What is the New Choices Waiver

Posted on

Oct 27, 2015

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The New Choices Waiver is Medicaid program designed to help nursing home residents move to more independent community settings, whenever possible, without compromising medical or safety needs. The basic eligibility requirements are:

Must be a least 21 years of age.
Must have resided in a nursing home for a minimum of 90 days and be medically eligible for Medicaid long term care; or, must have resided in a nursing home for a minimum of 30 days on a Medicare stay and be eligible for Medicaid long term care at the end of the Medicare stay.
Medicaid or Medicare must have paid for the nursing home stay for a minimum of 30 days immediately prior to discharge on New Choices Waiver.

Referrals are done directly with the Long Term Care Bureau at the Department of Health and can be made to either Kathleen Bowman at 538-6497, or Vicki Ruesch at 538-6148.

Eligible referrals are given their choice of case management agencies who will first conduct an assessment to see if the person can have their care needs safely managed outside of the nursing home. If that is possible, the case management agency will work with the person to find a placement that can manage their needs.Potential placements include assisted living, residential settings, independent living, or home with family.Waiver participants are required to pay for their own room and board costs (generally between $400 and $700 per month) and the New Choices Waiver pays for the services provided at the facility. The case management agency will also help arrange for other needed services such as home health, medical equipment, medical supplies, homemaker services, budget assistance, and respite care.

Case managers remain involved on an ongoing basis to help coordinate medical and mental health care, changes in service needs, changes in placement sites, and hospital admissions and discharges. Case managers are also available to provide ongoing care assessments and help with problem solving any issues related to service and placement.

For more information please contact either Jim Reichelt or Don Fennimore with FlexCare at 273-6366.FlexCare has been a case management provider for these services since 2000 and has successfully moved over 1,400 individuals back into the community.



Author:Jim Reichelt or Don Fennimore

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