Sample Policies for Medicaid Home Care in Washington, Virginia, Oregon, Florida, Nebraska, Michigan, and Colorado

Medicaid Waivers provide free caregivers and other home-based services to people who need care in their homes. The criteria to qualify is slightly different (but often fairly similar) in each state.

Please be warned: Medicaid policies change constantly. These are just samples to give you and idea what a policy might look like and how a policy might work. By the time you read this, the policy may be different.

Sample Assessment Tool in Oregon

Oregon Assessment Tool

Sample Time Assessment Form in Nebraska

Time Assessment and Service Plan

Florida Full Assessment Forms

Florida Condensed Assessment Forms

Sample Assessment in Florida

Priority score and rank criteria

Sample Care Determination Policy in Michigan


Sample Assessment Form

Sample Policy from Washington State 

In Washington state, you must need help, because of a physical or cognitive disability, with certain activities of daily living.

Activities of Daily Living

  1. Eating/feeding
  2. bathing
  3. transfer (e.g., moving from a bed to a chair)
  4. bed mobility (positioning)
  5. locomotion (walking or moving around)
  6. using the toilet
  7. medication management


  • You must need extensive help with two or more of the listed activities
  • Or at least some help with three or more
  • Or a person who needs supervision because of a cognitive impairment may qualify if extensive help with one of the listed activities is needed.

Possible Services

  • Home Aide for Personal Care
  • Housework (shopping, cooking, cleaning)
  • Self-directed (you can choose who you want as your home aide)
  • Transportation to doctors
  • Transportation to other activities or places
  • Assistive technology (up to $550 to purchase items)
  • Personal emergency response services (if at risk for falls)
  • Case Management
  • Durable Medical Equipment
  • Home Modifications (both renters and homeowners)
  • Vehicle Modifications (for example: wheelchair lift)
  • Home Care Skilled Nursing
  • Home Delivered Meals
  • New Freedom Waiver (funds to buy other health-related things)

Fantastic guide on how the system works in Washington: Washington Law Help Guide

Sample Policy from Virginia 

Activities of Daily Living

  1. Bathing
  2. Dressing
  3. Toileting
  4. Transferring
  5. Eating/Feeding
  6. Bowel/Bladder Continence
  7. Mobility

First Way to Qualify

  • Dependent in two to four activities and
  • Semi-dependent OR dependent in behavior pattern and orientation and
  • Semi-dependent in joint motion OR dependent in medication administration.

Second Way to Qualify

  • Dependent in five to seven activities and
  • Dependent in mobility

Third Way to Qualify

  • Semi-dependent in five to seven activities and
  • Dependent in mobility and behavior pattern and orientation

Additional Criteria

  • Medical condition requires observation and assessment or
  • Potential for the medical instability is high or
  • Requires at least one ongoing medical or nursing service

What do these terms mean?

Description of “dependent” and “semi-dependent” for different age groups: Special Criteria for Pre-Admission Screenings

Detailed description of each Activity of Daily Living: Criteria for Applying for Medicaid Home Aides

Sample Policy in Colorado


Learn More

Where to Apply: How to Find Medicaid Home Aide Programs in Your State

Financial: How to Apply for a Medicaid Waiver When You Have Too Much Money

Learn more: How to Have a Screening Interview for a State Home Aide Program

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