By Michael D. Wilhelm
Throughout human history until the second half of the 20th century, most people aged and died at their home or the home of a family member. By the 1980s, only 17 percent of people died at home, as the experience of aging and death in the industrialized world shifted to hospitals and nursing homes. This dramatic change was caused by many factors, including the elderly living longer, having less children, and having children with duel income families (leaving less children available to care for aging parents). Even as more and more of our elderly population age in hospitals and nursing homes, their preference to live at home remains strong. Nearly 90 percent of seniors want to stay at home as they age, which is often referred to as “aging in place.”
Indiana has adopted the concept of aging in place and has implemented certain programs and policies to reverse the trend of aging in hospitals and nursing homes. One such program available to seniors in Indiana is the Medicaid Aged and Disabled Waiver. The Medicaid Waiver program began as a response to the national trend toward providing Home and Community-Based Services (“HCBS”). In the past, Medicaid paid only for institutionally based long-term care services, such as nursing homes. The Medicaid Waiver program “waives” the requirement of an admission into a nursing home in order for Medicaid to pay for HCBS.
The overall goal of Medicaid Waiver is to take people out of institutions (or prevent them from going there in the first place) by allowing them to live at home. Specific goals of Medicaid Waiver services are to provide to the person meaningful and necessary services and supports in the home or community, to respect the Medicaid Waiver recipient’s personal beliefs and customs, and to ensure that services are cost-effective. Some of the services and supports available in the home include bathing, cleaning, dressing, home-delivered meals, and home modifications. These Medicaid Waiver services directly address the needs of the elderly who have been finding it increasingly difficult to remain in their homes and help reverse the trend of aging in institutions.
A resident of Indiana must meet a combination of state and federal requirements in order to be eligible for a Medicaid Waiver. Specifically, a person: 1) must fit into an eligibility category (aged, blind, or disabled); 2) meet Medicaid resource and income guidelines; 3) need nursing home level of care if not for the Medicaid Waiver services; and 4) have expenses for services to the person that are less than the cost of being in a nursing home.
DeFur Voran LLP’s Elder Law Group develops and implements plans for clients so that they meet Medicaid resource and income guidelines. If you would like more information on the Medicaid Waiver program, please call us at 317-585-8085 or 765-288-3651 or contact us here.