Level One Waiver Ohio: Eligibility, Funding Caps, and How to Apply

Ohio runs three developmental disabilities Medicaid waivers, and figuring out which one applies to your young adult is one of the most confusing parts of the transition from school to adult services. The Level One waiver is designed for individuals who need minimal paid supports and have strong natural support networks — a family member who provides most daily care, with professional help covering the gaps.

Understanding the differences between the three waivers matters because each comes with different funding caps, different service options, and different waiting list dynamics.

The Three Ohio DD Waivers

Level One Waiver — For individuals with minimal paid support needs who live in stable environments with strong natural supports. Funding cap: $41,424 per waiver span for those under 22 and still eligible for school services, $62,136 per span for adults 22 and older (or those no longer receiving school-based FAPE).

Self-Empowered Life Funding (SELF) Waiver — For individuals who want to actively self-direct their services. The individual acts as the employer — recruiting, training, and managing their own staff. Same funding caps as the Level One: $41,424 (school-age) and $62,136 (adult). As of July 1, 2026, Environmental Accessibility Adaptations are now an eligible service under SELF.

Individual Options (IO) Waiver — Ohio's most comprehensive waiver, designed for individuals with intensive daily or 24-hour care needs. Unlike the other two, the IO waiver has no standard preset cap. Funding is calculated dynamically based on the individual's assessed level of care using the Ohio Developmental Disabilities Profile (ODDP).

Who Qualifies for a DD Waiver

Before applying for any waiver, the young adult must first establish eligibility with their local County Board of Developmental Disabilities (CBDD). That requires demonstrating a qualifying developmental disability that:

• Manifested before age 22
• Is expected to continue indefinitely
• Is a chronic, severe physical or cognitive impairment (not solely a mental illness diagnosis)
• Results in substantial functional limitations in at least three out of seven life activity domains

Those seven domains are mobility, self-care, self-direction, capacity for independent living, learning, receptive and expressive language, and economic self-sufficiency (this last one is assessed only for individuals 16 and older).

The functional assessment shifts at age 16 from the Children's Ohio Eligibility Determination Instrument (COEDI) to the adult version (OEDI). Some youth who qualified as children may be found ineligible at the age-16 redetermination because the adult assessment uses different baselines and adds the economic self-sufficiency domain.

How the Waiting List Works

Ohio does not use a first-come, first-served waiting list. Instead, county boards administer a Waiting List Assessment (WLA) under OAC Rule 5123-9-04 to determine the urgency of the individual's need.

The WLA classifies individuals into three categories:

Immediate Need — A crisis exists that creates risk of substantial harm within 30 calendar days. Triggers include the death of a primary caregiver with no backup, abuse or neglect in the current living arrangement, or discharge from an institutional setting. Individuals with an immediate need are not placed on the waiting list — the county board must resolve the crisis within 30 calendar days.

Current Need — An unmet need for waiver services exists within 12 months. Examples include a caregiver whose health is declining, a student aging out of school services who needs adult supports, or someone who needs adult day services or employment supports that OOD and school-based FAPE can't fund. If the need can't be met through non-waiver community resources, the individual goes on the waiting list.

No Assessed Need — No unmet need identified at this time.

The county board must conduct the WLA interview within 15 calendar days of a request or identification of an unmet need, complete the assessment within 45 calendar days of the interview, and send a written determination within 10 calendar days of approval.

The 2026 Provider Moratorium

From May 14, 2026, through November 14, 2026, the Ohio Department of Medicaid has frozen new Home Health and Hospice provider enrollment. That means no new applications are being accepted for home health agencies, personal care aides, home care attendants, or private duty nurses.

For families whose young adult just secured a Level One or SELF waiver, this creates a real constraint: you can only hire providers who were already enrolled in Ohio Medicaid before the freeze. Your county board's Service and Support Administrator (SSA) can help identify existing enrolled providers in your area, but provider choice is genuinely limited during this window.

Practical Steps for Transition-Age Families

If your teenager is approaching adulthood and you expect they'll need waiver-funded services after high school:

1. Establish county board eligibility early — don't wait until the age-16 OEDI redetermination. Contact your local CBDD to start the intake process.
2. Request a Waiting List Assessment as soon as you can articulate an unmet need that won't be covered by school services or OOD.
3. Understand which waiver fits — Level One if your family provides most daily care, SELF if your young adult wants to manage their own staff, IO if they need intensive or around-the-clock support.
4. Apply for OOD's formal VR services at least two years before expected school exit, so OOD handles initial employment supports while the waiver covers the long-term piece.

The Ohio IEP Transition to Adulthood Guide includes a county board waiver comparison matrix and a WLA interview prep worksheet, so you can walk into the assessment with your documentation already organized.

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