Hello, does anyone have experience with California Medi-Cal's Home and Community Based Alternatives (HCBA) program? My grandma (91, stage 5 Parkinson's) was just approved for 16 hours a day of in-home LVN care but it hasn't started yet as she's getting therapy in a SNF right now. I'd love to hear from anyone who has experience working with this program.
For TX, the program pays the inhome caregiver about $10.50 hr with FICA done. A couple of the big cities do get a slightly higher wage adjusted for HCOL but it’s still low wage. TX has minimum wage of a mere $7.25 hr. Placement is done via agencies that have service agreements with a fixed rate with the State. Elder gets a waiver approved for a certain # of hours for their care plan. For TX, big issue is finding an agency with workers who can fulfill the care plan. $10.50 is flat not competitive as you can go work at Target for $15-$19+ hr. For TX lots of folks have the IHHS in home healthcare services waiver but no workforce to take the position.
Many States have the paltry $7.25 hr min wage (especially the South). It’s real hard to find workers who will stay working for laughable low pay when they can easily find a better paying gig.
CA HCBS rate based on cost of living for an area plus CA has an initial higher minimum wage. Statewide minimum wage $16.90 hr for next year. And many cities and counties have their own minimum wage higher than the Statewide $16.90. They end up getting $20-$30 hr. It’s competitive pay.
The facilty where she is in now for rehab likely has a list of agencies who participate in the CA HCBA waiver program. I’d ask admissions office about this. So you can call around to try to coordinate this in advance of her discharge. When she gets discharged, there will be orders done for her in-home care plan.
On a tangent to this, please pls pls whomever is grans POA and grans family members care team - please - have a clear and frank discussion at the facility as to what will be needed for grans day to day care AND IF it is truly feasible for a 91 yr old with end stage Parkinson's to move back to her home or to a family members home.
If she really truly needs someone always there 24/7 for both oversight and hands-on care, that will take a team of family members dedicated and consistently being there for her. Could be a team of 3-4 on a schedule always there for her. It is not a 1 person job. That LVN coming in maybe 3 days a week for 5-6 hrs will only be doing so much (bathing, medication management, taking her for a walk). The LVNs are restricted as to what they can and cannot do medically. Once she is discharged from rehab and exits the facility, she is 100% the responsibility of whomever is her POA. Oftentimes family is well intentioned in wanting to take a family member home but it becomes impossible to have family be there as needed. It may be that gran will need to hire inhome care to do additional hours to that 16 the State will cover. Or perhaps it is best for her to remain in the facility and segueway from being a patient in rehabilitation to becoming a custodial care resident.
I surely do hope you will update us on how this program works for you. I hope others have some experience here to share with you, but to date I wasn't even away there was ANY program that would EVER provide as many as 16 hours in-home care of Medicaid.
Good luck, and please DO update us when she returns home and is a recipient of this care. I often see seniors out on slow walks with an aid, and wonder just what they are paying or receiving in care. And I am aware of some few programs that are absolutely great, On-Lok with it's transportation to daily meal, visits, BP checks, classes. Village with it programs. But wasn't aware of this program.