Ohio · waiver service
Ohio Home Care Waiver in Ohio
The Ohio Home Care Waiver is an Ohio Department of Medicaid program for people 59 and younger with disabilities who need nursing-facility-level care at home. It pays personal care aides, nurses and Structured Family Caregiving. Parents of minor children and spouses can be paid only as agency employees and only under Ohio's strict legally-responsible-person rules.
Also called: OHCW · Ohio Home Care · Ohio home care waiver program · ODM home care waiver
Who do you care for?
Quick facts
- Pay
- Agency rate $28.96/hr; non-agency $22.32/hr (Medicaid rates, not wages)
- Adult children & other relatives
- Yes
- Spouse
- Sometimes
- Parent of a minor child
- Sometimes
- Waitlist
- possible
Who qualifies for Ohio Home Care Waiver
- Age 59 or younger (members move to PASSPORT at 60).
- Meets Medicaid financial rules, decided by your county Job and Family Services office.
- Needs a nursing facility (or hospital) level of care.
- Has a need for waiver services that can be met safely at home.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- relatives can work as personal care aides through an agency or as non-agency providers; a relative with legal decision-making authority is limited to 40 paid hours a week.
- Spouse Sometimes
- a spouse must be employed through an agency, there must be no other willing provider, the care must meet Ohio's extraordinary-care test, and paid care is capped at 40 hours a week.
- Parent of a minor child Sometimes
- a parent of a minor must work for an agency, be the provider of last resort, meet the extraordinary-care test, and generally work 40 hours a week or less; nurse parents can provide paid waiver nursing through an agency.
- Living together
- required only for Structured Family Caregiving.
Who employs the caregiver: Mostly agency. Parents of minors and spouses must be employed by an agency. Other relatives can work for an agency or enroll as a non-agency (independent) provider. Structured Family Caregiving runs through an accredited or Medicare-certified agency.
Spouse rules differ by program — see spouse pay in Ohio.
How much Ohio Home Care Waiver pays
Agency rate $28.96/hr; non-agency $22.32/hr (Medicaid rates, not wages). Ohio Administrative Code 5160-46-06 (effective April 17, 2026) sets personal care aide rates at $28.96 per hour for agency aides and $22.32 per hour for non-agency aides (plus 15-minute unit rates). These are what Medicaid pays the provider; an agency sets the wage it pays an employed family member. Structured Family Caregiving pays the agency $102.68 a day.
Hours and budget: A case manager assesses needs and writes a person-centered services plan that sets the hours of personal care aide and other services. Paid care from a parent of a minor or a spouse is capped at 40 hours a week unless the state grants an exception.
Compare with other Ohio programs on the Ohio caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
Enrollment depends on waiver capacity; no current waitlist figure was published on the pages reviewed.
How to apply for Ohio Home Care Waiver
- Apply for Ohio Medicaid through the Ohio Benefits portal or your county Job and Family Services office.
- Submit form ODM 02399, Request for Medicaid Home and Community-Based Services Waiver, to your county JFS or Ohio Benefits Long Term Services and Supports.
- Complete the level-of-care assessment with the case management agency.
- If a parent or spouse will be the caregiver, ask the case manager about the Ohio Extraordinary Care Instrument (ODM 10372) and find an agency to employ them.
- Ohio Department of Medicaid Consumer Hotline · 1-800-324-8680 · official site
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Ohio Home Care Waiver questions
Can a parent be paid to care for a disabled child on the Ohio Home Care Waiver?
Only in limited cases. The parent must work through an agency, there must be no other willing provider, the care must pass the extraordinary-care test, and paid hours are generally 40 a week or less.
Can I be paid to care for my spouse on the Ohio Home Care Waiver?
The same limits apply: agency employment, no other willing provider, extraordinary care, and 40 hours a week or less.
What is the age limit for the Ohio Home Care Waiver?
It serves people 59 and younger. At 60, members move to PASSPORT.
How much does a personal care aide get paid?
Medicaid pays agencies $28.96 per hour and non-agency aides $22.32 per hour under the April 2026 rule. An agency decides the wage it pays its employees.
Does the Ohio Home Care Waiver offer Structured Family Caregiving?
Yes, for members 18 and older who live with their caregiver.
Can other relatives be paid without these limits?
Adult children and other relatives without legal decision-making authority are not under the parent and spouse rules, but those who hold a power of attorney or guardianship are capped at 40 paid hours a week.
Sources: dam.assets.ohio.gov · codes.ohio.gov · codes.ohio.gov · dam.assets.ohio.gov · kidswaivers.org · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Ohio caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Ohio — pick yours for the local picture.
Across the line
States that border Ohio
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.