Nevada Medicaid Waiver - WIN / HCBW For Persons with Physical Disabilities

Program Description

The Nevada Home and Community Based Waiver (HCBW) for Persons with Physical Disabilities, is often also referred to as the Physical Disability Waiver or simply abbreviated as WIN. It is a program for low-income, physically disabled Nevada residents. This program allows individuals who require a nursing home level of care to remain living at home, in the home of a relative, or in an assisted living residence, by providing care and other supportive services, such as assistance with personal activities of daily living, housecleaning, errands, meal preparation and more.

Another program that may be of interest to a broader spectrum of older Nevada residents is the Frail Elderly Waiver. This provides services similar to the ones provided by the HCBW for Persons with Physical Disabilities. However, unlike the HCBW for Persons with Physical Disabilities, which has no age limitations, individuals must be 65 years of age or older to be eligible for the Frail Elderly Waiver. There is also no requirement of being physically disabled, only that an applicant requires a nursing home level of care. Make note, applicants are only able to receive services via one home and community based service waiver even if they are found to otherwise be eligible for both.

The HCBW for Persons with Physical Disabilities is operated by Nevada’s Department of Health and Human Services’ Division of Health Care Financing and Policy (DHCFP), while the Frail Elderly Waiver is administered by the Aging and Disability Services Division.

 

Eligibility Guidelines

In order to be eligible for the HCBW for Persons with Physical Disabilities, there are both functional and financial requirements that Nevada residents must meet.

Applicants must be assessed and certified as disabled by a DHCFP physician. They must also require a nursing home level of care, and if not for the care provided by the waiver, be at risk of nursing home placement within 30 days.

Financially, as of 2017, applicants must not have monthly income in excess of $2,205 or stated another way, annual income cannot be greater than $26,460. (This amount is equivalent to 300% of the current Federal Benefit Rate.) For a couple, allowable monthly income is slightly higher at $3,309 or $39,708 / year. Assets are limited to $2,000 for a single individual and $3,000 for a couple. However, certain assets are considered exempt, such as one’s home, provided the applicant lives in the home and the owners’ home equity is not valued over $560,000. A vehicle, household items, personal effects, and a burial policy up to $1,500 are also considered exempt items. Persons whose incomes or assets exceed these limits or married couples in which only one spouse requires care, should consider working with a Medicaid planning professional.

Neither of these Medicaid waiver programs are entitlement programs. This means that applicants do not automatically receive services if they are eligible, as there are a limited number of spots available and waiting lists may exist.

 

Benefits and Services

A variety of care and support services are available under the WIN / Physical Disabilities Waiver. These services must be approved in the beneficiary’s plan of care and can include the following:

  • Assisted Living Services 
  • Attendant Care – assistance with activities associated with daily living, such as mobility, bathing, dressing, light cleaning, etc. 
  • Case Management
  • Chore Services – minor home reparations, yard cleaning, window washing, etc. 
  • Home Modifications – addition of wheelchair ramps, grab bars, remodeling of bathrooms to allow wheelchair access, etc. 
  • Homemaker – housecleaning, grocery shopping, meal preparation, laundry
  • Meal Delivery
  • Personal Emergency Response Systems (PERS)
  • Respite Care – up to 120 hours / year in the home or residence of the beneficiary
  • Specialized Home Care Supplies / Durable Medical Equipment

 

How to Apply / Learn More

Although a bit technical and difficult to comprehend, one can download a file here to learn more about the HCBW for Persons with Physical Disabilities.

One can also obtain information or apply for services by calling the Division of Health Care Financing and Policy. To see a list of DHCFP’s district offices and relevant contact information, click here.

Once accepted, program beneficiaries should expect annual reassessments of their functional ability and care requirements.