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Washington Medicaid’s New Freedom Program
Overview of the Washington Medicaid’s New Freedom Program
The New Freedom waiver program is an option only for individuals who are residents of King County and require a nursing home level of care but choose to receive in-home services in place of moving into a skilled nursing facility. The goal of the pilot program is to prevent costly institutionalization of the disabled by allowing them to continue residing at home, providing them a care services budget and a great deal of flexibility with regards to its allocation. This model of program is based on the Medicaid principle of Cash and Counseling which is also referred to as consumer direction and participant direction.
The New Freedom program has the state and the individual in need of care working collaboratively to determine the care needs and the budget to fulfill those needs. Participating individuals are then given the control and flexibility to allocate the budget for the goods and services they require and to choose their care providers. This model has the dual benefit of empowering the individual and reducing the administrative costs for the state.
To avoid confusion, it is worth mentioning that this program is also referred to as New Freedom Consumer Directed Services or NFCDS. Also of importance, this program is offered as an alternative to Washington Medicaid Personal Care (MPC). Participants cannot be concurrently enrolled in both programs.
In empowering participants to select their own care providers, most Cash and Counseling programs allow participants to hire certain family members to provide care. It is unclear at this point whether the New Freedom program will allow relatives as paid caregivers.
To avoid confusion, it is worth mentioning that this program is also referred to as New Freedom Consumer Directed Services or NFCDS. Also of importance, this program is offered as an alternative to Washington Medicaid Personal Care (MPC). Participants cannot be concurrently enrolled in both programs.
In empowering participants to select their own care providers, most Cash and Counseling programs allow participants to hire certain family members to provide care. It is unclear at this point whether the New Freedom program will allow relatives as paid caregivers.
Qualifications for the New Freedom Program
There are 3 types of requirements to participate in the New Freedom program: residential, functional and financial.
1) Residential – program participants must reside in King County and live at home (as opposed to residing in a nursing facility or assisted living residence).
2) Functional – participants must be assessed to require the level of care typically provided in a nursing home.
3) Financial – participants must be eligible for Medicaid which involves a complicated review of a family’s income, assets and asset transfers as far back as 5 years. Rules change frequently and there are many exceptions, but typically monthly income cannot exceed $2,000 and “countable asset” limits, excluding the car and home, range from $2,000 to $8,000. Given the implications of not qualifying for Medicaid to the comfort of an individual, their family’s finances and even their health, it is advisable to consult with a Medicaid Planning professional prior to applying. Find assistance applying for Medicaid.
1) Residential – program participants must reside in King County and live at home (as opposed to residing in a nursing facility or assisted living residence).
2) Functional – participants must be assessed to require the level of care typically provided in a nursing home.
3) Financial – participants must be eligible for Medicaid which involves a complicated review of a family’s income, assets and asset transfers as far back as 5 years. Rules change frequently and there are many exceptions, but typically monthly income cannot exceed $2,000 and “countable asset” limits, excluding the car and home, range from $2,000 to $8,000. Given the implications of not qualifying for Medicaid to the comfort of an individual, their family’s finances and even their health, it is advisable to consult with a Medicaid Planning professional prior to applying. Find assistance applying for Medicaid.
Benefits / Services Covered by of the New Freedom Program
The objective of the New Freedom Program is to enable program participants to spend their care dollars as they best see fit. That said, the development of a care plan is a collaborative effort between the program participant and their Case Manager. It can include the following the types of expenses.
1) Personal Assistance Services – help with the activities of daily living such as bathing, grooming, mobility and eating and the instrumental activities of daily living such as housekeeping, cooking, meal planning and preparation, shopping for groceries and other essentials and assistance with transportation.
2) Goods and Supplies - that increase independence such as assistive technology, personal emergency response services, remote monitoring equipment and adaptive lighting.
3) Home and Vehicle Modifications – alterations to one’s home or car to accommodate for a disability such as the addition of wheelchair ramps and lifts or grab bars.
4) Health Maintenance Support – medical, dental and vision care, physical, massage and alternative therapies such as acupuncture.
1) Personal Assistance Services – help with the activities of daily living such as bathing, grooming, mobility and eating and the instrumental activities of daily living such as housekeeping, cooking, meal planning and preparation, shopping for groceries and other essentials and assistance with transportation.
2) Goods and Supplies - that increase independence such as assistive technology, personal emergency response services, remote monitoring equipment and adaptive lighting.
3) Home and Vehicle Modifications – alterations to one’s home or car to accommodate for a disability such as the addition of wheelchair ramps and lifts or grab bars.
4) Health Maintenance Support – medical, dental and vision care, physical, massage and alternative therapies such as acupuncture.
How to Apply for the New Freedom Program
One should contact the King County Health Services Department for further direction on the application process. Alternatively one can also try to reach a program administrator at (360) 725-2466. At the time of writing, a Word Document with more details about the program was available for download here.
Use our Eldercare Financial Resource Locator Tool to find other public and private programs that can help pay for or reduce the costs of long term care for the elderly.
Use our Eldercare Financial Resource Locator Tool to find other public and private programs that can help pay for or reduce the costs of long term care for the elderly.
