Program Description
Under the Rhode Island Comprehensive Demonstration Waiver (formally known as the Global Consumer Choice Compact Waiver), Medicaid-eligible Rhode Island residents can receive a variety of assistance services in their homes, communities, or assisted living residences, instead of nursing homes.
The creation of this waiver in 2009 merged Rhode Island’s state Medicaid plan and the state’s previous Medicaid waivers. The programs under the Comprehensive Demonstration Waiver that are most relevant to seniors include:
Many services offered under these programs allow for consumer direction, also known as self-direction. Eligible applicants have the flexibility to choose who will provide their services. Adult children and other relatives of seniors can be hired and compensated as caregivers.
What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers, allow qualifying program participants to receive services outside of a nursing home. Medicaid’s standard benefit is to pay for nursing home care. However, those who wish to live at home, in assisted living or in adult foster care, sometimes Medicaid will pay for nursing-home-level care in those locations if it can be obtained at a lower cost than in a nursing home.
Eligibility Guidelines
Different eligibility guidelines exist depending on the category one falls under. What follows are the requirements for the services that are most relevant to seniors.
General Requirements
To be eligible for long-term care services under the Comprehensive Demonstration Waiver, applicants must be residents of Rhode Island and be at least 65 years of age, or 18-64 and have a disability.
Financial Requirements
Income Limits
As of 2023, seniors must have an income no greater than $2,742 a month, or $32,904 a year.
For married applicants, the income of the non-applicant spouse is not considered. In addition, the applicant spouse may be able to transfer part of their monthly income to their non-applicant spouse. This is called a monthly maintenance needs allowance (MMNA). For 2023, the max MMNA is $3,715.50 a month.
Asset Limits
An individual cannot have more than $4,000 in countable assets, such as banking accounts, stocks, and bonds. A home is considered exempt if the individual continues to live in the home and the equity in the home is not valued at more than $688,000.
Over the Financial Limits?
An option for persons over these limits is to work with a Medicaid planner, who can help families to gain Medicaid eligibility for their loved one. Read more about Medicaid planning here.
Benefits and Services
The Comprehensive Demonstration Waiver covers a very wide array of care and support services. However, not all beneficiaries are eligible to receive all benefits. There must be a functional need for the service and, usually, the state requires that individuals have no other means of obtaining the service or benefit.
What follows is an extensive list of long-term-care benefits, but not every participant is entitled to each benefit.
- Homemaker Services – light housekeeping, meal preparation, laundry
- Home and Vehicle Modifications – roll-in shower, widening of doorways, installation of grab bars, lifts, and ramps
- Specialized Medical Equipment
- Home Delivery of Meals
- Personal Emergency Response System (PERS) – installation and monthly fee
- Transitional Service – from an institution back into the community
- Residential Supports
- Assisted Living – supportive services, such as personal care, chore, homemaker, adult companionship, and monitoring of medication
- Adult Companion – non-medical assistance and supervision
- Respite Care
- Personal Care Assistance – assistance with bathing, dressing, eating, mobility, light housecleaning, preparation of meals
- Adult Day Services / Adult Day Care
- Physical Therapy
- Skilled Nursing / Private Duty Nursing
- Case Management
- PACE (Program for All Inclusive Care) – provides medical and supportive services
- Shared Living (RIte@Home) – eligible seniors choose to live with a caregiver who assists with activities such as dressing, eating, bathing, preparing meals, laundry, transportation, etc.
- Non-Medical Transportation
How to Apply / Learn More
More information on the Comprehensive Demonstration Waiver can be found here and here, while information on the programs available under this waiver can be found here. Or one can call the Long Term Care Office at 855-697-4347 or The Point at 401-462-4444.
One can apply for Rhode Island Medicaid here. Or call The Point (401-462-4444) for assistance.
The Comprehensive Demonstration Waiver is only valid through December 31, 2023. However, the state has applied for an extension.
