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


The state limits the amount that can be charged to ALE waiver clients for room and board to the amount of SSI, which is $552.00 plus the Optional State Supplementation of $78.40, which equals $630.40, minus a $54 personal needs allowance, which equals $576.40.17 The facility is legally required to accept the OSS rates for waiver clients. Any income over this amount is required cost sharing.

Family supplementation--capped at twice the amount of the SSI/OSS combined payment for room and board--is allowed. The state does not limit room and board charges for private pay residents.

17. The maximum OSS payment is $78.40 per month.

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