Rhode Island Medicaid Home Care Programs: RIte@Home, Shared Living, and Adult Day Care

The Full Menu of Home Care Options

Rhode Island's global demonstration waiver consolidates all long-term care services — institutional and community-based — under a single administrative framework. This gives families more alternatives to nursing home placement than most states offer, but it also means navigating a complex set of programs with different eligibility tracks, service limits, and enrollment procedures.

If your parent needs long-term care but a nursing home is not the right fit — or if you want to delay or avoid institutional placement entirely — Rhode Island funds several distinct home and community-based programs through Medicaid LTSS.

RIte@Home (Shared Living)

The RIte@Home program is Rhode Island's shared living arrangement for older adults and people with disabilities who qualify for Medicaid LTSS. Under shared living, your parent moves into the home of a trained, licensed caregiver — or a caregiver moves into your parent's home — and provides daily assistance with personal care, meals, medication management, and household tasks.

The shared living caregiver is not an employee of your parent. They receive a monthly stipend from the state, and the arrangement is managed through a licensed shared living provider agency that recruits, trains, and supervises caregivers. The agency also handles background checks, home safety inspections, and ongoing monitoring.

Shared living fills a gap between independent home care (where aides come for scheduled hours and leave) and assisted living (where your parent moves into a licensed facility). For parents who need 24-hour supervision but not skilled nursing, and whose families cannot provide round-the-clock care themselves, shared living offers a residential setting with consistent one-on-one attention.

Eligibility requires a clinical level-of-care determination of either Highest or High under the global waiver. Financial eligibility follows the standard Medicaid LTSS rules — $4,000 countable asset limit, $2,982 monthly income standard.

Adult Day Health Services

Medicaid LTSS covers adult day health programs for individuals who need structured daytime supervision but can return home in the evening. These programs provide a combination of social activities, physical therapy, occupational therapy, nursing oversight, meals, and medication administration in a licensed day center.

Adult day care is particularly valuable for families where the primary caregiver works during the day. Your parent receives professional supervision and structured activities from roughly 7:30 AM to 4:00 PM, and the family provides care during evenings and weekends.

For individuals enrolled in PACE (the Program of All-Inclusive Care for the Elderly), adult day services are delivered through PACE's own regional centers in Providence, Woonsocket, and Westerly. PACE is a capitated managed care plan — participants must agree to receive all medical and care services from PACE providers, but the program covers everything from primary care to prescription drugs to personal care in a single integrated plan.

For Medicaid LTSS participants not enrolled in PACE, adult day health is authorized through the managed care organization's care plan, with the number of weekly days determined by the participant's clinical assessment.

Home Modifications Through Medicaid

Rhode Island Medicaid LTSS covers minor environmental modifications that help your parent remain safely in their home. These are not cosmetic renovations — they are functional adaptations that reduce the need for institutional care.

Covered modifications typically include grab bars in bathrooms, wheelchair ramps, doorway widening for wheelchair access, lever-style door handles, raised toilet seats, and shower bench installations. Under the Personal Choice Program, the participant's monthly budget can fund these modifications directly, provided they do not increase the home's total square footage and are approved in the person-centered care plan.

The key limitation: Medicaid will not pay for modifications that are primarily structural (adding a bedroom, building an addition) or that increase the property's market value. The modification must address a specific functional limitation documented in the clinical assessment.

The OHA @Home Cost Share Program

If your parent does not qualify for Medicaid LTSS — their assets or income are too high — Rhode Island still offers a subsidized home care option through the Office of Healthy Aging's @Home Cost Share program.

Eligibility requires:

• Age 65 or older (or age 19-64 with a documented Alzheimer's or related dementia diagnosis)
• Rhode Island residency
• Not currently eligible for Medicaid LTSS
• Annual income at or below 250% of the federal poverty level
• No asset test — this program has no resource limit

The @Home program subsidizes up to 20 hours per week of home care from a licensed provider, or adult day care services. Participants pay a sliding-scale co-pay based on income:

• Tier 1 (income up to $15,950 single / $21,550 couple): $4.50/hour for CNA services, $7.00/day for adult day health
• Tier 2 (income up to $25,520 single / $34,480 couple): $7.50/hour for CNA services, $15.00/day for adult day health

For comparison, private-pay home care in Rhode Island runs $25 to $27 per hour, and adult day health costs $90 to $100 per day. The subsidy is substantial.

This program is worth exploring if your parent's countable assets are above $4,000 but their income is moderate, especially while the family works through a spend-down to reach Medicaid LTSS eligibility. The @Home program can cover daytime care needs during the months it takes to process a Medicaid application.

Choosing the Right Program

The right program depends on your parent's clinical needs, living situation, and family capacity:

• Personal Choice Program: Best when a family member or trusted aide can provide consistent daily care and the family wants control over scheduling and hiring. The participant manages their own care budget.
• Shared living (RIte@Home): Best when your parent needs 24-hour supervision but not skilled nursing, and the family cannot provide that level of care themselves.
• Adult day health: Best when a family caregiver handles evenings and weekends but needs daytime coverage while working.
• PACE: Best for individuals 55+ who want a single integrated health plan covering everything from primary care to home care, and who live in the Providence, Woonsocket, or Westerly service areas (Block Island and Prudence Island are excluded).
• OHA @Home Cost Share: Best as a bridge program for families who do not yet qualify for Medicaid LTSS.

The Rhode Island Medicaid Long-Term Care & Asset Protection Guide includes a program comparison worksheet that maps each option against your parent's ADL needs, income, and living situation — helping you narrow the choices before contacting The POINT or a regional Community Action Program.

See more Rhode Island guides →