Long-Term Services And Supports

Publicly-funded long-term services and supports (LTSS) are available for people with chronic illnesses or disabilities who need a certain level of care and meet the eligibility criteria. To learn about these resources and to connect to an advisor, visit Welcome | MyOptionsRI.

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Medicaid Long-Term Services and Supports

Eligibility

People must meet both the financial and functional/clinical “level of care” need to qualify for Medicaid Long Term Care. In addition, a person's resources (cash, savings, etc.) must be less than $4,000. Please note: if a person's monthly income is over a certain amount, he/she may have to pay towards the cost of his/her LTSS services.

The type of services you receive depends on your level of care needs.

Highest Level of Care- People who have needs that meet the criteria for the 'Highest' Level of Care have the option of (1) nursing facility care or (2) home and community-based care.

High Level of Care- People who have needs that meet the criteria for the 'High' Level of Care are eligible for home and community-based services, but NOT for nursing home care. Home and community-based care services include:

  • Homemaker/ CNA services
  • Environmental modifications
  • Special medical equipment
  • Meals on Wheels
  • Personal emergency response systems
  • Case management
  • Senior companion
  • Assisted living
  • Personal care services
  • Self-directed care
  • Respite
  • Minor assistive devices

 

How to Apply

To apply for long-term services and supports (LTSS), you must start by filling out the Department of Human Services Application for Assistance and the supplemental LTSS forms. You can apply online through our customer portal at HealthSource RI | Your Health. Your Way or download the application and mail it to the Rhode Island Department of Human Services, P.O. Box 8709, Cranston, RI 02920-8787.  The full application and supplemental forms can be found here: Medicaid LTSS Application | Executive Office of Health and Human Services (ri.gov).

 

Community Transition Services

Community Transition Services (CTS) is a one-time allotment of funding for a person moving from a nursing home to a home in the community. The purpose of this funding is to assist a person in establishing a basic household and may include the payment of a security deposit or other costs related to obtaining housing, moving expenses, and/or the purchase of furniture and other essential household items.  Eligibility is determined individually by the Office of Community Programs (OCP) during the nursing home transition process, and is based on a person’s living arrangements, needs, and other available resources.

What are my LTSS service delivery options?

If you meet the clinical and financial criteria for Medicaid long-term services and supports (LTSS), you have the option of a getting your services through a health plan, through fee-for-services (or traditional Medicaid), or "self direction," which gives a person more control over choosing caregivers and managing them. 

  • Self-direction. is when you and/or your family can purchase home and community-based services on your own. Under this self-direction option, you will work with the Executive Office of Health and Human Services (EOHHS) staff to develop a budget for the services in your authorized plan of care. We will then connect you to an agency (a fiscal intermediary) that will help you pay for needed services.

@Home Cost Share Program

Older adults who do not qualify for Medicaid LTSS may be eligible for in-home supports, adult day health programming and/or assisted living services, including the @Home Cost Share, a program administered by the Office of Healthy Aging (OHA), a division of the Rhode Island Department of Human Services (DHS). For more information, click on our OHA @Home Program fact sheet or visit the OHA website by clicking here.

 

Choosing the Right Setting: LTSS Options

LTSS in Nursing Home

When a nursing home is the best option, it is important that you visit facilities you are interested in, take a tour and meet with the staff. You can visit state and federal websites to help you find nursing homes in your area. It is important to remember that you must have the highest level of need to qualify for Medicaid LTSS coverage in a nursing home.

See Nursing Homes: Choosing: Department of Health (ri.gov)

You can compare quality ratings for facilities in your area by clicking on the Medicare website. Data gathered by State inspectors are fed into this national system.

LTSS in Home and Community-Based Settings

Many older adults and people with disabilities who want to stay in their own homes cannot do so without help. The programs that can help you or someone you care for live comfortably and safely at home are called Home and Community Based Services. 

Some programs can help you fill prescriptions or get meals or rides. Other programs will help you out at home with activities like personal grooming or getting in and out of bed. The programs you use will be based on your needs. 

Medicaid LTSS provides medical care and covers most of the services and supports people need to stay in their homes or a community-setting. People who have the highest or high level of need may get Medicaid LTSS in the home or community setting.

Information about levels of care and core and preventive services for people eligible for Medicaid LTSS.

For More Information