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Ohio's PASSPORT Waiver, Explained

PASSPORT is Ohio's flagship in-home Medicaid waiver. It keeps people at home; it does not pay for assisted living.

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Short answer

Ohio's flagship home and community-based services (HCBS) Medicaid waiver, designed to keep Medicaid-eligible seniors who need nursing-facility level of care at home instead of in an institution.

What PASSPORT covers

Personal care, home-delivered meals, adult day care, minor home modifications, personal emergency response systems, medical transportation, and, added in October 2024, Structured Family Caregiving.

PASSPORT does not pay for assisted living room and board, anywhere. PASSPORT is an in-home program; it does not pay for room and board anywhere, including assisted living. Families sometimes assume PASSPORT can subsidize a move into a Residential Care Facility. It cannot; that is the separate Assisted Living Waiver's role.

Who delivers it

Ohio Department of Aging, delivered through PASSPORT Administrative Agencies (in this region, the Area Agencies on Aging). In this region, that means the Area Agency on Aging serving your county — Western Reserve for Cuyahoga, Lake, Lorain, Medina and Geauga, or Direction Home Akron Canton for Summit and Portage.

Source: Ohio Department of Aging: PASSPORT

Where to get free help in the Cleveland area

Short answer

This site's 7-county area is split between two Area Agencies on Aging. Western Reserve Area Agency on Aging covers Cuyahoga, Geauga, Lake, Lorain and Medina counties. Direction Home Akron Canton Area Agency on Aging and Disabilities covers Summit and Portage counties. Do not assume one agency covers the whole region.

This site's 7-county service area is split between two different Area Agencies on Aging. Do not assume one agency covers the entire region.

Western Reserve Area Agency on Aging (WRAAA) (PSA PSA 10A)

Serves Cuyahoga, Geauga, Lake, Lorain, and Medina counties. Benefits counseling, care coordination, funding for congregate and home-delivered meals, the Region 10A Long-Term Care Ombudsman program, caregiver support, and long-term care options counseling.

WRAAA covers 5 of this site's 7 counties. It does not cover Summit or Portage. Website

Direction Home Akron Canton Area Agency on Aging and Disabilities (PSA PSA 10B)

Serves Summit and Portage (also Stark and Wayne counties, outside this site's coverage area). Address: 1700 East 13th Street, Suite 114, Cleveland, OH 44114. Phone: 800-626-7277.

Summit and Portage counties are served by Direction Home, not by Western Reserve. A family in Solon or Aurora searching by county rather than by AAA territory can easily reach the wrong agency. Website

Other Cleveland-area organizations worth knowing

  • Benjamin Rose Meals on Wheels — 216-373-1994. Home-delivered meals for Cleveland and Cuyahoga County residents unable to shop for or prepare meals independently. Meals are free for participants age 60 and older; self-pay is available for those under 60. Website
  • Meals on Wheels Cleveland West — 440-871-2551. Serves the western Cuyahoga County suburbs. Eligible recipients are elderly, disabled, temporarily ill, convalescing, or homebound individuals unable to safely shop for or prepare their own meals. Website
  • Meals on Wheels of Northeast Ohio (VANTAGE Aging). Serves Summit and Portage counties (as well as Stark, Wayne, Carroll, Holmes, and Tuscarawas counties outside this site's coverage area). No formal eligibility requirements; meals are offered on a sliding fee scale. Does not currently list Medina County in its service area. Website
  • Benjamin Rose Institute on Aging — 216-791-8000. Cleveland-based nonprofit founded in 1908. Runs adult day services, the WeCare telephone care-coaching program for caregivers of people with chronic conditions, the Senior Companion Program, behavioral health services for adults 55 and older, and Rose Centers for Aging Well senior centers. Located at 11890 Fairhill Rd., Cleveland, OH 44120. Website
  • Greater Cleveland RTA Senior Fare and Paratransit. Riders 65 and older can buy a discounted Senior fare or All-Day Senior/Disabled Pass on Greater Cleveland RTA buses and trains with a valid photo ID or RTA-issued ID card. RTA ADA Paratransit provides curb-to-curb or door-to-door shared-ride service for riders who cannot use fixed-route buses due to a disability; ADA-certified paratransit riders can also use fixed-route bus and rail at no cost. Covers Cuyahoga County; does not extend into Lake, Lorain, Medina, Summit, Geauga, or Portage counties. Website
  • Laketran Dial-a-Ride and Seniors on the Go — 440-354-6100. Lake County's transit authority. Dial-a-Ride is a door-to-door, assisted transportation service within Lake County and to select medical facilities in Cuyahoga County. Seniors on the Go, launched with the Lake County Board of Commissioners in May 2025, provides fare-free Dial-a-Ride and local bus rides to Lake County residents 60 and older who complete a Reduced Fare Application. Website
  • United Way 211 — 2-1-1. Free, confidential, 24/7 information and referral service confirmed to cover Cuyahoga and Geauga counties (also Ross County, outside this region). Ohio's 211 network is a patchwork of locally operated providers rather than one statewide system; families in Lake, Lorain, Medina, Summit, or Portage counties should still try dialing 2-1-1, since local coverage (for example, United Way of Summit & Medina operates its own 211 helpline), but should confirm coverage directly at 211oh.org or 211.org rather than assuming statewide coverage the way Texas 211 works. Website

Questions Cleveland families ask

Are there minimum staffing rules for assisted living facilities in Ohio?

Staffing requirements are built into OAC 3701-16 and require facilities to maintain staff sufficient to meet residents' scheduled and unscheduled needs, though Ohio does not publish a single fixed resident-to-staff ratio for RCFs. Facilities must also ensure staff have training appropriate to residents' needs, including additional training obligations for staff working in a disclosed special care (memory care) unit.

Can a Cleveland assisted living resident get skilled nursing care without moving to a nursing home?

Yes, but only in a limited way. RCFs may provide skilled nursing services such as dressing changes, therapeutic diet supervision, and medication administration by licensed staff, capped at 120 days in any 12-month period under OAC 3701-16-02(D), unless the facility, resident, and physician agree in writing to extend it. Residents needing more than 8 hours a day of skilled nursing, ventilator support, or care for advanced pressure ulcers exceed what an RCF is licensed to provide.

Does Ohio's Medicaid expansion pay for a parent's assisted living or nursing home care?

No. Ohio's Medicaid expansion under the Affordable Care Act, effective January 1, 2014, covers adults age 19 to 64 up to 138 percent of the federal poverty level for acute and primary medical care. It's a completely separate pathway from the aged/blind/disabled Medicaid rules that govern nursing home and waiver eligibility for seniors. Long-term care coverage for seniors runs through Ohio's non-MAGI Medicaid rules, not the expansion population.

How does Ohio's Assisted Living Waiver work, and does it cover the full monthly bill?

The Assisted Living Waiver, administered by the Ohio Department of Aging through PASSPORT Administrative Agencies, pays for personal care and supportive services delivered inside a licensed Residential Care Facility for Medicaid-eligible adults 21 and older with a hands-on ADL need. It does not cover room and board; the resident pays that directly to the facility, capped at the SSI federal benefit rate minus a $50 personal needs allowance.

What is PASSPORT and how is it different from the Assisted Living Waiver?

PASSPORT is Ohio's flagship home and community-based Medicaid waiver, delivered through Area Agencies on Aging, designed to keep Medicaid-eligible seniors who need nursing-facility level of care living at home rather than in an institution. It covers personal care, home-delivered meals, adult day care, minor home modifications, medical transportation, and, as of October 2024, Structured Family Caregiving. Like the Assisted Living Waiver, it never pays for room and board, since it's strictly an in-home program.

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