Help at Home Before Medicaid: What Central Ohio's County Senior Levies Actually Pay For

PASSPORT requires long-term care Medicaid eligibility. The in-home help most central Ohio families qualify for first is funded by a county levy nobody ever explains to them.

By Ray Kessler, Certified Senior Advisor & Family Consultant · Published August 11, 2026

The Gap Almost Every Family Lands In

There is a specific conversation we have several times a month, and it always sounds roughly the same. A daughter in Hilliard or a son in Newark describes a parent who is managing, mostly — still in the house, still driving to church, but no longer cooking real meals, no longer safe in the shower alone, and increasingly dependent on an adult child who is burning through vacation days. The family has looked into two things. They have priced private-duty home care by the hour and found it more expensive than they expected. And they have looked at Medicaid and concluded, correctly, that a parent with a pension and a paid-off house on Sullivant Avenue is not going to qualify.

So they decide there is nothing available and go back to holding it together themselves. That conclusion is wrong, and it is wrong in a way that costs central Ohio families real money and real years. Between "pay privately" and "qualify for Medicaid" there is a third layer that exists in every one of the seven counties we serve, funded by voters at the ballot box, and it is the layer families are least likely to have heard of.

Franklin County Senior Options

Start with the largest one. Franklin County Senior Options is funded by the Franklin County Senior Services Levy and administered by the Franklin County Office on Aging, with the Central Ohio Area Agency on Aging handling in-home visits, enrollment, and case management for approximately 1,900 people receiving services.

The eligibility test is the part worth reading twice. COAAA describes it as three conditions: the person must be 60 or older, must be a resident of Franklin County, and must have a demonstrated unmet need for service. There is no requirement to be on Medicaid. Services are provided on a sliding fee scale and applicants must supply financial verification in order to enroll, so income is not irrelevant — it determines what the family contributes, not whether the door opens at all. That is a fundamentally different structure than a means-tested benefit, and families who have already been told "no" by Medicaid routinely assume the same answer applies here.

What the program covers is broader than most people picture. COAAA lists homemaker services, home-delivered meals, personal care assistance, transportation, emergency response systems, adult day services, incontinence supplies, nutritional supplements, and durable medical equipment. For a parent whose real problem is that Tuesday and Thursday mornings are dangerous and there is no food in the house, that list is close to the whole solution.

The entry points are a phone call: Franklin County Senior Options at 614-525-6200, or COAAA at 614-645-7250 or 800-589-7277. COAAA's offices are at 3776 S. High St. in Columbus.

Seven Counties, Seven Different Answers

Here is where families go wrong even after they learn the levy layer exists: they read about Franklin County and assume it describes the region. It does not. Each central Ohio county built its own program, on its own timeline, with its own funding mechanism, and the county line your parent's house sits on determines which set of rules applies. COAAA itself manages or funds services across eight counties — Delaware, Fairfield, Fayette, Franklin, Licking, Madison, Pickaway, and Union — but the county programs underneath that umbrella are not interchangeable.

Delaware County. SourcePoint has been supported by a county senior services levy that voters first approved in 1994 and have renewed since. Its levy-funded in-home services include care management, Meals on Wheels, emergency response systems, personal care, and medical transportation, and SourcePoint describes eligibility for in-home care as based on need rather than income, with services on a sliding fee scale. Note the geographic wrinkle that trips up families in Powell, Lewis Center, and the Delaware County slivers of Dublin, Westerville, and Columbus: SourcePoint serves the county, so a home address a few hundred feet on either side of the county line changes which agency you call.

Licking County. Voters established a senior levy in 1985, and the county describes the levy as renewed in 2024, generating roughly $6.3 million annually and supporting 15 organizations serving older adults. The Licking County Aging Program is the one most Newark and Heath families deal with directly, offering home-delivered meals, non-emergency transportation, homemaking and light housekeeping, personal care aides, adult day services, and chore services, with donations suggested rather than fees charged for many services.

Fairfield County. The county's senior services levy supports Meals on Wheels of Fairfield County, which has expanded well past its name into home-delivered meals, transportation, minor home repairs, emergency response systems, friendly visiting, in-home care, congregate dining, and caregiver support. Enrollment begins with an in-home assessment, during which eligibility and any cost-sharing are explained. Lancaster and Pickerington families should start there.

Union County. Union County is the structural outlier worth knowing about: its senior services are funded largely through a county sales and use tax levy rather than a property tax levy, with Title III grant funding alongside it, supporting personal care, homemaking, personal emergency response systems, mobile meals, and medical transportation. Marysville families sometimes assume that because they see no senior levy line on their property tax bill, no program exists.

Madison and Pickaway counties. Both deliver services through county senior center organizations, with sliding-scale arrangements in Madison County. These are smaller operations than Franklin County's, and the practical advice is different: call directly, ask a person what is available this month, and ask specifically whether there is a waiting list, because in smaller counties capacity fluctuates more visibly than in Columbus.

The general rule for the whole region is simple. The county where the older adult lives controls the program — not where the adult children live, not where the doctor is, not where the family has always thought of itself as being from.

