making, dusting and vacuuming, which are incidental to the assistance provided with ADLs or essential to the health and welfare of the client rather than the client’s family. Personal Care Service is not an entitlement, it is based on the needs of the individual client as reflected in the Plan of Care.

Adult Day Health (ADH) is a service that provides EDW clients with a variety of health, social, recreational, and support activities in a supervised group setting for four or more hours per day on a regular basis. Transportation between the individual’s place of residence and the adult day health center will be provided as a component of Adult Day Health Service. The cost of this transportation is included in the rate paid to providers of Adult Day Health Service. Adult Day Health is not an entitlement. It is based on the needs of the adult client.

Respite Care (Skilled and Unskilled) is provided to individuals unable to care for themselves and is furnished on a short-term basis because of the absence of, or need for relief of those persons normally providing the care. Skilled or Unskilled Respite is provided for the benefit of the client and to meet client needs in the absence of the primary caregiver(s) rather than to meet the needs of others in the client’s household. Respite Care is not an entitlement, it is based on the needs of the individual client as reflected in the Plan of Care.

Skilled Respite: Service will provide skilled medical or nursing observation and services and will be performed by a Registered Nurse or Licensed Practical Nurse in compliance with the Nurse Practice Act.

Unskilled Respite: Services will provide and/or assist with ADLs and observations. Unskilled Respite will be performed by a Personal Care worker.

Adult Companion Services is non-medical assistance, observation, supervision and socialization provided to a functionally impaired adult. Companions may provide limited assistance or supervise the individual with such tasks as ADLs, meal preparation, laundry and shopping, but do not perform these activities as separate services. The Companion may also perform housekeeping tasks which are incidental to the care and supervision of the individual. Companion Service is provided in accordance with a therapeutic goal as stated in the Plan of Care. The therapeutic goal may be related to client safety, toward promoting client independence or toward promoting the mental/emotional health of the client. Companion Service is not an entitlement, it is provided based on the needs of the individual client as reflected in the Plan of Care.

Home Delivered Meals are provided to an eligible individual age 21 or older that is unable to meet his or her nutritional needs. When specified in the Plan of Care, this service may include seven (7) or 14 frozen meals per week. A client may be authorized to receive seven (7) frozen meals plus seven (7) breakfast meals in lieu of 14 frozen meals. In addition, the service may include the provision of two (2) or more shelf-stable meals (not to exceed 6 meals per 6-month period) to meet emergency nutritional needs when authorized. Home Delivered Meals are not an entitlement, provision is based on the needs of the individual client.