VGM Live at Home Member Spotlight: Improving Ohio's State Waiver Program

Published in Home Modifications on February 28, 2024

Improving Ohio's State Waiver Program

In this member spotlight, Lyn Weiss, CEO of Access to Independence, speaks about the efforts and successes of improving the Ohio (OH) Medicaid waiver benefits for home accessibility, which play a crucial role in enhancing the quality of life and independence for individuals with disabilities or chronic conditions.

These efforts started at the OAMES conference in Fall 2022 when Lyn attended a session presented by a representative from OH Medicaid. Lyn raised the issue about the need to have an increase to the current $10,000 annual cap/limit on home modifications within the OH Medicaid waiver program. 

This limit has been in place for over 20 years and has prohibited home access companies from providing essential, high-cost modifications such as curved stairlifts, vertical platform lifts, and some bathroom modifications due to escalating product and labor costs exacerbated by the COVID-19 pandemic. 

Upon engagement with OH Medicaid, Lyn was directed to Jesse Wyatt, the ODM LTSS Bureau Chief who oversees the Medicaid waivers. Lyn contacted Mr. Wyatt and arranged a virtual meeting in February 2023. Participating in this meeting were key stakeholders including Kam Yuricich, Executive Director of OAMES, several OH home access providers, Mr. Wyatt, and ShaRhonda Sly, LISW, Home and Community-Based Services Policy Section Chief.

This meeting was followed by a site visit and facility tour in May at Access to Independence’s Aging in Place showroom in Ravenna, OH. This was a great opportunity to provide a hands-on experience demonstrating their products and services and illustrating the rising costs and challenges providers have faced. This site visit was pivotal to the group’s efforts as the representatives were very receptive to understanding the issues and how the providers’ services benefit their Medicaid members.

Access to Independence's Aging in Place showroom Visit

This visit was followed by several follow-up meetings with the core group of home access advocates and OH Medicaid representatives. The group was told that any increase in the cap would require review and approval by CMS, which is typically a long process, if successful. 

In an effort to resolve the issue in the short term, Lyn suggested the ability to utilize, for a single project, the home modifications/adaptive equipment/home maintenance services that are currently in place so that people needing the higher cost home modifications would have access to up to $30,000 per year instead of just $10,000 per year:

  • $10,000 cap for adaptive equipment 
  • $10,000 cap for home modifications
  • $10,000 cap for home maintenance and chores

For example, the bid for a custom curved stairlift with a total cost of $15,000 could be split between home modification and adaptive equipment services with a combined limit of $20,000.

The Medicaid reps found this suggestion to be a creative solution. It would provide more flexibility to home access providers, particularly for higher-budget projects. The timing was perfect, as OH Medicaid was in the middle of their five-year review of rule changes. This change allowing the bundling of these services was put into place as of Jan. 1, 2024. 

This was Lyn’s first time maneuvering through state government policy changes. She learned that change is possible with motivation and persistence. Also collaborating with advocates and other providers, competitors or not, can benefit everyone if you can work together towards a common goal. This sets a great example for other states to model going forward, showcasing the tangible impact of concerted action in affecting policy reform.

Access to Independence, located in Ravenna, OH, specializes in offering home medical equipment (HME) and home modifications throughout the Northeast Ohio area.

VGM Live at Home is so proud to have Lyn Weiss and all at Access to Independence as Part of Something Bigger!


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