Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States : Table 2

12/01/2003

: Table 2

FloridaSoutheast regionCovers services in residential care through both the waiver program and the personal care option. State uses the 300 percent special income option. The state sets rates for services only and allows family supplementation of room and board costs. State uses flat rates and pays $28 a day. Nursing home/waiver level-of-care criteria are not stringent. The state has major litigation problems.
MinnesotaMidwest regionCovers services in residential care through the waiver program. Approximately 3190 participants. State uses the 300 percent special income option. The state sets rates for services and room and board and does not allow family supplementation. Most states define and regulate residential care facilities. Minnesota defines assisted living as a service and not a place. The housing component is more like rental housing and is licensed like hotels. Other entities provide the services. The state has a housing subsidy program to help Medicaid clients pay for room and board.
North CarolinaMid-Atlantic regionCovers services in assisted living through the personal care option. Approximately 18,533 Medicaid beneficiaries in residential care settings, the largest number of any state. The state allows family supplementation in nursing homes and is currently looking at allowing it in residential care settings.
OregonNorthwest regionCovers services through the waiver program since the early 1980s. Approximately 2572 participants. State uses the 300 percent special income option. The state sets rates for services and room and board and does not allow family supplementation. The state uses nurse delegation extensively. They've enacted recent regulatory changes related to negotiated risk agreements.
TexasSouthern regionCovers services in assisted living through the waiver program. State uses the 300 percent special income option. The state also uses the state plan to cover personal care in small group homes under very specific circumstances. The state legislature has authorized a "money follows the person" initiative, which allows funding from the state's nursing home budget to pay for waiver services for people who transition from nursing homes to the community.
WisconsinMidwest regionCovers services in residential care settings through the waiver program and the personal care option, and serves approximately 1018 participants. State uses the 300 percent special income option. State does not allow family supplementation. Counties negotiate rates with providers, which include a basic payment and variable payments based on client care needs. The state has two different models of residential care, one highly regulated and the other not.