PASSPORT or the Assisted Living Waiver? Choosing Ohio's Medicaid Path for a Dayton Parent

How are the two programs alike?

Both are Ohio Medicaid home and community-based waivers run by the Ohio Department of Aging and delivered locally by the Area Agency on Aging, PSA 2. Both require a nursing facility level of care and Medicaid financial eligibility: in 2026, income up to $2,982 a month without a Qualified Income Trust and countable assets of $2,000 for a single person, with spousal protections for a married couple. And both exist to keep people out of nursing homes when that is safe.

How are they different?

Since October 2024 PASSPORT has also offered Structured Family Caregiving, which can pay a qualifying relative who lives with the participant. For some Miami Valley families that makes staying home workable for much longer.

When does PASSPORT fit best?

PASSPORT works when the risky parts of the day can be covered by a few hours of help, nights are safe, and someone, often a spouse or an adult child, is nearby. A typical plan might combine morning help with bathing and dressing, home-delivered meals, an emergency pendant and two days a week at an adult day program.

When does the Assisted Living Waiver fit best?

It fits when help is needed unpredictably across the day and night, when isolation or poor nutrition is the real problem, or when the family caregiver is near collapse. Room and board is capped, so a parent with modest income can afford it, but only in a participating building, and the choice of buildings is narrower than for private-pay residents.

Two Miami Valley examples

A Huber Heights man in his eighties with heart failure lives with his wife, who can no longer lift him. PASSPORT sends an aide each morning to help him bathe and dress, delivers meals on weekdays and pays for a shower chair and grab bars. His wife handles evenings. Staying home works because nights are calm and she is there.

A Xenia widow with early dementia lives alone. She has started missing meals and calling her daughter at 3 a.m., confused. A few PASSPORT hours a day would leave long unsupervised stretches and every night uncovered. She moves to a participating residential care facility on the Assisted Living Waiver, pays capped room and board from her Social Security, and has staff nearby around the clock. The financial rules for both were identical; what differed was how much of the day and night needed someone present.

Most families can place their parent somewhere between these two pictures. If you are unsure, ask the assessor which program they would recommend and why; they see hundreds of situations a year.

What families wish they had known

Families who have been through both programs tell us three things. First, call early: an assessment while a parent is still managing gives far more options than one made from a hospital bed. Second, write down what a typical day really looks like, including the hard parts a parent may downplay to an assessor, such as night wandering or skipped meals. Third, ask about both programs even if you think you know which one you want, because capacity, provider availability and a parent's needs can change the answer.

Neither program pays for everything. PASSPORT leaves housing, groceries and most nights to the family. The Assisted Living Waiver leaves room and board to the resident and limits the choice of buildings. Knowing those gaps in advance is what lets a family plan around them instead of discovering them in a crisis.

How do we start?

One phone call to the Area Agency on Aging, PSA 2 at 1-800-258-7277 starts the assessment for either program. Ask the assessor to explain both and to tell you about current capacity. File the Medicaid application with county Job and Family Services at the same time; the two processes run in parallel.