MAC Center Mississippi: How to Get an E&D Waiver Assessment for Your Parent

Your parent needs help at home — bathing, meal preparation, medication reminders, someone to check on them daily. Medicare's home health coverage is temporary. A private aide costs $20 to $28 per hour out of pocket. The Mississippi Elderly and Disabled (E&D) Waiver can fund these services through Medicaid, but the process starts at one place: the Mississippi Access to Care (MAC) Center.

What the MAC Center Does

The MAC Centers are state-funded "No Wrong Door" hubs that coordinate clinical assessments for Mississippi's home and community-based services programs. They operate through the regional Planning and Development Districts (PDDs) across the state.

When you call the MAC Center, they will:

1. Screen your parent for potential eligibility
2. Schedule an in-person clinical assessment at your parent's home or current location
3. Determine whether your parent meets the nursing facility level of care (NFLOC) requirement
4. Connect you with case management services if your parent qualifies

MAC Center contact: 1-844-822-4622

You can also request a screening through the Mississippi Department of Human Services or the regional PDD office serving your parent's county.

The LTSS Assessment

Clinical eligibility for the E&D Waiver is determined through an in-person assessment using the Long-Term Services and Supports (LTSS) InterRAI tool. This is not a simple checklist — it's a comprehensive clinical evaluation conducted by a team consisting of a Registered Nurse and a licensed Social Worker.

What the Assessment Covers

The LTSS assessment evaluates your parent across multiple domains:

• Activities of daily living (ADLs) — bathing, dressing, toileting, transferring, eating
• Instrumental activities of daily living (IADLs) — managing medications, preparing meals, managing finances, using the phone, transportation
• Cognitive function — memory, orientation, decision-making capacity
• Behavioral symptoms — wandering, aggression, resistance to care
• Medical conditions — chronic diagnoses, recent hospitalizations, fall history
• Home environment — safety hazards, caregiver availability, current support services

The Score Threshold

To qualify for the E&D Waiver, your parent must score 50 or higher on the LTSS instrument. This score indicates that your parent needs a nursing facility level of care — meaning that without waiver-funded home services, institutional placement would be necessary.

A score below 50 means your parent's care needs don't reach the institutional threshold. This doesn't mean they don't need help — it means they don't qualify for this particular Medicaid program.

How to Prepare for the Assessment

The assessment team will ask detailed questions and observe your parent performing tasks. To ensure the assessment accurately reflects your parent's condition:

• Don't coach your parent to perform better — If your parent struggles to stand from a chair, don't rush to help. Let the assessors see the struggle.
• Be present as the primary caregiver — You can provide information about what your parent is like on a bad day, not just the day of the visit.
• Document recent changes — If your parent has fallen three times in the past month, has been hospitalized twice this year, or has new confusion, mention these specifically.
• Have medical records available — Recent hospital discharge summaries, medication lists, and physician notes strengthen the clinical picture.

Financial Eligibility

Meeting the clinical threshold is only half the equation. Your parent must also meet Mississippi Medicaid's financial requirements:

• Gross monthly income under $2,982 (or a Qualified Income Trust for higher income)
• Countable assets under $4,000 for an individual
• Community Spouse Resource Allowance up to $162,660 if a spouse lives at home

The E&D Waiver uses the same financial eligibility criteria as nursing home Medicaid. If your parent's income exceeds the cap, a Qualified Income Trust (Miller Trust) must be established and funded monthly.

The Physician Certification

In addition to the LTSS assessment, the E&D Waiver requires a physician certification confirming that your parent needs institutional-level care. Your parent's primary care physician must complete and sign this certification. It must be renewed every 12 months.

Ask your parent's doctor about this before the MAC Center assessment — having the physician certification ready speeds up the approval process.

The Waitlist Reality

The E&D Waiver is not an entitlement. Mississippi has approximately 22,200 federally authorized waiver slots statewide. When all slots are filled, eligible applicants are placed on an administrative waitlist.

The waitlist timeline varies by region. In densely populated areas around Jackson, Gulfport, and the Gulf Coast, wait times can stretch to several months. In rural counties with fewer applicants, a slot may open sooner.

While waiting, explore interim options:

• Medicare home health — if your parent is homebound and has a skilled care need
• Area Agency on Aging services — Meals on Wheels, volunteer companions, limited respite care
• Private pay home care — $20–$28/hour for personal care aides in Mississippi

What the E&D Waiver Covers

Once approved and assigned a slot, the waiver funds:

• Personal care attendant — help with bathing, dressing, grooming, mobility
• Home-delivered meals — daily meal delivery for homebound seniors
• Adult day health — supervised daytime programs with nursing oversight
• Respite care — temporary relief for the primary family caregiver
• Extended home health services — skilled nursing and therapy beyond what Medicare covers
• Environmental accessibility modifications — ramps, grab bars, bathroom modifications to keep the home safe

A case management team coordinates these services and conducts regular reassessments to ensure the care plan matches your parent's evolving needs.

The Mississippi Hospital-to-Home Transition Toolkit includes the E&D Waiver application roadmap, a Medicaid financial worksheet to determine whether your parent qualifies, and a QIT setup guide for families whose income exceeds the cap.

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