Hybrid Caregiving, Part 1

 After working all summer on getting set up and approved for Medicaid services, it finally happened. And let me tell you, I've seen God working in all of it...

About two weeks ago, I got a letter from Medicaid saying I was approved for the MED Works program, which basically gives me access to the services I need without limiting my income to the poverty level. If you aren't aware, many Medicaid services have an income cap, so basically if you work more than part-time for more than minimum wage, you make too much to qualify... but that is a subject for another soap box or blog post, and I do not want to digress here. The big takeaway here is that I don't have to minimize my work now or stash money under my mattress because this program looks at the physical/medical needs instead of economic status.

What services did I need, you ask? Well if you've been following along this summer you might remember that I've been trying to figure out how to make my caregiving system more sustainable for the long term, and have been praying that my Great Caregiver would make a way. Through some great conversations with wise people whose opinions I trust, I came up with a "hybrid" idea: Having my friends continue to volunteer to pop in or hang out with me throughout the day and having a home care agency cover overnights and mornings.

So when I got approved for the program, I talked with my case manager and told her I would like to have 12-hour shifts (9pm-9am) every day through a home care agency. Her initial response was to send me a PDF listing of 350 agencies in our region to choose from... that is not an exaggeration, I just went back and counted. I dutifully began cold calling agencies and after getting varying levels of "we can't help you" from 12 of them (most of them waiting until the end of the day to return my call and say so), I called my case manager back and told her she was going to have to give me a little more assistance. So she narrowed down the list to 5 agencies in Fort Wayne that she knew were actively taking new clients, which meant they had sufficient staff (a common problem in this field, and I can't help but wonder if part of the reason is that there are 350 agencies??). I called and left messages at all five, then prayed that God would have the right one call me back. 

One agency returned my call. They called me at 9:00 the next morning, in fact, and promptly scheduled a home visit with one of their nurses for the very next day. The person I talked to on the phone was pleasant and professional and competent... three things that, together, have been surprisingly rare in administration at the agencies I've used over the past 20 years. The nurse was likewise and took great care in listening to me and learning about my needs. 

I did tell the agency about my amazing group of ladies and asked if any of them might be able to apply at the agency to work with me. The answer was yes, they would be happy to take applications from any of my friends who wanted to do that. They told me that they would need to apply online, get a background check and TB test, and come in for training, and whatever hours they were able to cover, the agency would give them preference for my case. This was such good news to me, because I didn't know if or how many of my friends would be interested, but I wanted to be able to give them the choice. And really, how cool is it that they could get paid to have a sleepover with me? 

The nurse did the in-take meeting with me on a Thursday, and by the following Tuesday, I got another call from them saying that all 84 hours/week had been approved AND they had sufficient staff to begin on Thursday, August 31. (Can I just pause here to say that in NC, I was never able to get more than 12 hours of service PER WEEK, so this feels like I won the lottery - way to go, Indiana!) It turns out at least two of my friends applied and are on the weekly schedule. Then the agency has a lady who can fill in the rest. And if any of these caregivers need time off, the agency will have substitutes, so I don't have to figure it out! It's a great way for me to be able to take care of my friends and also have all the care I need. 

This post is getting way too long, so I'm going to stop it there and post again in a few days. If you want to know how the new caregiver did this week and what is happening to my friendship caregiving team, stay tuned!