Sometimes people who incur care needs have no family to assist them in the process of obtaining the necessary personal care. In these cases, it is not uncommon for a close friend to admirably step in and assist with the person in need, engaging in care coordination to shepherd the individual into and through the care continuum, receiving the medical assistance that is needed.
When a person needs in home care, it often falls to family members to assist. When that is not available, a good friend is often willing to step in and ensure that the person is receiving the proper care, is safe and has a workable plan for the foreseeable future.
The first step for the trusted friend will be to determine exactly what level of care the person needs in the home. Obtaining an assessment of the person’s ability to perform activities of daily living (ADLs) (including instrumental activities of daily living). This determination will assist with the calculation of how many hours of personal care assistance from a home health aide are required. Is adult day care or adult foster care an option that would help the situation? Are homemaker services or meal delivery ll that are necessary? Should the paid caregiver plan to spend nights in the home? Should professional case management be retained? Is the Area Agency on Aging an option to provide information, or is self directed care sufficient? Is perhaps short-term respite care all that is needed? Could structured family caregiving provide some of the solutions? Is a combination of coordinated caregiving the way to go?
Once the level of need has been determined, the next step is to calculate what assets and financial assets are available to pay for care. Is a fiscal intermediary or a financial management service necessary to sort through these options, will the obtainment of self-directed service? Does health insurance, or a managed care organization, cover any of the services?
If personal finances are low, then perhaps services provided by your Medicaid state plan could be the answer. Home and Community based services (HCBS) administered by Medicaid Community First Choice (CFC)provided to a Medicaid beneficiary through Home and Community Based Services Waivers (HCBS Waivers) can bring care giving directly into the home. If this the case Medicaid eligibility must be investigated. What are the asset limits (in Missouri the asset limit is approximately $6,000). What are the income limits? In Missouri there are income limits, but through the use of a Miller Trust can create Medicaid eligibility no matter the amount of income.
If Medicaid eligibility is achieved for HCBS services to bring a paid caregiver into the home, the valued friend can experience adult family living with all of the structured family caregiving (sfc) necessary to continue to live in the community. MCO, AAA
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Article prepared by Mark Easley, Juris Doctorate. While QMC does not engage in the practice of law, Mr. Easley has practiced law for over 35 years and has assisted thousands of clients in the elder law, long term care, Medicaid areas of practice.
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