Waiver programs are Medicaid programs that allow individuals with disabilities and long-term care needs to receive services in their homes or communities instead of in a nursing facility. These programs are designed to help individuals remain independent and active in their communities.
To be eligible for a waiver program, individuals must meet certain financial, medical, and program requirements.
- Financial Requirements:
- Individuals must have a low income.
- Individuals’ income must be below 138% of the federal poverty level.
- Individuals must be eligible for Medicaid.
- Medical Requirements:
- Individuals must have a disability or long-term care need that requires assistance.
- The individual’s disability or long-term care need must be expected to last at least 6 months or be life-threatening.
- Program Requirements:
- Individuals must be living in the state of Oregon.
- Individuals must be able to benefit from the services provided through the waiver.
The application process for waiver programs varies from state to state. However, the general process includes:
- Contacting the Oregon Health Authority (OHA) to find out more about waiver programs and to get an application.
- Completing the application and submitting it to the OHA.
- Attending an assessment to determine eligibility for the waiver program.
- Being approved for the waiver program.
The state of Oregon offers a number of waiver programs, including:
- Community Options (CO) Waiver: This waiver provides a wide range of services to individuals with disabilities and long-term care needs, including personal care, home health, and respite care.
- Aging and Disability Services (ADS) Waiver: This waiver provides services to individuals with disabilities who are age 65 and older, and to their caregivers.
- Children with Complex Medical Needs (CCMN) Waiver: This waiver provides services to children with complex medical needs.
- Transitional Care Waiver: This waiver provides services to individuals who are transitioning from a nursing facility to their homes.
- Family Caregivers Support Services (FCSS) Waiver: This waiver provides support services to family caregivers who are caring for an individual with a disability or long-term care need.
HealtheFirst is a platform that can help home care agencies in Oregon run more smoothly and efficiently. HealtheFirst provides a variety of features that can help agencies improve their operations, including:
- Case management: HealtheFirst can help agencies manage their cases more effectively by providing a centralized platform for storing and tracking client information. This can help agencies to ensure that each client is receiving the care they need, and that their care is being coordinated effectively.
- Scheduling: HealtheFirst can help agencies schedule their staff more efficiently by providing a tool that allows them to view and book appointments in real time. This can help agencies to ensure that their staff is always available to meet the needs of their clients, and that clients are not left waiting for care.
- Billing: HealtheFirst can help agencies bill their clients and payers more accurately by providing a platform that automates the billing process. This can help agencies to reduce the time they spend on billing, and to improve their chances of collecting payment from their clients.
- Communication: HealtheFirst can help agencies communicate with their clients and staff more effectively by providing a secure messaging platform. This can help agencies to stay in touch with their clients and staff, and to resolve any issues that may arise quickly and efficiently.
- Reporting: HealtheFirst can help agencies generate reports that track their performance and identify areas for improvement. This can help agencies to identify areas where they can improve their services, and to make sure that they are providing the best possible care to their clients.
The OHA provides a list of home care agencies that are approved to provide services under the waiver programs. You can find this list on the OHA website.