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549 (07/2026) Chapter 2:Eligibility • Section 10: Long-Term Care (LTC) services Not provider controlled: • The individual rents or owns their own housing that is available to the general community without any financial entanglement from the provider. Other resources Intellectual or Developmental Disability Service Eligibility overview Medicaid eligibility Like many others, individuals with I/DD and children needing intensive in-home services can be eligible for an HSD medical program including CHIP, Child Welfare (CW) medical or OSIPM. These individuals may receive DD Comprehensive or K Plan services if they choose and if they meet the Level of Care requirements. Note: A child receiving CHIP Title XXI benefits is not eligible to receive DD Comprehensive services. CHIP eligible children may only receive K Plans services. Although the Medicaid eligibility rules are the same for DD LTC as they are for APD LTC, the types of Home and Community-Based Services (HCBS) are different for individuals with DD services. The main differences are: • Individuals with I/DD may choose to receive services under the DDC waiver, DDK State Plan Amendment, or they may choose to receive case management services only (no waiver). • DD waivers are waiving the requirement to reside in an intermediate care facility for individuals with intellectual disabilities (ICF-IID), nursing facility or hospital, and • For adults, case management services are provided through either a CDDP or a brokerage. • For children, case management services are provided through the CDDP or ODDS programs such as Children’s Intensive In-Home Services (CIIS) and Medically Fragile/Involved Children’s Unit. Medicaid eligibility is determined by ODHS|OHA eligibility workers and the process is essentially the same for all individuals. The primary difference is in who determines service eligibility and provides the case management services. This may be done by many different entities. The primary use of the service category code is to identify the basis of the individual’s service eligibility and the range of services (waivered services, personal care, etc.). The service category codes also help identify the group that makes the service eligibility decision. Staff that perform case management are: • For individuals who meet both APD and DD service eligibility criteria: APD/AAA case managers, CDDP service coordinators, or brokerage personal agents, depending on individual’s choice. • For individuals with DD service eligibility and:
Who receive 1915(i) behavioral health services (adults), adult and child foster homes, supported living and children living in their family home: CDDP service coordinators.
Are adults living in their own or family homes and are not receiving supported living services: brokerage