Franklin County, Ohio vs Hillsborough County, Florida

Every Ohio county funds a Veterans Service Commission that gives temporary financial help to veterans and their families facing an emergency or hardship — commonly rent, utilities, food, and other essentials. This is state law, not charity: Ohio Revised Code Chapter 5901 requires each of the 88 counties to run this program with local property tax dollars. Veterans, active-duty members, spouses, surviving spouses, dependent parents, and minor children can apply after living in the county for at least three months. Each county commission sets its own rules and amounts, so what is covered varies from county to county. The same county office also helps with VA paperwork at no charge.

PIPP Plus is Ohio's distinctive ongoing utility payment program for low-income households. Eligible households pay 6% of monthly household income for natural gas and 6% for electricity (or 10% total for electric heat). The remainder is paid by the program. Income limit: 175% FPL (~$27,930 single). Must apply EVERY YEAR to maintain enrollment. ONGOING year-round assistance — distinctive vs HEAP's seasonal model. Distinctive — PIPP is one of the most generous ongoing utility programs in the US. Apply via Ohio Benefits or at local Community Action Agency. Phone: 1-800-282-0880.

Estimated bill savings: $500–$3,000 a year

Ohio Winter Crisis Program (Nov 1 - March 31) provides emergency assistance to prevent heat shutoff or restore disconnected heat for low-income households. Income limit: 175% FPL (~$27,930 single). Maximum benefit varies by year (recently up to $750 per household). Must have an active heat shutoff notice or be already disconnected. Apply by appointment at the local Community Action Agency. Apply via Ohio Benefits or call 1-800-282-0880.

Estimated bill savings: $175–$750 a year

Franklin County Senior Options (FCSO) helps residents 60+ maintain independence: homemaker services, home-delivered meals, personal care assistance, transportation, emergency response systems, adult day services, incontinence supplies, nutritional supplements, durable medical equipment (614-525-6200). Layered referrals: Franklin County Job and Family Services (Ohio Works First, emergency assistance, Medicaid); IMPACT Community Action (HEAP/PIPP+); COAAA case management; hospital FAP + HCAP; Catholic Social Services / Salvation Army / LSS; Mid-Ohio Food Collective; Ohio 2-1-1.

Estimated bill savings: $200–$3,000 a year

Next Generation MyCare puts Medicare and Medicaid benefits into one health plan for Ohioans who have both. The plan covers all regular Medicare and Medicaid benefits, including long-term care at home, in assisted living or in a nursing home, plus behavioral health. Members get a care team, better rides to appointments and shorter waits for prior approvals, and plans may add extras. The program is now available in every Ohio county. People who qualify are enrolled automatically if they do not pick a plan. People on the PASSPORT, Assisted Living or Ohio Home Care waiver who join move to the MyCare Ohio Waiver with the same or more benefits. To choose or change a plan, call the Ohio Medicaid Consumer Hotline at 800-324-8680.

Franklin County hospital safety net: Franklin = OhioHealth (Grant trauma + Riverside, Columbus headquarters) + OSU Wexner (Ohio State academic) + Mount Carmel (Trinity Catholic) — three-system competition in OhioHealth's home county. Ohio's Hospital Care Assurance Program (HCAP) requires hospitals receiving HCAP funds (essentially all Ohio acute-care hospitals) to provide basic, medically necessary hospital-level services free of charge to Ohio residents at or below 100% FPL; each hospital's own Financial Assistance Program (typically sliding to 200-400% FPL) layers above HCAP. Apply at the hospital financial counseling office or at https://www.ohiohealth.com/billing-insurance/pay-your-bill/financial-assistance. Phone: 614-566-5594.

Estimated bill savings: $500–$30,000 a year

In-home care for veterans who want to stay in their own home and choose who provides their care — often a family member, who is paid for the care they give. The local VA Medical Center approves a monthly spending budget; COAAA handles the case management and coordinates the in-home services, which can include meal preparation, personal care, homemaking, and medication administration. Referrals come to COAAA through the VA Medical Center, so start by asking the veteran's VA care team about Veteran-Directed Care, or call COAAA at 800-589-7277.

