Residential Options Waiver (ROW)

The Residential Options Waiver (ROW) helps people be as independent as possible.

To do this, ROW has a very long list of services that they cover in order to meet the needs of your family member.

Please note: The waiver system has recently changed! You will still hear about the 4 different waivers, but they will soon be  integrated into one. Please call your OCDD office for more information!

See below for some of the services that this waiver may cover. But understand that there is a new system and it should cover just the services that each person really needs.

The ROW covers support coordination, community living supports, host homes, companion care, shared living, respite care (out of home), personal emergency response system (PERS), one-time transitional services, environmental accessibilities adaptations, assistive technology, specialized medical equipment and supplies, professional, dental, nursing, support employment, prevocational, day habilitation, and community access.

A person who qualifies will not necessarily get all of these services. It will depend on their situation and their needs.

Click on the boxes below to learn more about each service:

Support coordination will help your family member get the waiver and Medicaid services they need.

Here's what will happen:

  • You and your family member will choose an agency that offers support coordination.

  • They will give you a Support Coordinator.

  • The Coordinator will come to your home and do an intake and assessment - they'll get to know your family member and their needs.

  • They will help you create a service plan for your family member. This is called the Plan of Care (POC).

The Support Coordinator will be your teammate in the waiver process. They will be your main contact for anything relating to waiver services.

The Support Coordinator will help you do these things:

  • Write a POC based on your family member's needs and goals

  • Plan services and choose providers, based on who your family member wants to work with

  • Meet with your family member on a regular basis to check in and get updates

  • Transition your family member out of services, if needed 

Community Living Supports (CLS) are for those who can do many things on their own without a lot of help.

If your family member lives with you or lives on their own, CLS can help them build more skills to stay independent.


Host Home services are for people who want to live in a family setting, but are not able to live with their own family.

A Host Home family will welcome your family member into their home. This family would help with any activities of daily living (bathing, eating, etc) and offer support.


If you would like to have your family member live in a Host Home, ask the Support Coordinator to help set this up.

Companion Care services are for people who do not need 24-hour support, but would like to have someone around as a friend or roommate.

Your family member could get a companion or roommate who will live with them and help with certain things.


  • The roommate will be paid by the Medicaid waiver provider agency, and will buy food and personal items your family member needs.

  • Your family member and their roommate will create a Companion Agreement. This will describe your family member's needs and what services the roommate will do for them.

Shared Living services are for people who are working on getting the skills they need to be able to live with other people in the community.

The phrase "shared living" includes living with roommates in a home provided by the service provider.

A Shared Living provider will make sure that your family member has 24-hour staff ready to help with activities of daily living (bathing, eating, etc) and safety.

Staff will help your family member with their goals in the Plan of Care (POC).

Respite means getting a much-needed break!

Respite Care services can help if you or your family member's caregiver needs a break for a short period of time.

For example, if you are going away on vacation and you can't bring your family member, they can stay with a Respite Care Provider while you are gone. This allows your family member to keep up their same schedule of services and activities even when you are away.

Your Support Coordinator will help you find a provider that offers these services.

PERS.pngAsk your family member's Support Coordinator for a PERS if you would like to have this extra layer of safety.

One-Time Transitional services cover the costs for moving your family member from a nursing facility to their own home or apartment.

This service will help to buy things that they will need to set up their home.



  • This service can only be used once!

  • It does not cover costs for moving your family member to a Host Home - only to their own home.

  • If you are using this service to buy things, make sure you get each item approved first. Your Support Coordinator will help with this.


This service will pay for any adaptations or modifications you need to make to your family member's home or car in order to keep them healthy and safe.



  • A therapist will need to approve of an adaptation (change) before this service will pay for it.

  • All changes should be on your family member's POC. 

This service will cover devices and equipment that your family member needs in order to stay healthy.

This includes items they need for life support or physical conditions.



  • This service covers things that help your family member adapt to their disability.

  • It does NOT cover appliances (washer, dryer, stove, etc.), cars, costs for bus passes or taxis, toys, or telephones.

If your family member gets CLS and Companion Care, they can also get help with transportation.

Community Access services will help them to get to activities and services listed in their POC.


Click the "Community Living Supports" and "Companion Care" boxes above to learn more.

Transportation Limits:

  • Each person can only use 264 "one-way" trips (so if your family member is going to church and back, that counts as two trips)

  • All trips must be for things listed in your family member's POC

  • If they need more than three one-way trips in one day, they need to get approval from OCDD (the Support Coordinator can help with this)

  • They will be asked to take public transportation whenever possible. This will save costs (their bus or train ticket will be covered!)

This service pays for therapies or professional services for your family member.

The goal is to help them stay healthy, learn skills, and be independent.

What are professional services?

  • Occupational Therapy - learning to do ADLs

  • Physical Therapy - strengthening the body and muscles

  • Speech Therapy - learning how to communicate clearly (speaking or other types)

  • Nutrition or Dietary Services - learning what to eat and why, and about food and allergies

  • Social Work - connecting with helpful services, groups, and people

  • Psychology - talking to a therapist during counseling, getting advice on how to cope and handle different experiences


  • In some cases you will also be able to get counseling or training as a part of these services.

  • This is for people who are age 21 or older. 

Nursing services are for people who have medical needs that require help from a doctor or nurse.

  • If your family member needs these services, make sure they are included in the POC.

  • Services may include assessments to see what your family member needs, and training to help you and your family member understand the medical needs.

  • The nurse who helps your family member will need to send an update to the Support Coordinator every 60 days. This is to make sure that nothing is missing and that your family member is getting the help they need.

Although your family member may have insurance that covers some dental care, this piece of the ROW can help with extra things that might not be covered.

What services are included?

Dental services include regular exams, cleanings, and x-rays as long as they are listed in the POC.

If your family member needs something more, like oral surgery, they will need to meet with a Medicaid dentist. The Support Coordinator will work with the dentist to find out how much the dental work would cost. If there is enough money, this service will pay for it.

If your family member would like to work in the community, this service that can help make that happen.


Each person getting this service will have job support.

This includes:

  • on-the-job help to get the work done

  • personal help with ADLs - activities of daily living (eating, cleaning, etc.)

  • travel training to learn how to get to work 

Prevocational services will help your family member get ready for having a job.

This means that these services will help them build the skills they need in order to get a job.

Types of prevocational services include: 

  • learning to follow rules and instructions

  • paying attention to the task you are working on

  • finishing tasks

  • being safe at work

  • figuring out what to do when you need help

The Support Coordinator will review the progress for each activity. When your family member has made enough progress on these tasks, they can work with the Support Coordinator to take the next step in finding a job.

Day Habilitation services help people with disabilities learn new skills.

These skills often focus on making the person more independent.



  • These services can also be fun activities, like playing sports or joining a club. As long as the activity is helping your family member meet their POC goals, it counts!
  • Day Habilitation may also include building skills outside of the home, like making food choices at a restaurant or doing non-paid work in the community to practice social skills.
  • ROW will pay for transportation to the community setting where these services take place. 


Source: LDH