Mississippi Medicaid Independent Living Waiver with Consumer Direction: Benefits & Eligibility

 What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services out of the nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of the care outside of a nursing home needs to be less than the cost of care in a nursing home.

Program Description

The Mississippi Independent Living Waiver (IL) is a statewide program for adults who have impairments that are neurological or orthopedic in nature. These individuals require nursing home level care and would need to be institutionalized, if not for assistance provided by this program. While the IL Waiver is not intended solely for seniors, there are many diagnoses that may qualify an elderly individual. Examples that are common among the elderly are arthritis, osteoarthritis, joint fractures, Alzheimer’s disease, Parkinson’s disease, and Lewy Body Dementia. Via this waiver, supports and benefits, such as home modifications, specialized medical equipment, and personal care assistance, are provided that allow the individual to continue to live in the community, rather than need to be placed in a nursing home.

Participant direction, also referred to as consumer direction or self-direction, is permitted with personal care services, and is a huge benefit for many families. This means eligible applicants may hire the personal care attendant of their choosing and become the employer of that person. Individuals who elect this option will receive financial management services to assist with the payroll and taxation tasks associated with having an employee. A relative, may be hired as a personal care attendant, given they are qualified to provide this care and have completed the appropriate training. It’s important to note, spouses and family members who are legally responsible for the eligible individual cannot be hired to provide personal care services.

For those who do not want the responsibility of having an employee, the Co-Participant option for personal care services is also available. The individual can still hire the person of their choosing, but they do not have to be responsible for the financial aspect.

This waiver is administered by the Mississippi Department of Rehabilitation Services and the Division of Medicaid.

 

Eligibility Guidelines

There are eligibility requirements for applicants of the IL waiver which differ for married or single applicants and there are requirements for personal care attendants, which is of particular importance if an eligible applicant would like to hire a relative to provide care.

Eligibility Criteria for a Single Applicant
In 2017, single, divorced or widowed applicants are permitted a maximum of $2,205 per month in income. It may be possible for persons with incomes in excess of this amount to still qualify through the use of a special trust called a Qualifying Income Trust or Miller Trust. Applicants are also limited by their “countable assets”. In 2017, single applicants are allowed $2,000. However, certain assets are not considered countable. Exempt assets include a home, vehicle, home furnishings, irrevocable funeral trusts and other personal items. Note, in 2017, the home is exempt only if the value of the owner’s home equity is less than $560,000.

Eligibility Criteria for a Married Applicant
Married applicants, provided both spouses are not applying for Medicaid, will have their incomes evaluated separately. The applicant can have $2,205 per month in income and their spouse can have up to $3,022.50. In Medicaid-speak, this is referred to as the Monthly Maintenance Needs Allowance. Asset calculations are more complex. The applicant can have $4,000 in countable resources but their spouse can have $120,900. Assets that are jointly held can be counted as though they belong only the spouse but only up to the $120,900 amount. Assets exceeding that amount might be put into annuities or shelters known to Medicaid planning experts. However, they cannot be given away nor gifted.

Persons whose income or assets exceed these limits may still gain full eligibility by working with a professional Medicaid planner

Personal Care Attendant Eligibility
Personal Care Attendants must be 18 years of age or older, must be able to read and write, communicate well, as well as be able to follow instructions, both verbally and written. The individual must also meet competency and training requirements. They cannot be married to or the legal guardian of the individual for whom they will provide care. However, they are permitted to be related. Sons, daughters, sons-in-laws, daughters-in-laws, sibling and grandchildren can all receive compensation as caregivers.

 

Benefits and Services

The following benefits are available via the IL waiver. Note that eligibility for the waiver does not automatically mean all participants are eligible for all benefits.

  • Personal Care Services– assistance with activities of daily living, such as mobility, toiletry, eating, bathing, and dressing. Benefits may also include light housecleaning, meal preparation, and grocery shopping. 
  • Home Modifications – grab bars, roll in shower, widening of doorways, etc. 
  • Case Management – provides assessment, service plan, and coordinates services
  • Specialized Supplies and Medical Equipment – wheelchairs, motor scooters, etc. 
  • Financial Management Services – for those who opt for the consumer directed option 
  • Assistance with Transitioning Back into the Community (from a nursing home)

 

How to Apply / Learn More

To learn more about the IL waiver, one can download a PDF here

To apply, contact the Department of Rehabilitation Services at 800-443-1000 or find your county office, click here