Stacy0122 Posted October 2020
I am trying to make a legitimate change in the world. Suggestions?
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I am trying to change Medicaid Estate Recovery Program, MERP, create a support system for caregivers and get caregivers to be paid a decent wage with insurance for sacrifice.
My Senator, Ms. Heat Miser of MI, told me I am dumb and MERP is not a federal law but a state law. She gave state info, representative and senate, I called and they push back to federal law.
I cannot make a change by myself and this is not political. I have a call on Monday and need real ideas and suggestions for change.
Any input would be appreciated.
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Second, I would do all the research I could, draft a plan, with different scenarios. This could easily involve reading House and Senate hearings, Federal Register, and state hearings as well. on any or all of your topics.
Third, I would print out the governing legislation, study it well, and identify specific changes or amendments.
Fourth, in the process of the second and third steps, target the legislation that would have to be amended or deleted, and add your own suggestions.
Fifth, identify primary, alternative, fallback and walkaway positions. You may be successful on some levels but not on others. Identify your priorities and decide ahead of time which are lesser priorities and might involve more concessions, such as acceptance of a better alternative in lieu of fighting for all the points on your agenda. And recognize that you're taking on a mammoth task, so be prepared for setbacks and disappointments.
Sixth, identify, contact and reach out to supporters to build a coalition if possible. I don't think one person could realistically change any of the situations you identified, so you'll need a lot of support to make your proposals credible.
Seventh, many if not most of the people here are still actively in caregiving roles, or past them and still in recovery, or moving forward. I don't think we/they would have much lobbying time, so suggestions might be more realistic than commitments of their time.
Eighth, I don't think I would even consider starting until the November election is over. There's too much turmoil and concentration on other issues.
Ninth, good luck!
OTOH, I am interested in your thoughts on some of the issued you raised:
A. What changes do you plan to suggest for MERP?
B. How, what, and who would be involved, and how extensive would a support system for caregivers be? Are you considering backup for specific assignments, or psychological support?
C. Who would you anticipate would pay caregivers a decent wage "with insurance for sacrifice"? My understanding is that caregivers are primarily paid by family, either directly or through an agency. How would you change this?
And what kind of insurance are you considering? Full health care insurance? Liability or W/C insurance?
Your plans are laudable, but please remember you're taking on some possibly insurmountable issues.
I would like to say that I admire your courage and ambition!
Best of luck to you! Keep us posted and we will continue to cheer you on!
respond and his competitor stayed the issue was too complex.
As for my thoughts:
MERP is an outdated program. So, lets say you are married and live in your parents home, your spouse brings home 40k, you nothing due to caregiving. So your parent lives til 90, your 65 lets say. Should Medicaid recoup the home when you have cargave for years,? Is it honestly feasable at 40k a year for a 65 year old to take out a mortgage? This is not meant to be age discriminatory but NO.
I believe if a caregiver is dealing with care, there should be resourses available. People with mental illnesses or addictions have a hotline and resources, why not caregiving? It is ignorant.
I would change it all, through socializing medicine, yeah, the bad word. Subsidies for health and govt wages are good at times. I could fix the tax system but its broken.
I have been reading alot of astrology lately. I am an Aquarius so I need to fix the wrongs. It is my beliefs and my fight to better things and I am ok with that. It is something I need to do. I just do not want to miss out on other peoples thoughts.
As for the election, this is why I have been doing this for months. Whichever party at least acknowledges my concerns will get a vote. I dont expect change but a legitimate discussion.
If Trump spends $70K on his hair, it's his money to spend. Don't be jealous of someone else's $$ and success.
I wish we had answers for you. It’s complicated. Remember that change is slow. Things aren’t usually as black and white as they seem. There are many gray areas to explore.
So many issues to be considered. It’s trial and error to some extent. What is working? What isn’t working or no longer feasible?
Everyone wants improvement. It’s a matter of tons of research to determine what is needed. It’s definitely not an easy or quick fix. Don’t lose hope. Continue to be an active citizen. State your mind but listen to others as well. We can all learn from other’s experiences.
Wishing you success in accomplishing what you desire.
Have you investigated this?
I know a person in her early 20s, going to school, working full time nights because her 1st grader has home school. She also has guardianship of her grandmother. She was granted guardianship, 2 month after her grandmother was violently sexually assaulted and taken advantage of financially by someone who was hired to mow lawns and small projects. The police stated she was not declared incompetent at the time of the assault so there was nothing they could do, he said, she said.She moved in with her grandmother, cared for her for over 2 years before placing her in a memory care with 20 hours of help from Medicaid a week. She was told she needed to sell the home. With a judges approval, the home was sold $11,000 less than fair market value and all proceeds went to the facility.
Medicaid moved her to an Assisted Living that she needs to go to 3 times a day to give meds. She received a notice now stating that she needs pay back the $11,000 and owes the facility for the time she has been there and either self pay until December or bring her home.
My entire point in this is there needs to be changes to laws and a support system created for caregivers where they can get advice, information on navigating the system or just a listening ear. When someone has called a suicide hotline due to stress and pressure, that is too far.
