If you are considering applying for home care, or finding a home health aide for a loved one, you are probably already encountering the stress of caring for a parent or spouse or relative. If you plan to receive this care through Medicaid, you will have the additional stresses of not being the soul decision maker in the type of care your loved one requires. You must work with an intermediary, probably a social service agency to insure they are aware of all your loved one’s needs and provide you with adequate coverage. This is not an easy task. By following the steps outlined below and being diligent about your demands, you should be able to provide your loved one with the care he or she requires.
1.) Getting Medicaid. This can be very simple or very complicated depending on your loved one’s financial situation. If your loved one needs only to transfer some income and assets, the Medicaid application form can probably be done by a local social worker. This is often done free of charge through a social service agency in your area.
If your loved one’s financial holdings are more complicated you might need to set up a third party trust, and will have to spend some money to hire either an eldercare attorney, or a Medicaid consulting firm. A Medicaid consulting firm can help you with fairly uncomplicated financial questions. They can help you with simple transfers of assets and create a pooled trust for additional income.
I suggest you contact both an agency and an attorney and get some feedback from each, before deciding which is best for you.
2. Your doctor’s role: Your loved one’s medical doctor will fill out a form specifying the type of care you parent or loved one requires. This is the key to getting your loved one the care she needs. This form will describe your loved one’s medical condition and requirements.
The key to getting adequate care begins by understanding how the this assessment form is interpreted. The form is a task-oriented assessment. To say your loved one needs supervision is not enough for getting care. The form must indicate what an aide needs to do and how often, i.e. transport patient from her bed and to the bathroom five times a day; or have the aide prompt the patient to take her medicine twice a day. The description must offers an outline of how much time an aide will need to accomplish these tasks.
3. The Home Visit. A nurse from the assigned home care agency will visit your loved one’s home to assess the setting and determine the number of hours of care she requires. Again this is a time for you to be involved and make sure the nurse understand all your loved one’s needs. Make sure the nurse understands your loved one’s conditions. If the nurse is unaware that your mother’s arthritis makes it impossible for her to open cans or bottles, and is unable to feed herself, she might not recommend assistance at meal preparation. If your mother’s memory is not good, she might forget to take her pills. She will need an aide to prompt and direct her.
4. Don’ Settle, Appeal! If you are still not satisfied with the amount of time the nurse has recommended for your loved one’s care, you can first appeal to the agency to reconsider. Be sure to bring documents such as medical records, to backup your concerns. If you are still not satisfied, you can request a “Fair Hearing.” In New York State the appeal process is through the Office of Temporary and Disability Assistance (OTDA). The Judge will listen and issue a written decision stating whether the local agency’s decision is wrong or right. If the Judge feels that a change is due, he/she will request the social service agency correct their decision.