The Mississippi Independent Living Waiver (IL) is a statewide program for those who are a minimum of 16 years of age 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, train, and manage the personal care attendant of their choosing, including select relatives. Via the Independent Living waiver, care recipients direct their own care with the aid of their case manager through what is called a co-participant service model. Individuals 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.
Applicants must be residents of Mississippi, a minimum of 16 years old, and have a serious impairment that is neurological or orthopedic. There are eligibility requirements for applicants of the IL waiver, which differ for married or single applicants. There are also 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 2020, single, divorced, or widowed applicants are permitted a maximum of $2,349 per month in income. This figure is equivalent to 300% of the current Federal Benefit Rate (FBR). However, it may be possible for persons with income 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”, or said another way, non-exempt assets. In 2020, single applicants are allowed up to $4,000 in assets. However, certain assets are not considered countable. Exempt assets include a home, vehicle, home furnishings, irrevocable funeral trusts, and other personal items. Note, in 2020, the home is exempt only if the value of the owner’s home equity is less than $595,000.
Eligibility Criteria for a Married Applicant
Married applicants, with both spouses applying for the IL Medicaid waiver, will have their incomes evaluated separately. That said, each applicant could have as much as $2,349 per month in income. If only one spouse is applying and the non-applicant spouse (also referred to as the community spouse) does not have income, or has very little income, the applicant spouse is able to transfer some of his or her income to the non-applicant spouse. As of 2020, up to $3,216 / month in income can be transferred to the community spouse. In Medicaid-speak, this is referred to as the Monthly Maintenance Needs Allowance.
Asset calculations are more complex, and for Medicaid purposes, assets are considered jointly owned. Applicants can have up to $4,000 in countable resources, but as of 2020, non-applicant spouses can have up to $128,640. This is called the Community Spouse Resource Allowance. Assets exceeding the abovementioned amounts might be put into Medicaid exempt annuities or shelters known to Medicaid planning experts. However, assets cannot be given away nor gifted, as doing so may violate Medicaid’s 5-year Look-Back Period, resulting in a period of ineligibility.
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. A relative may be hired as a personal care attendant, given he or she is qualified to provide this care and have completed the appropriate training and does not live in the home with the care recipient. 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. As mentioned previously, caregivers can be related to the care recipient. Sons, daughters, sons-in-laws, daughters-in-laws, siblings, and grandchildren can all receive compensation as caregivers, given they don’t live in the same home as the IL waiver recipient.
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.