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Thread: Getting off of Medicaid/public assistance?

  1. #1

    Getting off of Medicaid/public assistance?

    From another thread:

    Quote Originally Posted by Chris Chappell
    We all (able/dis) need to be more self-sufficient and not rely on gov't help for everything. Granted, there are many, many cases that scream for necessary assistance but then there are others where people are stretching the system and the benefits with a sense of entitlement and selfishness. We all need to adjust and learn to live with less. If people (all) spent less, saved more, worked a little and kept themselves healthier then we'd all be able to utilize the services in a supplemental fashion vs a primary one. The gov't agencies and services shouldn't be primary anything.

    Onward and upward,

    Chris
    I tend to agree with the first and last sentences. Being as self-sufficient as possible (financially speaking) is an admirable goal, as is limiting your reliance on government agencies. Unfortunately, some injuries make achieving these goals very difficult for someone who hasn't saved prior to their injury and starts on Medicaid.

    In the most extreme example, take someone whose injury requires 24/7 care.

    There are 8,736 hours in 52 weeks. Assuming a low $15/hr for properly trained caregivers, a person requiring 24/7 care wanting to live on their own (such as it is, caregivers only) would have to earn $131,040 a year just to pay their caregivers. Add in supplies and living expenses, and that person's going to need to make a decent salary.

    The 24/7 caregiver requirement prevents the person from seeking certain jobs (teaching? fugetaboutit.), limiting potential career choices. Still, getting a good starting salary (from the limited career options) is a viable option if the person has the right aptitude.

    Let's say the person gets a job offer for $100,000--they have to turn it down. $150,000? Probably the same. $175,000 would be the bare minimum starting offer, probably, that the person could take to achieve their goal of self-sufficiency.

    Open question: outside of winning the lottery (or founding the next Google, Facebook or even Flickr), what viable, legal, sustainable options exist to help this get off the public dole?

    Steven
    ...it's worse than we thought. it turns out the people at the white house are not secret muslims, they're nerds.

  2. #2
    I am having that problem right now. 2 years ago I went back to work to a job that I enjoy very much - that I hope to make a career - but that pays $10/hour.
    I make the same amount of money that I did when I collected a check from social assistance but I lost my benefits. This means no funding for catheters, medications, equipment or equipment repairs. It also meant that I lost my supportive housing. I am now living in an inaccessible house trying to save money for a ramp, dependant on my partner for attendant care which is causing big problems in our relationship (been on the waiting list for community attendant care for 2 years), paying out of pocket for supplies and meds, using a broken wheelchair and wearing a leg brace that causes a sore.
    Every week I feel like giving up and getting back on the "system" but I believe that somewhere down the road I can make it on my own.
    What needs to happen more is that government assistance should be more supportive with transitional programs for people trying to get back to work or who are able to work part time or who are able to work full time but can't afford their disability related expenses.
    It sucks that I am willing and able to work but might have to go back on disability because I can't afford my disability.

  3. #3
    Agreed, Alex. The government definitely need to improve upon their existing solutions designed to help people get off of public assistance.

    I'm hoping that Obama's health care initiative will contain a viable option. I would love to be able to directly own a business (i.e., my name) and build it up, but the asset limit for Medicaid kills that option.
    ...it's worse than we thought. it turns out the people at the white house are not secret muslims, they're nerds.

  4. #4
    Steven _ great points. Attaching actual $$ is where it really hits home and should awaken the gov't to the realities of the expenses that the taxpayer funded agencies do pay for or will pay for given enough time. It's a double-edged sword that is extremely difficult to wield. On the one hand...on the other hand.... In your example the thought that popped into my head is education. In order to pay the $$ predicted a professional career (doctor, lawyer, etc.) is probably the only realistic way out other than winning the lottery.

    Alex ~ My hat's off to you. I respect your efforts greatly and am proud of you. Hang in there!

    What came to mind after reading your post was what ways can your life be easier? You mentioned daily care. How much do you need? What type? Are there any other options to make your care more independent? Can you go any higher in your field to earn more $$? What's your support system like, if any? I ask because I was in a similar situation a few years back. Then, with tendon transfer surgery and a colostomy I was able to be 100% grade A independent, which was my goal. This allowed me to go back to work full-time and lose the expense of caregivers which had been about $1,000 a month.

