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WV provides home based services under the Medicaid Waiver program. Called the Aged and Disabled Waiver ADW, my mother was approved for the highest level of in-home care. She was also awarded additional hours under the Personal Care program.


Approved since September 2022, not one of the 22 approved caregiver agencies has been able to place a caregiver. They got all excited when I called because her approved level translates to the highest contract income for the agency. But when I tell them where we are, they backtrack and say they don't have a caregiver for our area. Our county has the state capital of Charleston, WV. We are 4 mile from the city limits of Charleston. We don't need the caregiver to have their own transportation for any outside trips. We are directly on the public transit bus line. 10 ft. from a bus stop.


I've even begged for even just a portion of what we're eligible for. ANYTHING. I've said I'm flexible for ANY days or hours.


I can't believe that not 1 of these agencies has placed a new worker in 7 months. They'd go out of business. My case worker and I have both repeatedly called every agency on the approved list with no results. I've contacted the state Bureau of Medical Services to file a complaint. They said they would investigate and contact me within 2 days. That was 2 weeks ago. And of course they aren't returning my calls either.


So every week, every day, for 7 months I have been providing care for my mother. Every day hoping this would be the week someone would provide a worker so I can go back to work. I've been counting on this since we applied 12 months ago.


I assume I have no recourse since they can't really force a worker to work in our area. I guess I'm just venting here, but it does seem rather discriminatory.


BTW. Our location does not have a high crime rate nor anything that would deter someone from working here. I've been told that people just seem to think it's too far away. 5 miles from major shopping areas and 4 miles from the city limits.

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How many hours a week total would she be getting? In my adventures with a care agency, the employees mostly wanted the maximum hours in a single location, and a consistent schedule. Right now we're in an extreme labor shortage, which has been impacting the care/medical fields. My friend in FL had to go to a rehab facility 2-hrs from his home because it was the only one with enough staff to accommodate him. This is on the SE coast of FL... a highly populated area, but also neck-deep in elderly folks. I wish you all the best as you find care!
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lisamaech May 2023
Shes eligible for 55 hours a week
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Seeems like distance is the problem. All of the 22 agencies are too far from you. You are a few miles from the edge of town but where are these agencies located? My guess is many miles from you.

Are there any other agencies closer to you? If they are not on the approved list, perhaps they can apply to be approved.

What about the possibility of relocating to live near where services are available? It's a big change but it may be the right move in the long run.
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Call the Medicaid caseworker assigned to ur Mom. Tell her the 22 agencies cannot help you.
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If the State is putting out requests but no agencies are applying, you have no recourse as the State is making an attempt. Now you can ask - in writing - for the caseworker to have their case manager do an “escalation utilization of the care plan”. Move it up the system….

What you are experiencing is the likelihood for rural health care in the future. ((On another tangent, OB doc and children’s hospitals flat do not exist in many parts of the US within an hr or 2 drive, which to me is staggering)) And it sounds like you are not really that “rural”, but far enough out of the way that the distance and type of travel (maybe isolated or not better roads) is just too sketchy.

Plus a huge labor shortage. Add to that the State programs tend to take weeks to process payments; it’s not worth a home health company to participate in a State program if you can get private pay clients. A lot of those State programs pay slightly above the State minimum wage plus an administrative fee to the agency. My state’s (Louisiana) minimum wage is $ 7.25 hr and even if the agency was to pay federal mileage of .65, it’s not worth doing home health as you can work at Target @ $15 starting wage per hr plus solid benefits. Fwiw TX & MS also $7.25 minimum wage.

fwiw realize that in home health may do a fresh assessment on your mom. Should she be assessed at close to 38/40 hours, the report may indicate that she needs 24/7 oversight which means custodial care in a facility. It can be a narrow path to be able to keep them at home and stay within the guidelines. So be cautious, ok. Good luck.
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