Aging from EPSDT – Part VIII: Strategies

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In the previous 7 posts, we looked at the details of what exactly is wrong with the system that forces children with disabilities covered by early and periodic screening, diagnosis and treatment (EPSDT) programs to become adults with disabilities covered .. nothing. Now is the time to look at how the same families can find a way to cope with the realities of the broken system in which they work.

Become your adult adult provider

Some countries have implemented programs that allow parents or brothers to receive money from Medicaid in order to provide health care for their loved one with special needs. Programs are called "Cash and Counseling" or "Self-Directed Care" depending on the country. 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 person entitled to Medicare must apply for a program, and the state will evaluate them to determine how many hours of home care should work each week. They use the "honest and usual" rate paid to home care workers in your geographic area, multiply by the estimated number of hours they believe your loved one will need, and give them a budget of that amount to work. They can choose to pay to anyone (in some countries you must place a nursing class), and can choose to pay any amount to or above the state minimum wage. (Keep in mind that this gives them the freedom to stop paying you and paying for a professional for a specific time period if you need a break, which is an intimate benefit for family careers in the world.)

Go to a Better Covered State for Medicaid

If you live in one of the 19 countries that have not yet accepted the expansion of Obamacare Medicaid (Alabama, Florida, Georgia, Ajdaho, Kansas, Maine, Mississippi, Missouri, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Virginia, Wisconsin or Wyoming) may be difficult to accept, but moving to one of the remaining 31 states (or the District of Columbia) may be in your best interests. It can be a tough call, of course – it depends on many factors, the smallest finding of housing and employment – but if you can make that move, the effects on a loved one with disabilities can be terrible.

If you try to go this route, there are a few things that you will have to do:

1. Make sure that Medicaid programs available at your target state will cover your beloved person (see Part III of this series).
2. Check the income and resource limits and ensure that you continue to qualify. (Some countries offer spending on resource constraints and others do not.)
3. Go.
4. Publish your new home country.
5. Sign up for Medicaid in your new home country.
6. Turn off your Medicaid in your former state.

It's hard to do the easiest – but it may be best.

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