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MACPAC > TABLE 2. Medicaid Authorities Used to Cover Services in Residential Care Settings by State, 2016

TABLE 2. Medicaid Authorities Used to Cover Services in Residential Care Settings by State, 2016

Published On

March 03, 2020

State Section 1915(c) HCBS waiver(s) Section 1115 demonstration waiver State plan personal care Section 1915(k) state plan No Medicaid coverage
Total 29 11 14 2 5
Alabama – – – – ✓
Alaska ✓1 – – – –
Arizona – ✓ – – –
Arkansas ✓ – ✓ – –
California ✓ ✓ – – –
Colorado ✓ – – – –
Connecticut ✓2 – – – –
Delaware – ✓ – – –
District of Columbia3 ✓ – – – –
Florida ✓4 – ✓ – –
Georgia5 ✓ – – – –
Hawaii – ✓ – – –
Idaho ✓ – ✓ – –
Illinois7 ✓8 – – – –
Indiana ✓ – – – –
Iowa ✓ – – – –
Kansas ✓ ✓ – – –
Kentucky – – – – ✓
Louisiana – – – – ✓
Maine – – ✓ – –
Maryland ✓ – – – –
Massachusetts ✓ – ✓ – –
Michigan – – ✓ – –
Minnesota ✓9 – – – –
Mississippi ✓ – – – –
Missouri – – ✓ – –
Montana ✓ – – – –
Nebraska ✓ – – – –
Nevada ✓10 – – – –
New Hampshire ✓ – – – –
New Jersey – ✓ – – –
New Mexico – ✓ – – –
New York – – ✓ – –
North Carolina – – ✓ – –
North Dakota ✓ – ✓ – –
Ohio ✓11 – – – –
Oklahoma ✓ – – – –
Oregon – – – ✓ –
Pennsylvania – – – – ✓
Rhode Island – ✓ – – –
South Carolina – – ✓ – –
South Dakota ✓ – – – –
Tennessee – ✓ – – –
Texas – ✓ – – –
Utah ✓ – – – –
Vermont – ✓ ✓ – –
Virginia12 ✓ – – – –
Washington – – ✓ ✓13 –
West Virginia – – – – ✓
Wisconsin ✓14 – ✓ – –
Wyoming ✓ – – – –
Notes: HCBS is home- and community-based services. RCS is residential care settings.
1 Alaska authorizes services provided in RCS under two Section 1915(c) HCBS waivers: the Alaskans Living Independently waiver program and the Adults with Physical and Developmental Disabilities waiver program.
2 Connecticut authorizes services provided in RCS under two Section 1915(c) HCBS waivers: a personal care assistance waiver and a home and community-based services for elders waiver.
3 The District of Columbia licenses assisted living residences and community residential facilities, but the Medicaid program only covers services in assisted living residences.
4 Florida uses a Section 1915(b)/(c) statewide managed long-term services and supports waiver to cover services provided in RCS.
5 Georgia licenses two types of RCS, personal care homes and assisted living communities, but Medicaid covers only services in licensed personal care homes that have up to 24 beds.
6 Georgia authorizes services provided in RCS under two Section 1915(c) HCBS waivers: an elderly and disabled waiver program and an independent care waiver program.
7 Illinois licenses four different types of RCS: assisted living establishments, shared housing establishments, sheltered care facilities, and supportive living facilities. However, the Medicaid program only covers services in supportive living facilities.
8 Illinois authorizes residential care services under two Section 1915(c) HCBS waiver programs: a supported living waiver program and a managed long-term services and supports waiver program.
9 Minnesota authorizes services provided in RCS under two Section 1915(c) HCBS waiver programs: an elderly waiver program and a community alternatives for disabled individuals waiver program.
10 Nevada authorizes services provided in RCS under two Section 1915(c) HCBS waivers: a home and community-based waiver program for the frail elderly and a home and community-based waiver program for persons with physical disabilities.
11 Ohio uses two waiver programs to cover services provided in RCS: a Section 1915(c) assisted living waiver program and a Section 1915(b)/(c) integrated care delivery system waiver program. The Section 1915(b)/(c) integrated care delivery system waiver program—a managed care program—is only for individuals with nursing home level-of-care needs living in one of 29 participating counties in the state.
12 Virginia’s Medicaid program covers assisted living services only for individuals with Alzheimer’s disease or related dementia.
13 Washington transitioned to the Section 1915(k) Community First Choice Options program from the Section 1915(c) Community Options Program Entry System in 2015.
14 Wisconsin authorizes services provided in RCS under two Section 1915(c) waiver programs—an elderly and physically disabled waiver program and a community options waiver program—and a Section 1915(b)/(c) waiver program: Family Care.
Sources: Carder, P., J. O’Keeffe, and C. O’Keeffe, 2015, Compendium of residential care and assisted living regulations and policy: 2015 edition, Washington, DC: ASPE, https://aspe.hhs.gov/basic-report/compendium-residential-care-and-assisted-living-regulations-and-policy-2015-edition.