CPE Reflection #6 - Understanding Home Health Care & Medicaid Support
Every once in a while, my privilege smacks me in the face. My family isn’t on Medicaid. I don’t have any experience with home health services. Anytime someone has faced a medical procedure, we have insurance coverage that doesn’t leave us facing short-term financial hardship or long-term financial ruin.
A patient was discharged this week after spending 45 days in the hospital. I did a quick chart review to understand more about their plans outside the hospital. This patient was being discharged to home, where they live alone. I had absolutely no idea to what level we, as a community, are supporting those who need extra help to support themselves.
Coordinated by a Medicaid caseworker, this patient will receive the following services indefinitely: 7 meal deliveries per week, supplement deliveries, lifeline services, and personal care services (Monday - Friday, 4 hours each day in the afternoon). The caseworker will also arrange for transportation to/from medical appointments and was working with the patient, prior to this admission, on remodeling a shower to make it more accessible. All of this is part of the Long Term Care (LTC) program that the patient previously qualified for.
Both sides of the Medicaid political argument were playing inside my head as I processed what I was reading. On one hand, I can immediately recognize how expensive it must be to support individuals who can’t support themselves. 20 hours of personal care alone could easily add up to $20k+ per year. That doesn’t even touch the case worker, the food and supplements, or the lifeline services. On the other hand, these are basic human needs. Things like access to food, necessary medication, and doctor visits aren’t optional in life. In this case, the patient is barely ambulatory. They have trouble getting around in their hospital room. It’s not like they can hop in the car and run to the grocery store when they run out of milk.
The state isn’t the only agency attempting to support this patient. In addition to the reduced reimbursement costs provided by Medicaid, the hospital provided food, medication, and transportation resources at discharge. The hospital also stocks a clothing closet to ensure that no one gets discharged wearing a hospital gown. Additionally, the patient was referred to the Atrium Health Community Workers program for additional support with food and transportation.
The future deacon in me can’t help but think about how this ties so closely to serving “all people, particularly the poor, the weak, the sick, and the lonely.” People in a similar situation to what’s described here are prime targets for diaconal ministry. And no surprise, we’re not going to find them sitting in the church. Deacons have to get people outside the walls of the church to find these situations and mobilize their parish to do the work.
