By: Barbara Ellington-Lofton
You may have read my articles in Healthy Cells for several years. If so, you know they usually address issues of long-term care Medicaid. Because I work with Bedford Care Centers, my articles are about nursing homes – admission, benefits, where to begin, and what to expect.
Would you be shocked to learn that Mississippi Medicaid covers much more than nursing home care? Nursing home income and asset limits are usually much more liberal than those for at home Medicaid. But today we’ll see that there are some Medicaid programs that cover individuals living at home and are just as liberal in income and asset requirements. And some individuals who continue to work can be covered while remaining in the workforce.
Over 40 years ago, a program was established to provide Medicaid benefits and some additional services to a group of individuals who could qualify for Medicaid in a nursing home, but chose to remain at home. Initially these were offered only to those who qualified for Supplemental Security Income (SSI). Through the years both income and asset limits have increased, and now are the same as those for nursing home residents. These are the MS Medicaid Home and Community Based Service (HCBS) waivers. There are waivers for the Elderly and Disabled, Assisted Living, Independent Living, Intellectual Disability/Developmentally Disabled waiver, and the Traumatic Brain/Spinal Cord Injury patients. They require being age 65 or older, or with a level of disability that is the same as that for Social Security or SSI, and needing a nursing home or institutional level of care, but electing to remain in a private living arrangement. These waivers can serve a limited number of individuals at any one time, resulting in waiting lists, some as long as 2 years, and some longer. But once accepted into the waiver and approved for Medicaid, services such as personal care attendant services, assistance with bathing and dressing, and assistance with other ADL’s (assistance with daily living) can be provided as a service covered by Medicaid.
Another program is the Disabled Child Living at Home. This program came about as a federal requirement that allows children who would qualify for care in a hospital, nursing home, or other institutional setting, to qualify for Medicaid at home without consideration of parental income or assets. The child must be under age 21, meet the Social Security definition of disability, and meet the requirement for care in a nursing home or other institution. Federal law also requires that children under age 21 who qualify for Medicaid be provided expanded benefits that are medically necessary, whether or not they are covered by the Medicaid state plan. Of course, these expanded benefits can be difficult to access, and many time advocacy groups can assist in this process.
In July 1999 the MS State Legislature instituted a program to allow individuals who work in spite of disabilities to be covered by Medicaid. The basic eligibility requirements for the Working Disabled Program are that the individual work at least 40 hours per month at some paid activity. The paid activity does not have to be one that produces a paycheck (but all wages should be reviewed for federal and state tax requirements). The person must also meet the definition of disability set by the Social Security Administration for Social Security disability and/or SSI, except for meeting the provision of Substantial Gainful Activity. The earned income limit is 250% of the Federal Poverty Level and the unearned income limit is 135% of the Federal Poverty Level. The countable asset limit is $24,000 for an individual and $26,000 for a couple. Some assets, such as a home, one car, and some retirement accounts, are not countable.
Mississippi Medicaid has 40 + Categories of Eligibility. The Medicaid Regional Office is charged with determining which category will be most beneficial for you, provided all technical factors are met. The Medicaid website, www.medicaid.ms.gov, provides information and flyers about different categories, income and asset limits, and benefits offered.
When you hear “Medicaid,” my hope is that you now know that Medicaid offers many categories with different income and asset rules, and varied benefits and services.
Barbara Ellington-Lofton is a Resident Benefits Specialist for Bedford Care Centers. She can be reached by phone at 601-450-3744 or e-mail at firstname.lastname@example.org..
Being a caregiver is a difficult task, no matter the time of year. However, the difficulty of being the sole caregiver for another person can be elevated especially during the holiday season.
Being a primary caregiver is a 24/7 hour seven day a week job and with all of the responsibilities that accompany caregiving who has time to decorate a Christmas tree? Who is going to bake the cookies and plan Christmas dinner? Who is going to do the Christmas shopping plus wrap all the presents? Being a caregiver shouldn’t mean that you miss out on the holiday traditions that are meaningful to you and Bedford at Home is here to help you most of your most of your holiday season and enjoy making precious memories with your loved ones. Here are some ways you can recognize and reduce the stress of caregiving during the Holiday Season.
Be Aware of Possible Burnout
Caregiver burnout can happen at any time, but is particularly common at Christmastime. The holiday season is a time of joy – a time to partake of family traditions, share memories with old friends, and celebrate the beginning of a New Year. Christmas and the holidays produce high levels of emotional stress. Isolation, depression and guilt can lead to a caregiver’s breakdown. Here are some signs that you may be experiencing caregiver burnout:
Why Holidays Mean Extra Stress
Only the person who has walked in a caregiver’s shoes for months at a time can know what the job of a caregiver is like. The caregiver that has no outside help and no support system is a sure candidate for burnout. Any one of the most common caregiver duties can weigh a person down both mentally and physically:
How can I Reduce the Burnout and stress for the Caregiver in My Life?
A primary caregiver is usually too caught up in her role to celebrate the holidays. She feels guilty for not upholding family traditions like baking cookies and decorating the house. Knowing her family’s (and her own) disappointment gets her down until depression takes hold. How can relatives help when they don’t live in the same house – or even the same town as the caregiver? If you plan to visit a friend or relative who is a caregiver, plan to stay in a nearby hotel or at another relative’s home. Few things are more stressful than a houseful of company, especially for the caregiver of a dependent elderly person.
It’s a thoughtful idea to let the caregiver know well in advance that travel and visiting plans won’t disrupt her household. Knowing guests will stay in a hotel and have plans to eat out will help relieve the extra pressure. Good communication will save a lot of wear and tear on her nerves. Avoid criticizing the caregiver’s home. Whether it’s a living room that needs dusting, dirty dishes still in the dishwasher or some other fault, don’t say anything (unless of course there is a real health concern). Pitch in and do a little housekeeping – mop the floors, empty the garbage cans or dust the living room – if the gesture will be accepted without putting more guilt on the caregiver.
Don’t expect to be fed or entertained. A primary home caregiver rarely has time to go to the grocery store, much less make a big holiday dinner. Why not take the caregiver out for a meal? Or, if she can’t leave the house, then why not bring dinner already prepared to her home? Do whatever works best with the least amount of work for the caregiver.
Prepare for Holiday Changes
Caregivers should be prepared to accept changes in family holiday celebrations especially when a patient begins to decline. Giving up hosting Christmas dinner for the entire family may be tough, but there is no joy in being overworked and overwhelmed for the sake of tradition. A solution may be to alternate hosting duties between family members. In any case, a well planned, well delegated list of duties to share in meal preparation, decor and clean up will help those holiday events be a little easier. If changes are necessary, accepting those changes early on is in the best coping for the caregiver and the loved one. If attending events outside of you home is impossible for the caregiver or the patient, you may be able to “Facetime” or ‘Skype” so that you can connect with loved ones.
Don’t Be Afraid to Ask for Help
If you are a primary caregiver, don’t be afraid to ask for help. If you have local friends and family, ask them to pitch in and help you make it through the holidays. Bedford at Home is a lovely owned company offering services provided by CNA’s,LPS’s, RN’s and Personal Care assistants. We offer short and long-term respite services, including but not limited to: Travel Companions, sitting with your loved one during hospital and long-term care stays, or just providing relief when you need a day off. All services are available 24/4, including weekends and holidays. Bedford at Home wants to help you be the best caregiver you can be.
For more information, call us at 601-271-6004 or visit us online at bedfordathome.com