Support • Empower • Thrive
LTCS Levels 1–5 • Information for Families and Guardians
Understanding Your Options
Long-Term Community Supports (LTCS) helps a person with an intellectual or developmental disability live in the community and take part in daytime activities. Staff help the person learn and use everyday skills. It is a separate Medicaid service, not a level of 1915(i).
The health plan reviews the person’s disability, daily support needs, living arrangement, and need for ongoing teaching and support. Ask about LTCS when the person needs more coordinated support to remain in the community. Age alone does not qualify someone.
Level 1 — Home Living: Day activities while the person continues living at home. This level does not include paid help inside the home.
Level 2 — Independent / Supported Living: Help for a person living in their own home, along with daytime activities.
Level 3 — Companion Living / AFL: Living with an approved paid companion or Alternative Family Living provider, with daytime activities.
Level 4 — Small Shared Home: Living support in a smaller supervised or group-home setting, with daytime activities.
Level 5 — Group Living: Support in a group home, with daytime activities.
These descriptions summarize published LTCS models. Older Vaya and Partners definitions differ on minimum age, home size, and overnight staffing. Ask Vaya Partners or your health plan for the current definition that applies to your coverage. Do not choose a home based on the level number alone.
Who will help during the day and overnight? What activities are included? What happens if needs change? What will the member pay for rent, food, and utilities? LTCS does not pay room and board. Employment support may need separate approval.
Call WNC Direct Care and the care manager—the person who helps arrange services. Describe the help needed on a typical day. Ask for an assessment, a written service decision, and help finding an available provider. Request the proposed level, staffing schedule, and covered services in writing before changing current care.