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OH Self-Empowered Life Funding Waiver

Published on
July 21, 2023
Last updated
February 29, 2024
Written by
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Katie Wilkinson
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The Self-Empowered Life Funding (SELF) Waiver is a Medicaid program that empowers individuals with intellectual or developmental disabilities to direct their own services while providing a limited budget for needed supports and services.
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The Self-Empowered Life Funding waiver is a crucial Medicaid program in Ohio that aims to provide home and community-based services for people with intellectual or developmental disabilities. As a cost-capped waiver, SELF offers participants the autonomy to direct and manage their services, granting them greater control over their care. However, it's essential to explore the restrictions and funding limitations this waiver entails to determine if it suits the unique needs of prospective enrollees. This article delves into the details of the SELF Waiver, shedding light on its significance in the healthcare system and its potential benefits to caregivers and their loved ones.

Overview of the Self-Empowered Life Funding Waiver

The Self-Empowered Life Funding (SELF) waiver is a significant Medicaid home and community-based services program designed to support Ohioans with intellectual or developmental disabilities. Its primary purpose is to empower individuals by offering them greater control over their care decisions, an approach commonly known as "participant direction." Through this waiver, eligible participants gain the freedom to direct and manage their services, giving them a more active role in tailoring their support to meet their unique needs and preferences.

The Ohio Department of Developmental Disabilities administers the SELF Waiver, and is vital in providing community-based care as an alternative to institutionalization. Its objectives encompass enhancing the quality of life for waiver recipients, promoting independence and inclusion within their communities, and fostering a person-centered approach to care. By allowing individuals to manage their budgets, hire and train their caregivers, and choose services that suit their requirements, the SELF Waiver aims to offer a more personalized and empowering experience for its enrollees.

Eligibility Requirements

Individuals must meet specific eligibility criteria to qualify for the Self-Empowered Life Funding (SELF) Waiver in Ohio. First and foremost, applicants must be eligible for Medicaid, which is a foundational participation requirement. Additionally, they need to demonstrate a level of care indicating developmental disabilities, confirming their need for the specialized services provided by the waiver.

  • They are eligible for Medicaid and have a developmental disabilities level of care.
  • They need at least one SELF Waiver service.
  • They can be healthy and safe while using the waiver services.
  • They do not reside in a nursing facility or an ICF/IID.
  • The cost of their waiver services does not exceed the cost of care in an ICF/IID.
  • There are no age restrictions for this waiver.
  • The income limit for this waiver is 300% of the Supplemental Security Income (SSI) federal benefit rate. The SSI federal benefit rate for 2023 is $914 for an individual and $1,371 for a couple. The income limit for this waiver is 300% of these amounts, which is $2,742 for an individual and $4,113 for a couple per month.
  • Unlike other waivers like Level One and Individual Options, participant-direction is a requirement of this waiver. Participants must be willing and able to direct at least one service, or they may choose a representative to direct at least one service on their behalf.
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Services and Supports

The SELF Waiver offers a comprehensive range of services and supports tailored to meet the unique needs of each participant. These services are incorporated into an individual's service plan based on the assessments conducted to identify their specific requirements.

Some of the services available under the SELF Waiver include:

  1. Participant-Directed Goods and Services: Empowers individuals to choose the goods and services they need.
  2. Adult Day Support: Provides assistance and supervision in a community-based setting to enhance daily living skills.
  3. Participant-Directed Homemaker/Personal Care: Allows participants to manage and direct their homemaker and personal care services.
  4. Vocational Habilitation: Assists individuals in developing vocational skills and pursuing employment opportunities.
  5. Remote Support: Utilizes technology to provide real-time assistance and supervision.
  6. Career Planning: Helps participants explore career options and develop career goals.
  7. Support Brokerage: Provides guidance and assistance in navigating the waiver system.
  8. Individual Employment Support: Aids individuals in finding and maintaining employment.
  9. Community Respite: Offers temporary relief for caregivers by providing short-term care.
  10. Clinical/Therapeutic Intervention: Provides therapeutic services to address behavioral or emotional needs.
  11. Non-Medical Transportation: Assists with transportation needs related to community integration.
  12. Participant/Family Stability Assistance: Supports participants in maintaining stable living arrangements.
  13. Transportation: Offers transportation services to access community resources.
  14. Group Employment Support: Provides support in group-based employment settings.
  15. Functional Behavioral Assessment: Assesses and addresses challenging behaviors.
  16. Self-Directed Transportation: Allows participants to manage their transportation services.
  17. Assistive Technology: Provides devices or tools to enhance independence.
  18. Home Delivered Meals: Offers nutritious meals delivered to participants' homes.
  19. Residential Respite: Provides short-term residential care for individuals.
  20. Waiver Nursing Delegation: Allows specific nursing tasks to be delegated to unlicensed staff.

By offering this diverse array of services and supports, the SELF Waiver aims to promote independence, inclusion, and a higher quality of life for its participants with intellectual or developmental disabilities.

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Compensation for family caregivers

Under the Self-Empowered Life Funding (SELF) Waiver, unpaid family caregivers can compensate through a self-directed option, meaning eligible participants can hire and manage their support staff, including family members, and pay them for caregiving services. The self-directed option empowers individuals to choose who provides their care, allowing them to involve family members in the caregiving process while providing financial compensation for their efforts.

However, it is essential to note that compensation for family caregivers under the SELF Waiver is subject to specific eligibility requirements and limitations. Participants must meet the necessary criteria and demonstrate their ability to responsibly manage their budgets and oversee the caregiving arrangements. Additionally, there may be specific rules and regulations governing the payment rates and hours for family caregivers and the types of services they can provide.

Learn more about Medicaid self-directed care >>

Limitations and challenges

The Self-Empowered Life Funding (SELF) Waiver has certain limitations that participants need to be aware of. One limitation is the restricted funding available for services within each waiver span. For adults, the limit for services is set at $45,000, and for children, it is $30,000. Moreover, certain services have specific funding caps, such as Support Brokerage, which can be at most $8,000 within 12 months, and the Functional Behavioral Assessment, limited to $1,500. Assistive Technology costs are also constrained, with a $5,000 per waiver span cap. These limitations may pose challenges for individuals with extensive needs who require more comprehensive services and support.

A note from Givers

If you care for a loved one with developmental disabilities in Ohio, find out if you are eligible for compensation through the SELF Waiver's self-directed option. Take the first step towards getting the recognition you deserve by filling out this form to determine your eligibility for caregiver compensation.

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