By Sandi Rosenbaum, Educational Advocate, Littman Krooks LLP
Relocation to another state is a complex prospect for individuals with disabilities and their families. Jason DaSilva’s NY Times Op-Doc of July 24, “How Healthcare Makes Disability a Trap,” illustrates an important aspect of life for people with disabilities.
Mr. DaSilva, who has multiple sclerosis and relies on round-the-clock Personal Care Attendants, funded by New York State Medicaid, explored the possibility of relocating to Texas to follow his ex-wife and young child after she took a job in Austin.
As he discovered, Medicaid services, which include essential services for people with disabilities, are administered at the state level, and each state has its own programs and criteria. Among these are Medicaid Home and Community Based Service (HCBS) Waiver programs. The federal government developed these programs decades ago to promote deinstitutionalization. The services allow individuals who require an institutional level of care to receive those services in their homes and in the community, often at greatly reduced cost to the state.
Mr. DaSilva, who with the help of his Personal Care Attendants, lives in his own apartment and works as an independent documentary film maker, discovered that such round-the-clock care is available through Texas Medicaid only in a nursing home, which he tried out in order to be close to his son. He found himself restricted by the schedules set by the nursing home; attendants assisted him with grooming and feeding on the institution’s schedule and were not available to allow him to come and go freely. He ultimately decided to stay in New York where he can continue living independently with needed supports.
When researching such a move, it is critical to understand what services will be available in the prospective new state. The services vary from state to state, as does the eligibility criteria for HCBS waiver and other services. An individual must apply a new for eligibility and might not qualify in the new state. It’s important for family members of a loved one with a disability to help with the planning when relocating.