BUT WHY?
The ACA provision will “...prohibit guardians from serving as the paid caregiver of an adult child with developmental disabilities” which would severly impact families providing stay at home care. This is especially true for single parents who are guardians and use the caregiving allowance to be a stay home caregiver. That provision is set to go into effect Jan. 1, 2014 with a goal to protect against the possibility of financial fraud, since the guardian has the ability to hire himself or herself as the paid caregiver.
The provision is part of the K Plan, a Medicaid state plan option under the Affordable Care Act. Oregon is the first state in the nation to implement the plan, which emphasizes home and community-based services. An Oregon state official says she can't recall a case where that arrangement was a problem.
POLITICS?
A confused and exhausted Copeland laments, “Every can of worms I open, I feel like there’s just another can of worms...All of our energy goes into learning about our child’s medical needs. To try and learn all the politics involved in it, too? It’s just too much for some of us.”
Copeland continues, "In our specific situation, it is going to cost the state exponentially more to do less care for Andrea if Andrea has to be cared for in a center...I could never expect somebody else to address her needs the way I do."
As Peggy Noonan blogs, "...no mother or child should be put in this position by a government..."
Is Hawaii ready for this? Sadly, its looking like the decision, to approve or deny, are to be made in the far-away land of Washington.
FOLLOW UP
OREGON: As of August 16, 2013 the Oregon Department of Human Services reports that federal officials have agreed to work with the state to develop “the right processes” to allow guardians — oftentimes relatives — to continue as paid caregivers. It’s unclear yet what those processes will be, said Patrice Botsford, director of developmental disabilities services for the department.
“We’ll be working on it next week,” she said. “We will do it as rapidly as we possibly can.”
For now, this news eases some of the tension of the 455 Oregon families where the guardian is the paid caregiver.
HAWAII: (b) RULE OF CONSTRUCTION REGARDING HAWAII’S PREPAID HEALTH CARE ACT. Nothing in this title (or an amendment made by this title) shall be construed to modify or limit the application of the exemption for Hawaii’s Prepaid Health Care Act (Haw. Rev. Stat. §§ 393–1 et seq.) as provided for under section 514(b)(5) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1144(b)(5)).
A July 8, 2014 story by David Savage of the TRIBUNE WASHINGTON BUREAU/MCT
The Supreme Court dealt a setback to the union movement, ruling that personal home care employees cannot be forced to pay dues to a union.
Justice Samuel A. Alito Jr. wrote the 5-4 ruling that these employees, many of whom care for their children or family member with disabilities at home, have a constitutional right not to support a union they oppose.
Deana Copeland (right) fears that a new provision of the Affordable Care Act (ACA) would eliminate her as the caregiver of her 22 year old daughter, Andrea Hood, who has cerebral palsy, spina bifida and autonomic dysreflexia.
