I would like to move my parents from IL to TX where I live. they are both on Medicaid. There will also be physical challenges to the move such as wheelchairs, low vision, poor hearing, obesity, dementia and incontinence. Does anyone have suggestions?
Good luck with this. Please keep us updated on how you are doing.
Carol
Also, if you are the P.O. A. for your parents, check with TX to make sure that the ones (legal and medical) you have are acceptable there. And if so, be sure to have an ample supply of them. If not, make sure to have ones drawn up that the state does/will accept. The state of VA recognized mine from IL.
If you have not yet selected a facility for your parents, I would start screening and "interviewing" them now, and select one. There are multiple websites that have reviews/ ratings of facilities, and some of them have state inspection reports online, along with specific user comments. That helps, but nothing beats an actual site visit, and your 'gut feeling' after the 'interview' with the staff and touring the whole facility (including 'back of house' areas). Some of the issues I covered in my search included the following: acceptance of Medicaid, room availability/ setup for double occupancy, OT & PT therapy functions for residents (on or off site?) activity functions for residents (both on & off 'campus'), food service, facility condition/ cleanliness/ maintenance, resident-staffing ratios (RN and CNA's), 'memory care' capabilities for residents (on site?), local transportation for residence, and physician/ specialists arrangements and extent of coverage allowed by the state and how that is implemented at the facility.
If you already have a care facility arranged in TX, make sure to get the application there done as "Medicaid Pending" so it doesn't default to private pay (big $) during the application/ review/ approval period of the state agency. And, generally there is a (probably state specific) limited ("retroactive coverage') time frame for Medicaid. Be certain that the application to the state is accurate, complete, compliant, and fully documented, so that it can & will be reviewed and approved on the first submission. As you probably already know, the wheels of the bureaucracy can, and often do rotate in slow motion. In VA, when dad's first application was denied, I had to resubmit a totally new form, complete with all new (updated) documentation, and the whole cycle started anew. As you probably know, the wheels of the bureaucracy can (and often do) rotate in slow motion.
As for the actual 'move', I would suggest a couple of things. If possible, get a second person to go along to help with your parents (and driving!), make sure any overnight accommodations are accessible, and depending on your situation, check into a rental van, that may make the wheelchair issue easier. Bear in mind that all of the moving expenses are most likely out of pocket, and I could not find any information that these expenses are allowable, covered, or reimbursable by Medicaid.
My (overweight, but not obese) dad had hearing and vision issues, slight (early) dementia, and moderate mobility impairment, but was still cognitive and ambulatory enough to handle a road trip. I was fortunate that he was still able to travel with me (in a crew cab pickup), and I planned an overnight trip, to keep the drive times reasonably comfortable for him (two days with 7 hours of road time day). It was challenging, but feasible, and I had allowed for schedule flexibility and additional "contingency" time if needed for any possible medical or basic fatigue issues. I tried to keep the route through as many major metro areas as possible in case an emergency developed (fortunately, none did). The care facility in IL was able to provide an ample supply of his prescriptions to cover the trip and about a week's reserve, just in case of any delays during the relocation to VA.
Basically, I tried to do the best 'due diligence' possible in order to get the optimal results for my dad. I found that the old adage of "plan for the worst, and hope for the best" was certainly pertinent for this type of event! I hope that at least some of this helps, and I wish you the best of luck.
I have dealt with moving MIL from LA to TX and the nuances of TX rules. & I have gone through Medicaid application in 2011 for my late mom who was a TX resident. For MIL, her application was first after Hurricane Katrina in 2005 and TX was very forgiving on folks having documents and basically if you were ok for LA Medicaid, it carried over. Then 6 months later in 2006 everybody had to apply to TX program. If they had not gotten a TX ID or TX drivers license or changed their SS and other monthly income to be sent to a TX address then they had to do so or be ruled ineligible for TX Medicaid to pay although they qualified for Medicaid.
For those who still had a home or a car in Louisiana, those assets would now be considered NON-EXEMPT assets. So all that still had their old home or old car back in LA were now over the 2k asset limit and therefore ineligible for Medicaid. The ones I knew this happened to either had to private pay for NH or moved back to a NH somewhere in Shreveport area as that was the only area that had Medicaid beds - it was a pretty chaotic period of time. Under Medicaid rules, you are allowed a home & a car but as far as TX was concerned they had to be in the state to be an exempt asset. I would assume this hasn't changed since then. So Annie if your folks still have a home or car in IL, they are going to need to sell the house in IL asap and use the proceeds as a spend down; the car they can bring with them but have to register it with TxDot within 30 days of the move and get TX auto insurance (TxDot has no sense of humor).
You are going to have to get their ID changed to TX, that too is done @ TXDot - so google to see what is needed to do this. TxDot locations always seem to be very crowded & humorless if you do not bring all the required documents with you.
On banking, if there is any way that there is a banking group that is in IL and in TX and close enough to you to get to, I'd suggest you get all their SS, retirement and all other income moved to that banking group & asap. It will just make is easier for when you need to change addresses. You basically are going to need to do a change of address to all & any items for them that is a document needed to accompany their TX Medicaid application.
Your DPOA on them needs to be done by a TX attorney with TX notary seal. There are many many NAELA certified elder law attorneys throughout the state of Tx too which is fortunate. You will find that anything with out of state notary will not fly. UPS stores in better locations often have notaries in TX.
For TX Medicaid, my experience is that is is easier to get them into a NH than onto a Medicaid waiver program for AL. TX Medicaid reimbursement rate to the NH is pretty low - about $ 155 a day in 2015. So most Medicaid taking NH are pretty basic in what is provided as the $ is just not there for the NH to spend. Very tight profit margin. The better Medicaid NH stay pretty full with 90% occupancy rate. You may find that you have to get them into a less than desirable NH first and then once they clear Medicaid, move them to another nicer NH. Once they are approved for Medicaid, moving them from one NH to another is simple and without any penalty from the old NH as they are paid on a day rate by the state - I did it for my mom at about month 10 of her first NH, and other than the floor nurse being a butt rash on getting all of mom's medications, it was simple.
Good luck if you do decide on the move.
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