Traditionally, disabled and elderly Americans who needed help with everyday tasks either moved into nursing homes or arranged for at-home care. Unfortunately, neither option provides the freedom to control the care they receive. Today, many states offer Medicaid recipients the opportunity to choose caregivers and direct the services they receive. Residents who qualify for the programs are free to live life on their terms and can choose caregivers they like.
How Do Self-Directed Services Work?
Self-directed services, officially known as Consumer-Directed Services, is a program offered by many states and designed to allow recipients to stay in their homes while receiving care. It targets residents with physical disabilities who need help with daily tasks. A state agency administers services. For example, Missouri’s Division of Health and Senior Services (DHSS) is responsible for the program.
What Are the Eligibility Requirements?
Residents must meet minimum income requirements and be enrolled in the state’s Medicaid program. Citizens who are not currently receiving Medicare need to apply and be registered before they can qualify for self-directed services through the appropriate agency. Administrators will then arrange a home assessment.
The program is designed for residents who need non-medical assistance, which accounts for a vast segment of the population. Per the medical publication, Health Affairs, “an estimated twelve million Americans of all ages need some kind of long-term care, and about one-third of these require supportive assistance from another person to function in their daily lives.” Recipients must be able to hire, direct, and train their caregivers.
In Missouri, qualifying residents must be at least 18 years old, have a disability that prevents them from performing daily tasks, require the type of assistance typically provided by nursing homes, and be able to direct a caregiver. They also need to meet the following income requirements:
· Single or windowed recipients’ net household income cannot exceed $885 per month.
· Married residents’ income cannot exceed $1,198 per month.
· Single recipients cannot own assets valued at more than $2,000
· Married residents cannot own assets valued at more than $4,000
How Do Self-Directed Services Benefit Users?
The idea behind self-directed care programs is to assist residents who need help with essential needs, but give them freedom in the process. It does not cover medical care and may not include mental health services.
Typical caregiver tasks include:
· Help with personal hygiene, grooming, and bathing
· Help with toilet use
· Mobility assistance
· Medication reminders
· Cleaning and laundry
According to a recent Forbes article, some citizens choose self-directed care after finding that traditional home care agencies were too inflexible.
Who Qualifies as a Caregiver?
One of the most attractive benefits of self-directed care is that the disabled and elderly can choose their caregivers. The only restriction is that a personal care assistant (PCA) cannot be a legal guardian or spouse. However, other family members can qualify. The arrangement allows recipients to select caregivers they know and trust, and PCAs have a chance to make money since they are paid for their services.
Administering agencies provide guidelines that help qualified residents choose the best PCA for their needs. Professionals recommend choosing a caregiver who understands the recipient’s needs and has relevant experience. It is also essential that the job fits a caregiver’s life. For the arrangement to work, the compensation and work requirements must mesh with their schedules and expenses.
Self-directed care programs tied to state Medicaid programs are filling needs traditionally met by home nursing agencies or nursing homes. Medicaid recipients who qualify can choose caregivers to help them with everyday tasks. There are income restrictions, but those who meet the requirements enjoy more freedom than traditional options provide.