How to Qualify for the NCW?

Posted on

May 12, 2021

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Qualifying for the New Choices Waiver program can be complicated. There are two primary ways that an individual qualifies for the NCW. Learning how one qualifies is better understood when you realize why the State has this waiver to begin with. The NCW was designed to help individuals live in a community or home-like setting as opposed to a nursing home. Meaning, the goal of the NWC waiver program is to transition individuals from a more restrictive and expensive nursing home to a more home-like setting like an assisted living or even their own home. With that is mind here are the 2 primary ways individuals can get on the NCW program.
1. An individual can apply for the NCW after they lived in a nursing home for 30-90 days. The length of stay depends on when they qualify for Medicaid. This is referred to as Reserved Slots and can be done any time of the year. When an individual qualifies for the NCW this way, they will move from the nursing home on the 1st of the month. This is the most common way people get onto the NCW.
2. An individual can apply for the NCW after they have privately paid for an assisted living for more than 12 months. This is referred to the Non-Reserved Slots and can only be done during the open enrollment periods. March 1st-14th, July 1st-14th, and Nov 1st-14th. The state only admits 35 residents on the NCW in each of these enrollment periods. They prioritize all the applicants based on how long they have been privately paying an assisted living. So while residents can apply after 12 months, in practice its closer to 24 months for those that will meet the cut-off.
For more information on how to qualify and to apply, please call 385-273-1456.

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I hired a companion for my father when he was in a skilled nursing facility. He was not getting his teeth brushed or flossed regularly, and I was seeing a decline in his dentition. Having this extra support provided him with much needed assistance and the care companion had the added benefit of encouraging him to eat more at every meal, something that was a bonus as he was not meeting his nutrient needs. Touching base with staff to request that oral care and meal monitoring be done can also be helpful. Having an advocate to ensure necessary care is getting done can also be very effective in the health care setting.  What is proper oral care and effective meal monitoring?  Proper oral care includes brushing the teeth for at least 1 minute after every meal. It also includes using a soft bristle brush, fluoride toothpaste, flossing daily. A final component of oral care that is often not discussed is denture care. Dentures should be cleaned at least once per day and removed at bedtime. Removing them prior to sleeping can greatly reduce the risk of pneumonia (Iinuma et al. 2014). Effective meal monitoring includes adequate supervision during mealtime for those at risk of aspiration. Such supervision includes ensuring the individual is properly positioned for a meal (head of bed as high as can be tolerated and supine position), takes small bites, eats slowly, swallows a couple times in between each bite, and intermittently takes a sip of liquid to clear the mouth of food particles. The use of straws is generally not recommended for an individual at risk for aspiration as it propels the food to the back of the throat and hence can increase risk. I recall when I was working as a Registered Nurse (RN) in acute care that I was constantly removing straws from the bedside of at risk individuals and often reminding them to eat slowly and swallow at least twice between each bite to ensure food clearance. Individuals at risk for aspiration often require a modified texture diet as it can further prevent the aspiration of food and liquids.   This is a brief summary of the attention to detail needed in addressing oral hygiene and meal monitoring amongst the aging population. Both measures can play a significant role in reducing aspiration pneumonia.  If you would like more information on understanding proper oral care or any other questions that you may have regarding aging life care, please feel free to reach out to me.    Sources:1.      Sjogren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. 2008. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 56:21242130. 2.      Iinuma T, Arai Y, Abe Y, Takayama M, Fukumoto M, Fukui Y, et al. 2014. Denture wearing during sleep doubles the risk of pneumonia in the very elderly. J Dent Res. doi: 10.1177/0022034514552493 3.      F Muller, 2015. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541086/#