    I'm currently working with our CO congressman and a few healthcare related groups to address the very situation / example that you present. You're not alone and demographics will dictate only swelling ranks as opposed to shrinking. Thank you for sharing your story.


    Onward and upward Alex.

  5. #5
    I am currently working as an apprentice/assistant in a canine rehabilitation center while I go to school to become certified to be a canine rehabiliationist myself. Once I am certified my pay will go up to $25-$30/hr and then life will be much more under control. That could be as soon as next spring or at the latest the spring following depending how quickly I move through (which depends on finances to pay for school and how much I need to work while in school etc).
    my problem really comes down to lack of benefits. My catheter/drug and other disability related costs are currently more than 50% of my income.
    Independant wise alot of it comes down to the fact that my home is not accessible. So once I can afford to make modifications - mainly a ramp and bathroom modifications - I may not need attendant care.

    I know there is a light at the end of the tunnel but right now everything seems so much more difficult than it should be and I hate the fact that when I go to agencies asking for help - not with a monthly check but with medical/disability related costs - they say there is nothing they can do unless I go back on social assistance.
    Mostly I hate that at the end of a 18 hour day of school and work I have to call and find someone to help me crawl up my steps and bring my wheelchair inside my house because I am ineligible for funding for a ramp and can't seem to scrape together the money myself YET if I were to quit my job and go back on social assistance I could have that ramp in a matter of weeks.

  6. #6
    Chris, the PASS plan option may also exist, but I would have to sell someone on any plan I come up with for achieving self-sufficiency.

    If that involves starting a new business (e.g., Google, Facebook, Flickr), I would have to convince the person that a) my plan was viable and b) that I am capable of achieving it.

    Alex, have you looked into the PASS plan before?
    ...it's worse than we thought. it turns out the people at the white house are not secret muslims, they're nerds.

  7. #7
    Hey Steven
    I am in Canada. But I have looked in to ODSP employment supports which sounds similar and I did utilize that program when I first returned to work. They paid for hand controls for my vehicle and gave me a $500 return to work startup. Now I have been out of the system completely for 19 months and I was ineligible for any further assistance after working full time for 3 months.
    I have considered going back on disability until I finish school but the place I am working now is providing me with the work experience I need and offered me the opportunity to advance to the position I want once I complete my qualifications so I don't really think it is an option. Going back on disability would allow me to finish school faster, leave me with less student loan debt and I could figure out what I need (ramp, wheelchair etc) and try to get it all approved before going back to work. I may end up needing to do that but I really would lose some amazing career opportunites so I hope I can just stick it out.

  8. #8
    Alex ~ have you tried a local church, rotary, or kiwanis club to help build you a ramp?

    Is there such a thing as vocational rehab in Canada that might help out with a new chair, etc.?

  9. #9
    I have tried everything I could think of, has been recommended to me or that I have found online - keep striking out.
    For a ramp - one program I don't qualify because I don't own the house, another I don't qualify because I knew the house was inaccessible when I moved in (Because there are accessible houses on every corner!), another because I am working and therefore not disabled enough to need home modifications?! etc etc
    I tried one service group and didnt hear back. I live in a big city which has some advantages but loses the advantage of actually knowing people - like in a small community. Makes it harder to get service clubs/churches etc to help

    For the chair - the problem is that the government funded 60% of a power chair for me in 2005. I can't use the power chair because I can't get it in my house, my car or my workplace. I am also stronger now and can manage in a manual. I need a new manual but because the last time I got a chair a physio decided power was more appropriate for me and submitted paperwork to that effect it is making it difficult to get funding for a manual. I have appealed based on change of needs but so far no luck.

    Anyway - I feel like I have hijacked this thread with my own troubles when really the point I wanted to make was just that even though I am willing and able to work my disability related expenses may force me back on social assistance and I am sure that is why many others are afraid to venture out and return to work - that loss of benefits.

  10. #10
    Americans need to investigate Ticket to Work program. Talk to SSA.

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