Helps Ohioans on Medicaid who have lived in a nursing facility, hospital, or ICF for at least 60 days in a row move back into a home, apartment, or assisted living of their choice. A transition coordinator works with the facility's discharge team, finds and secures housing, and lines up community services. Community Transition Services funds can pay one-time start-up costs such as a security deposit, first rent, essential household items, and utility deposits. Apply online at homechoice.medicaid.ohio.gov or call (888) 221-1560.

The Assisted Living Medicaid Waiver pays for care in an assisted living facility that is licensed as a residential care facility by the Ohio Department of Health and certified by the Ohio Department of Aging. It is an alternative to nursing facility care that is less expensive and less restrictive. Covered services include 24-hour on-site response, personal care, housekeeping, laundry and maintenance, nursing, transportation, three meals a day, and social and recreational programming. Community Transition Services help people leaving a nursing facility get essential household furnishings. To qualify you must be 21 or older, need hands-on help with activities of daily living such as bathing or moving around, meet Medicaid financial rules, and be able to pay the state-set monthly room and board charge. Countable assets must be $2,000 or less, and monthly income must not be more than 300 percent of the Supplemental Security Income benefit. Depending on income, you may have to pay something each month toward the cost of services. Call 1-866-243-5678 to reach the Area Agency on Aging for your area.

The Hillsborough County Health Care Plan (HCHCP) is the county's safety-net health coverage program for uninsured, low-income adult residents. Unlike a hospital charity-care program (which only discounts a specific facility encounter), HCHCP is a real coverage plan: enrollees receive primary care, specialty care, outpatient treatment, hospitalization at contracted hospitals, behavioral health, durable medical equipment, and prescription assistance through HCHCP's network of providers. The program is funded primarily by the County's Indigent Health Care Surtax (a half-cent local sales tax dedicated to indigent health care) and serves as Hillsborough's safety net after the county's public hospital authority was restructured in 1997. To enroll, you must be a Hillsborough County resident, an adult 18 or older, ineligible for Medicaid or Medicare (or any other comprehensive insurance), and meet HCHCP's income and asset limits (typically at or below 100 percent of the Federal Poverty Level for full coverage, with sliding scale up to higher brackets). Note that because HCHCP requires you to be ineligible for Medicare, this program is principally for adults aged 18-64 — once you turn 65 and qualify for Medicare, HCHCP closes you out and routes you to Medicare with optional Medicare Savings Programs.

Estimated bill savings: $1,500–$18,000 a year

Florida's Alzheimer's Disease Initiative is the state's dedicated program for adults living with Alzheimer's disease or related dementias (ADRD) and the family members who care for them. It pays for the kinds of services that keep a person with memory loss safely at home and that give caregivers a break: in-home respite, model adult day care designed for dementia, emergency respite when a caregiver is hospitalized, and extended respite of up to about 30 days. ADI also funds case management, specialized medical equipment and supplies, caregiver counseling and support groups, and caregiver training. Connected to the program is the state-funded network of 17 Memory Disorder Clinics across 13 service areas, which provide diagnostic evaluation, research participation, and follow-up care for people with suspected or confirmed ADRD. Eligibility is built around a probable ADRD diagnosis with cognitive impairment that affects daily living — not a strict income test — but a sliding-fee co-pay applies above a base income threshold, and most regions operate a waitlist managed by the local Area Agency on Aging. To apply, contact the statewide Elder Helpline at 1-800-96-ELDER (1-800-963-5337) or your local Aging and Disability Resource Center.

