ROW – (Residential Options Waiver)

The Residential Options Waiver (ROW) program provides services in the home and in the community to individuals of all ages who are eligible to receive OCDD waiver services. It is a capped waiver where the person’s individual annual budget is based upon the person’s assessed support needs.

Supports needs are determined by an Inventory for Client and Agency Planning (ICAP) assessment.

This program is not intended to provide 24 hours a day of one to one support.

Individuals who:

• Meet Louisiana Medicaid eligibility, AND
• Meet the Louisiana definition for developmental disability which manifested prior to age 22 (Revised Statute 25:451.2, Paragraph (11)), AND
• Have an OCDD Statement of Approval, AND
• Meet Intermediate Care Facility-Intellectual Disability (ICF-ID) Level of Care Criteria, AND
• Meets one of four ROW priority group criteria.

Resources are the things people own. When we count resources for this program, we do not count the person’s home, the car they drive to medical appointments or other basic resources.

Single people can have no more than $2,000 in resources. Couples can have no more than $3,000 in resources (when both spouses receive long-term care).

The income limits (also known as Special Income Limit (SIL)) are $2,250 for an individual and $4,500 for a couple (when both spouses need long-term care).

However, there is a “Waiver Spend-down” option which allows your eligibility to be considered even if your income is over the limit. Waiver Spend-down has a standard $20 income deduction. $65 and ½ of the remainder is also deducted from all earned income.

After the income deductions are applied, the average monthly waiver rate and other allowable incurred medical expenses are used to “spend-down” an individual’s excess income, qualifying the individual for Waiver. Allowable incurred medical expenses include Medicare and private health insurance premiums, deductibles, coinsurance, or copayment charges, and medical/remedial care expenses incurred by an individual that are not subject to payment by a third party.

The individual’s liability is based on their income after the income deductions are applied. All individuals are allowed to retain a basic needs allowance from his/her income which is equal to $2,250 and the amount of incurred medical expenses not paid by a third party. Any remainder will be the individual’s liability for the cost of care in Waiver Spend-down.

OCDD’s four developmental disability home and community-based waivers, New Opportunities Waiver (NOW), Residential Options Waiver (ROW), Supports Waiver, and Children’s Choice Waiver have now been operationalized to a tiered waiver system of service delivery, which will allow for individuals to be supported in the most appropriate waiver. Home and community-based waiver opportunities will now be provided based on the individual’s prioritized need for support, which was identified in their RFSR Screening for Urgency of Need. Instead of being first come, first served, individuals with the most emergent and urgent need for support will have priority.

Individuals who have a need for services should contact their local Human Services District/Authority in order to go through the eligibility determination process. Once a person is eligible for OCDD services, they may ask to be placed on the Developmental Disability Request for Services Registry (RFSR).

OCDD maintains a Developmental Disability Request for Services Registry (RFSR) of individuals who have a need for waiver services along with the date the person initially requested waiver services.

As each individual is added to the RFSR, the individual is screened to determine their urgency of need for services. An individual, who meets the eligibility criteria, is in the highest urgency priority category(s) being served based on funding, and has the earliest RFSR date, will be offered the next available OCDD waiver opportunity that meets their needs.