In the previous 7 messages, we looked at what exactly is wrong with the system that forces children with disabilities covered by the Early and Periodic Screening, Diagnostics and Treatment Medicaid (EPSDT) program to become adults with disabilities covered by ... nothing. Now, it is time to see how the same families can find a way to cope with the realities of the destroyed system that work inside.
Become your adult child.
In some states, programs have been implemented that allow parents or siblings to receive money from Medicaid to provide medical care for their loved ones with special needs. Programs are called Cash, Counseling, or Self Help, depending on the state. They are available in Alabama, Arkansas, Florida, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Jersey, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia.
In short, your loved one, Medicare, must apply to use the program, and the government will evaluate them to determine how many hours they need at home each week to function. They use the “fair and normal” rate paid to home-based workers in your geographic area, multiplying it by a certain number of hours, which they think you will need, and give them a budget for this amount to work. They can pay someone (in some states you have to take a nursing course), and they can pay any amount on a state minimum salary or higher. (Note that this gives them the freedom to stop paying you and paying a professional for a certain period of time if you need a break, which is an integral benefit for the family caretakers of the world.)
Go to a state with higher Medicaid coverage
If you live in one of 19 states that have not yet adopted the Obamacare & Medicaid extension (Alabama, Florida, Georgia, Idaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas , Utah, Virginia, Wisconsin or Wyoming), it can be difficult to accept, but moving to one of the remaining 31 states (or DC) may be in the best shape. It can be a tough call, naturally - it depends on many factors, not least the search for housing and employment - but if you can make a move, the consequences for your loved one can be terrible,
If you try to follow this route, you will need to do several things:
1. Make sure that the Medicaid programs that are available in your target state will really cover your loved one (see Part III of this series).
2. Check your income and resource limits and make sure you still have qualifications. (In some states there is a limit on the use of resources, while others are not).
3. Moving.
4. Announce your new state.
5. Apply for Medicaid in your new home.
6. Complete your Medicaid in its previous condition.
This is the easiest thing to do, but it may be the best.
