Many families are struggling to gain access to funds to provide in-home and alternative care for their senior loved ones. What is this all about and what can families do?
We asked Jeff Stinson, certified elder law attorney at Stinson Law Firm, to shed some light on health care access in Indiana.
“This has been a difficult year for families in Indiana,” he says. “Funds that were previously readily available are no longer, and that has presented a real challenge for a lot of families.”
How did we get here? Under federal law, every state Medicaid program is required to offer coverage for nursing home care. But for many, a nursing home is not a desirable solution and many prefer alternative care options. The PathWays waiver and Health and Wellness waiver (formerly known as the Aged and Disabled Waiver) allow for funds to be allocated to families who want to choose other options, such as home care, assisted living, and adult day care services. Recent changes in Indiana have caused thousands to be placed on a waitlist for these benefits, placing many elderly and disabled individuals in extremely difficult positions.
“Up until April of this year, there has been plenty of funding to meet demand,” says Stinson. “Most people could access the coverage they needed. We’d see occasional gaps in coverage from time to time, but for years there was plenty to go around. Suddenly we no longer have enough supply to meet the demand.”
These changes surfaced after a $1 billion fiscal error was made in Family and Social Services. This is being corrected with money from the senior services budget. The error, coupled with the release of a new waiver system, created a perfect storm for those in desperate need of services.
“I have clients who are literally being rendered homeless because they are on a waitlist waiting for these services,” says Stinson. “There is absolutely no sympathy for these folks.”
In July the state limited waiver spots to 800 per month, which was subsequently increased to 1,200 spots per month in October.
“At this pace it will take months for people on the waitlist to get care,” Stinson says. “All the while, the state is continually adding more people to the waitlist.”
Stinson recognizes that there are limited options for those in this unfortunate position, but he does have a few recommendations for those without care.
“The state gives priority to those leaving a hospital or nursing home,” he says. “If your loved one has a fall and has to be admitted to the hospital or rehabilitation, immediately apply to help expedite the process. I encourage people to consider the PACE [Program of All-Inclusive Care for the Elderly] program as well. Indiana has some great PACE facilities and anyone who qualifies for Medicaid is eligible.”
While he does want to continue to raise awareness, he doesn’t hold a vision of the future that is all doom and gloom. He believes that Medicaid is a mainstay and will continue to help fund needed programs. Even so, he urges families to be outspoken.
“I encourage clients,” he says. “Talk to your legislator. Tell your story. Tell them why we need these alternatives. Studies have proven repeatedly that alternatives to nursing homes are cheaper than nursing homes. It makes no sense to limit these services. Legislators really need to know what is happening with budget cuts. Don’t just rubber-stamp a budget that cuts funding. Look at the people who will be affected.”