You haven't told us what perpetuated your reason to seek these changes. Were you caring for your LO or were you a paid caregiver for someone else? Were you a cancer caregiver, dementia caregiver or what? Michigan does already have an Alzheimer's care plan that may address caregiver pay. We may be able to offer some help if we knew more about your motive.
Caregivers of all disciplines are in high demand, but you're right, they are very underpayed in relation to their contribution to society. There is a tremendous turnover in that occupation because of low pay, poor benefits, lack of career path that must be addressed if the situation is to be improved. The process starts with the employer in the hiring screening process.
I think your first step is to make people aware of the situation by writing to your local newspaper's letters to the editor. Instead of calling try writing to your congressional reps. Also check your state's legislation website to search for any proposed or enacted legislation on caregivers. You need to do more research.
For Michigan specifically...
https://www.michigan.gov/mdhhs/0,5885,7-339-71547_4860_56113_58553---,00.html
If your friend's grandmother requires Medication management, then it needs to be added to her care plan at the AL or in a NH.
My question is, what do you see wrong with MERP. I have been thru it and to me it seems fair. The only thing I may change is needing to get Market Value for a house. Sort of impossible in the County I live in because there is no industry. You are lucky to get what you can. So, Medicaid has to look at where you live and maybe allow a % under Market Value. For this, I did use a lawyer since Moms house needed a lot of work so unlikely I would have gotten what was considered MV.
Medicaid is for people who basically are living on SS and a pension. Any assets they may have needs to be used for their care. Yes, its a shame that life long saving goes up the chimney when expensive ALs and LTC facilities are needed but that's the way it needs to be. Me, we have savings just for that reason, our future care. If not needed then my children will be left it. But we did not save for the children to inherit, we saved to lighten any responsibility they feel towards us. We realize we won't be able to stay in our house. We realize money will be needed if we need care. We realize that outside help maybe needed.
MERP is the state trying to recover money the tax payers put out for someone's care. The only thing a recipient may have is their house when they pass. If someone can prove residency they can usually stay if they also prove they can pay the upkeep and the bills on it. A Community spouse is given enough money to do this. Otherwise, the house needs to be sold and Medicaid recouping what they can. If there is no money, then nothing for Medicaid to recoup.
My Mom still had her house. She was on Medicaid 3 months, 6k was owed to Medicaid. Sold the house for 40k, paid the Medicaid lean, outstanding taxes, lawyer and recouped my out of pocket. We each got 3500. But if we had got nothing that was OK.
It is not an easy life, caring for an elderly loves ones, but the federal government has tried to balance needs of all.
If you mean health insurances and Medicare footing the cost of a family member caring for a LO, it won't happen. People pay enough for health insurance to add Caregiving being paid for in the mix. Personally, I do not want to pay more for my health insurance because someone else is being paid by the same insurance company to care for a LO. To me what needs to change is instead of one sibling doing all the caring, the others need to contribute to that care based on what they make.
What needs to be done is the LO needs to plan for their future needs. As a retiree I see a widowed neighbor (76) continually helping her 40+ yr old children with buying houses and supporting them in one way or the other. And this has gone on even when husband was alive. I asked him why at 67 he hadn't retired. He told me his was helping his kids. Really, they were all adults! And one daughter (38) he was helping because her husband was layed off, with 2 or 3 kids she got pregnant again. Now should I be paying for one of those children to care for this Widow if all her money has been given to her children, no. To me its up to her kids to pay her back in some way. If that means caring for her, so be it. One is a nurse the other has CNA training.
There is Longterm insurance that can be bought to help pay for in home caregivers. If a child chooses to care for a parent and gives up a job, that is by choice. There are posters that parents can very well pay them, they just won't. Same with POAs refusing to pay a sibling. There have been posters where parents spent their money on things they didn't need and trips but had nothing when they needed help.
We live in such a different time now. Two people have to work. People living passed what my daughter calls "the expiration date". Seniors caring for Seniors.
What needs to be done is stop telling our elderly they can stay in their homes by getting a reversed Mortgage, not always possible. I hate the phrase "We want Mom to stay in her house as long as possible" thats not always possible. I find those who say this are in denial and have no idea how serious things are.
What needs to happen is more affordable care facilities. Some people don't need LTC and ALs are expensive. They just need someone to make sure they get their meds. That they are fed. Maybe AL type places where they have rooms and Family being involved in the rest of their care. This way family members can still work knowing LO is safe during the day and night.
Not sure how the problem with our elderly can be solved. But expecting lower/middle class people to pay more taxes and higher premiums so that someone can be paid to caregive doesn't seem fair to me. Maybe more programs like the one in PA would work. An Agency trains you and pays you to take care of a friend or family member. I have a feeling though, this is subsidized by the State with tax dollars. But I would go for that.
OP, it is federal law that states must attempt to recover the money they spend on an elders care. Each state runs their own MERP, some states are more aggressive and stricter than the federal law. The only way to change to MERP the way you want, is to change the federal law.