Estimated service value: $2,400–$18,000 a year

Community Care for the Elderly is Florida's broadest state-funded in-home services program for functionally impaired seniors aged 60 and older who want to stay in their own home instead of moving to a facility. CCE is not Medicaid — it is funded by the state through the Florida Department of Elder Affairs, which works through 11 Area Agencies on Aging and 47 contracted lead agencies (and their subcontractors) to deliver a wide menu of services. Eligible clients may receive case management, adult day care, adult day health care, personal care, homemaker and chore services, home-delivered meals, home health aide and home nursing, respite for family caregivers, emergency alert response systems, escort and shopping assistance, transportation, emergency home repair, consumable medical supplies, counseling, and other community-based supports. There is no rigid income or asset test, but most counties operate a waitlist and apply a sliding-fee co-payment scale once a participant's income rises above a base threshold — at or below roughly 150% of the Federal Poverty Level the participant typically pays nothing, and the co-pay rises in steps for higher-income participants. Priority for services goes to seniors referred by Adult Protective Services as victims of abuse, neglect, or exploitation, followed by those with the greatest functional impairment. Apply through the statewide Elder Helpline at 1-800-96-ELDER (1-800-963-5337) or your local Aging and Disability Resource Center.

Estimated service value: $2,000–$15,000 a year

Home Care for the Elderly is a state-funded program that helps frail Florida seniors aged 60 and older stay in a private home with a non-spouse adult caregiver instead of moving to a nursing facility. Each enrolled participant receives a basic monthly subsidy of $160 paid to the caregiver to help offset the cost of food, household supplies, and personal care. The program can also authorize 'special subsidies' for specific needs — incontinence supplies, medications, medical and assistive devices, ramps and home accessibility modifications, nutritional supplements, home health aide visits, home nursing, and respite. To qualify, you must be at risk of nursing-home placement, have monthly income at or below the Institutional Care Program (ICP) standard (300% of the SSI federal benefit rate — $2,982 a month for one person in 2026), have countable assets at or below $2,000 ($3,000 for a couple), and live with an adult caregiver other than a spouse who is willing and able to provide or arrange care. You must also receive SSI, or Medicare cost-sharing help as a Qualified Medicare Beneficiary (QMB) or Special Low-Income Medicare Beneficiary (SLMB). HCE is administered statewide by the Florida Department of Elder Affairs through 11 regional Area Agencies on Aging, which contract with local Lead Agencies to manage cases and authorize subsidies. Apply through the statewide Elder Helpline at 1-800-96-ELDER (1-800-963-5337) or your local Aging and Disability Resource Center.

Estimated service value: $1,920–$6,000 a year

Optional State Supplementation is a monthly cash payment from the State of Florida that supplements an SSI-eligible senior's income so they can afford the cost of an Assisted Living Facility (ALF), Adult Family Care Home (AFCH), or Mental Health Residential Treatment Facility. OSS is for low-income seniors and disabled adults who need help with the activities of daily living but who do not require nursing-home-level care. The state pays the difference between the resident's countable income and a published 'provider rate plus personal needs allowance' total — for an individual in an ALF the monthly income eligibility standard is $1,045.40 and the base provider rate is $991.40, plus a $160 monthly Personal Needs Allowance the resident keeps for incidentals (Florida Administrative Code 65A-2.036, effective June 24, 2025). To qualify, you must meet SSI's categorical eligibility (age 65+, blind, or disabled with countable income and resources below the SSI limits), be assessed as needing the level of care the facility provides, and reside in a state-licensed facility that accepts OSS payments. Eligibility is determined by DCF; payments are made monthly.

Estimated cash: $1,200–$9,600 a year

Florida homeowners with a homestead exemption can put off paying part of their property taxes when the bill is high compared with their income. If you are 65 or older, you can defer the part of your taxes and assessments that is more than 3% of your household income (5% if you are younger than 65). You can defer the whole bill if household income was under $10,000 last year, or if you are 65 or older and your income is under the limit for the senior additional homestead exemption. The taxes are not canceled. They become a lien on the home, earn interest (no more than 7%), and come due when the home is sold or is no longer your homestead; a surviving spouse who qualifies can keep the deferral. You must apply each year with your county Tax Collector by March 31 and keep fire and extended insurance on the home.