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My step-dad had 50% POA until 10/14/15, when his 50% was given to my sister. He is now refusing any/all requests we are making for her care, and is now pursuing legal action against us ... because he doesn't want to spend any more of "his" money on her care.

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Aggregated responses to questions: 1) Medicare waiver isn't possible as it won't kick in until they're assets are a) below their threshold (which they aren't), or b) till he "exhausts" her half of the marital assets (which he is refusing to do despite living in a community property estate). My mom has no retirement savings or money/assets of her "own" (if you can categorize it that way), since all assets are presumed to be shared 50/50. State social services have clearly provided guidance that my mom is entitled to 50% of his IRA.

For health insurance, she has Medicare. A private health insurance policy was recently canceled per "counsel" of his attorney as being duplicative to Medicare (he claims; we doubt).

My mom suffers from PSP ... Progressive Supranuclear Palsy. Very rare condition. The brain slowly deteriorates impacting the speech center and that of muscle control. Cognitively, she is much more aware than her communication or motor skills can convey. Makes this element VERY difficult. (It took her over 30 minutes to sign the DPOA because she insisted on signing her name vs. making an "X"). She has already lived beyond the targeted range for this particular type of PSP, so we're all in the dark, even the doctors, about her lifespan. Given the exponential decline in her health, we all feel the end is near, so we're not talking about the complete depletion of the IRA. We're talking, at most, 2 more years.

From a financial standpoint, we want to increase the caregiver coverage from 8 hours/day to 12. The biggest obstacles are eating and bedtime. Apart from that is the underlying attitude my step-dad has. He's worn out, we get that. But he is also 75% deaf in one ear (and refuses to get a hearing aid), has autism, and is extremely self-centered. This latter condition overrides and "trumps" a LOT of the decision-making we try to make.
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BTW, have you checked to see if your parents' assets are low enough to qualify for Medicaid?
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I understand the dilemma. The parents have a certain amount of money in their marriage assets. The father is not wanting to spend it on the high cost of care. I assume it is something like going into a facility. I understand that it is hard to give up that amount of money, even when it is a beloved spouse. He probably worries about being left with nothing. This is an explosive situation that I would dread dealing with. My sympathies are with you, EAC. One problem you may run into is that your father could move the money into his private account that you would not have access to. You wouldn't be able to pay your mother's bills without legal intervention. This is a tricky situation that really needs a meeting of the minds. Otherwise it may require legal intervention.
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I was writing as you were posting, so now I see that you and your sister have both health and financial proxies. My question as to who's paying still is relevant - is that his objection? That he doesn't want to spend his money for decisions you're making? What kind of health insurance does your mother have?
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Who's her health care proxy? If it's your stepfather, you have a fairly unworkable situation - he can make the medical decisions but you and your sister have the financial authority to implement them, or not.

However, when you write that he doesn't want to spend any more of HIS money, I'm confused. Who really is handling your mother's financial affairs? It should be you and your sister, pursuant to the DPOA.

There's another issue and that's her physical situation. Is she in hospice, and if so what's the prediction for her lifespan? What are her physicians predicting as longevity, and what kind of care is it that you and your sister want to implement to which you stepfather objects? And why is he paying for the care when you and your sister have financial authority under the DPOA? Does your mother have independent funds of her own?
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Yes, as indicated. I already had 50%, but live out of town. As such, he was acting as if he had 100% and was either not consulting me or failing to consult me on major decisions. As such, my mother finally opted to revoke her husband's POA and assign it to my sister. She and I together have 100% POA for both health and financial decisions.
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Did your mother revoke your dad's POA and assign your sister as her new POA? What type of care are you considering? Please let us know a bit more. Someone may have some good advice for you.
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