Where PASSPORT Fits — and Where It Doesn't

Families often arrive having heard the word PASSPORT and nothing else. It is Ohio's Medicaid waiver alternative to nursing home care, and it is a genuinely valuable program, but its eligibility rules are the reason the levy programs exist. To qualify for PASSPORT, a person generally must be 60 or older, be financially eligible for long-term care Medicaid, and have functional needs at a nursing-home level of care as determined by a formal medical and functional evaluation. Two of those three conditions are ones a family cannot talk their way around.

That is what creates the gap. A parent whose income is too high for long-term care Medicaid, or whose needs are real but not yet at nursing-home level, is not a PASSPORT candidate — and is very often a solid county levy program candidate. The two systems are administered by overlapping organizations, which is exactly why one phone call to COAAA can screen for both at once rather than sending a family down one path and closing the other.

What an Ohio Home Care License Actually Means

Levy programs cover part of the week. Most families end up buying some private hours on top, which means evaluating home care companies — and this is where central Ohio families are most exposed, because a home care agency sends a stranger into a parent's house, often when no family member is present.

Ohio has a licensure framework here, administered by the Ohio Department of Health under Chapter 3740 of the Ohio Revised Code. ODH publishes two distinct application paths — one for skilled home health services and one for non-medical home health services — each carrying a $250 non-refundable application fee. The department describes a fingerprint impression card requirement for the primary owner of an agency seeking a non-medical license, specifically noting that it wants fingerprint impressions rather than a criminal record check. It also describes surety bond requirements for applicants whose business was not providing direct care on or immediately prior to September 30, 2021: $20,000 for non-medical home health services and $50,000 for skilled.

Two practical takeaways for families. First, "licensed" is a claim you can check rather than a word to accept from a sales conversation — ask which ODH license the company holds, skilled or non-medical, and verify it with the department. Second, the distinction between skilled and non-medical is not marketing. It determines what the caregiver in your parent's kitchen is permitted to do, and a family that hires non-medical help expecting wound care or injections has bought the wrong service. If you are unsure which one your parent's situation calls for, our home care overview lays out the difference, and a physician's order is usually the deciding document.

Five Questions Worth Asking Any Central Ohio Agency

Once you are talking to a private agency, the useful questions are narrower than the ones families usually ask. Which ODH license do you hold, and what is the number? Write it down. Is the caregiver your employee or a contractor? This determines who carries workers' compensation and liability if someone is hurt in your parent's home, and the answer changes the family's exposure substantially. What happens when the assigned aide calls off on a Saturday? Every agency has a good answer prepared; ask instead what happened the last three times it occurred. What is the minimum shift? Many agencies will not staff visits under a set number of hours, which matters enormously when what you need is forty minutes at bedtime. Do you bill Franklin County Senior Options, PASSPORT, or the county program in my parent's county? An agency already contracted as a provider under the local program can often coordinate levy-funded and privately paid hours into one schedule instead of two.

What the Levy Programs Will Not Do

Honesty about the limits is what makes this advice usable. County levy services are supportive services delivered in hours and visits — meals, bathing assistance a few mornings a week, a ride to a cardiology appointment at Riverside, a pendant that calls for help after a fall. They are not continuous supervision, and no county program in central Ohio is going to staff a home overnight.

That distinction is the one that determines whether staying home is realistic. If the concern is that daily tasks have become difficult, levy services plus a modest number of private hours frequently resolve it, sometimes for years. If the concern is that a parent with cognitive decline is unsafe alone at two in the morning, no combination of visiting services covers that gap, and the honest arithmetic is between round-the-clock in-home hours and a licensed community — a comparison that usually favors the licensed setting on cost alone. Families deserve to run that math before exhaustion runs it for them.

Two more limits worth naming. Capacity is finite: these are levy-funded programs with budgets set by voters, and in several central Ohio counties demand has grown faster than the funding, which can mean assessment scheduling delays or waiting lists for particular services. And enrollment is not instant — expect an in-home assessment by a trained staff member, expect to produce financial documentation, and expect the process to take longer than the crisis that prompted the call. Which is the argument for making the call before the crisis.

What to Do This Week

Three steps, in order. First, identify the county where your parent's home actually sits and call that county's program — Franklin County Senior Options at 614-525-6200, or COAAA at 614-645-7250 or 800-589-7277, which can point Delaware, Fairfield, Licking, Madison, Pickaway, and Union County families to the right local door. Ask for a screening even if you are certain you will not qualify; the screening is free and it is how families discover the sliding scale is not what they assumed.

Second, write down the actual week before you call. Not "Mom needs help" — how many mornings she cannot manage the shower, how many meals she skips, how many hours a week you are personally covering. Every one of these programs enrolls people based on a documented, demonstrated need, and the family that arrives with specifics gets assessed more accurately than the family that arrives with worry.

Third, if private hours are going to be part of the answer, start vetting agencies now rather than during a hospital discharge, when there is no time to check a license or ask about call-offs. The families who do best in central Ohio are almost never the ones with the most money. They are the ones who made the first phone call about eight months earlier than they felt they needed to.

Program details, fee scales, and levy funding change — the specifics above are what these county programs and the Ohio Department of Health published at the time of writing, and every one of them should be confirmed with the agency directly before you plan around it. Nothing here is legal, financial, or medical advice.

Frequently Asked Questions