Extremely frustrated and discouraged with this whole process/not optimistic.

Discussion in 'General Discussion' started by LaurieG, Dec 6, 2010.

  1. LaurieG

    LaurieG Newbie


    We applied for A&A retroactive to March of this year, and continue to get "we are busy" letters. In late September, I sent a Statement in Support of Claim plus the VCAA Notice Response to the Philadelphia office. I received another "we are busy" letter on October 29. So -- the company I am working with advised me to contact my mother's congressman. We rec'd a letter from them on 11/22 stating that it would be about 3 weeks before they could start working on my mother's case. I assume that is a form letter, so what with the holidays, we're probably looking at 4-6 weeks before they begin.

    I'm thinking that VA wants to drag this out for the very elderly (my mother is 90). If they can drag it out, they can count on the person passing away, and then they don't have to pay benefits.

    In the meantime, my mother's rent is increasing by almost $200 per month in 2011.

    I am not optimistic that we will get the A & A. Without the A & A, we will no longer be able to keep my mother in her current living situation. The next step seems to deplete her assets completely, apply for Medicaid, and put her in a nursing home. That would kill her.

    Are there ALFs that accept Medicaid funding? I'd like to get her into a situation that would NOT be a nursing home, and that would be safe for her.

    I live 1000 miles away, and her physical condition is such that she could not even handle the trip, even with my assistance, to relocate.

    Thanks for any words of advice.

  2. AngelaManz

    AngelaManz Jr. Member

    Have you sent the VA a letter requesting that her case be expedited due to her age and lack of funds? That would be a start. You can use the Statement in Support of Claim and make sure to call and follow up.

    Medicaid typically does not pay for assisted living, but many states have small grant programs that do provide some assistance. In Virginia, it's called the Auxillary grant. I would strongly suggest talking with an elder law attorney or geriatric care manager in mom's area to get more information about other possible living situations and financial help for her.
  3. AnnieN

    AnnieN Newbie

    Re: Medicaid and assisted living facilities.

    In our State (WA) there are ALFs that offer shared rooms for medicaid recipients. Not a lot, but there are some. From what I've read on this forum, availability for medicaid payment in ALFs is on a state-by-state basis. If you do a general search on "assisted living" you will come up with several good discussions on this topic. Good luck to you.
  4. vetadmin

    vetadmin Administrator Staff Member

    It varies from state to state, but many ALF's do have a certain number of Medicaid beds they allow for. The unfortunate news is that there is generally a wait list for them.

    Keep on your mom's congressman, and you can push back and tell them the situation is dire due to funds being deminished and unable to afford the increase.
  5. jpez

    jpez Full Member

    with you being so far away, you might also look into the PACE program.
    It is very zip code specific, so go to the medicare.gov site and then goto PACE programs.
    Program for All Inclusive Care for the Elderly.
    They are medi/medi funded. Medicare & Medicaid. there goal is to keep seniors out of nursing homes and in the community. There are 50 programs across the US.
    they usually have relations w/ assisted livings for the seniors to live at a reduced rate.
    IF your mom is in a service zip code, THEN get back w/ me and I'll explain more detail.
    I have placed over 35 clients in the PACE program and they always 'get better'.
    In my opinion, the PACE program is the model for how we should betaking care of seniors.
    AND she can still get the Special Monthly Pension w/ A&A rating.
  6. romalynn

    romalynn Newbie

    So jpez are you saying here that you must live within that zip code area in that state to use PACE

    We have only one in Seattle, WA at Zip 98108-2174

    thanks for your answer
  7. jpez

    jpez Full Member

    No. Now go to the specific website link and there will be a list of zip codes that they service.
    AND this is very very very important.
    If you are moving mom to an assisted living, look for one IN THE ZIP CODES SERVED!!!! :D
    like the first poster who is 1000 miles away.....what if she was off by one zipcode of being in a PACE program!!! Mom is already 1000 miles away, what is 1 more mile for TOTAL CARE!! ;D

    When I help clients, the first thing I ask is the zipcode. That's how important being in the PACE program is to my clients.
    Especially if that adult child is any distance away.

    One last thought, if the vet is married, and the vet needs the care, MEDICAID uses the spousal impovrishment rules for nursing home care. What that means is(varies by state): the wife keeps up to 109,000 of assets and 2700 of monthly income. So dad stays at home and Medicare/medicaid covers 100% of his healthcare. If dad needs to hire home care he can still get the PENSION/ housebound or A&A rating.

    THe only drawback is in states that have medicaid/assisted living programs, you can't be in PACE. But most PACE programs have clients in assisted living facilitys where PACE gets a deal on price.
  8. jpez

    jpez Full Member

    By the way, RomaLyn, I had a client in the Seattle PACE program a couple of yrs ago. THe family LOVED it.
  9. romalynn

    romalynn Newbie

    Thanks so much will keep this info and check it all out.
  10. LaurieG

    LaurieG Newbie

    Hi, everyone

    Thank you for your replies. My mother is not in a zip code for the PACE program. I'm going to contact her congressman's office this week about her situation. I was hoping to get something resolved before visiting her in FL next week, but it doesn't look like that is going to happen.

    Thanks again -

  11. jpez

    jpez Full Member

    I would apply for Medicaid anyway. you can have both. what is your mom's monthly income?
  12. AngelaManz

    AngelaManz Jr. Member

    PACE is a great program. Here in VA, PACE can be paid for by Medicaid and so it is a great option for folks who are Medicaid eligible. Again, this is why I would recommend that you talk with someone in your area that is familiar with all the local benefits available. Often there are options that are not widely advertised or understood.

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