Medicaid LTC: Florida Health Justice Project’s education and advocacy program
By Blanca Mesa, Esq.
As home-based care has taken on a greater urgency with the COVID-19 pandemic,
families are seeking ways to keep their loved ones safe from contracting the virus by
keeping them at home. They can’t always do that without help.
Many families depend on Florida’s Long Term Care program, which provides support in
the form of nursing and housekeeping assistants, medications, therapy and supplies,
among other services.
By providing key information and resources to advocates and caregivers, Florida Health
Justice Project is a leader in providing the tools and resources needed to help Florida’s
frail seniors who need home and community-based services (HCBS) in order to remain
safely at home and out of nursing home facilities. Informational materials are needed
because the program is extraordinarily complex.
For example, Alene, a Florida resident who is wheelchair bound after spinal surgery,
qualified for home-based care but found herself struggling alone after her managed care
program inexplicably cut back the hours for aides. Alene knew her rights and fought
back to get the help she was entitled to.
“There are seniors out there whose services are being cut and they are just accepting
the cut,” Alene says. “They don’t know that they have rights to get those services
reinstated or get some of their services back. Some plans will cut your services to the
Florida Health Justice Project’s education and outreach materials help seniors and their
caregivers navigate the often confusing process of applying for and securing Medicaid
long-term care services. Our materials also clarify the rights and responsibilities for
both patients, caregivers and the State of Florida.
Knowing your rights is critical when trying to secure services or appeal the loss of
services, or a reduction in service hours.
That was the case of B.O. and her elderly mother, who became more dependent after a
debilitating stroke. B.O. became her mother’s full-time caretaker while still working
full-time as a teacher. When her mother’s aides’ hours were inexplicably cut from 60
hours a week to 28, B.O. found herself in a desperate situation. By knowing her rights,
she was able to successfully appeal her mother’s case and get the hours reinstated.
But the approval process for HCBS services can be a daunting ordeal. The waiting list
to get approved is outrageously long, and the required paperwork is extensive and
complex; and the written notice requirements for those who are screened remain a work
For families new to the application process, FHJP has created a new instructional video,
“Florida’s Medicaid Long-term Care: Home and Community-based services (HCBS),”
which takes viewers step-by-step through the application process for Medicaid’s
long-term care benefits (home-based health care services). Spanish and Creole
translations are also available.
FHJP has also created an Advocate's Guide to the Florida Long-Term Care Medicaid
Waiver and HCBS Know Your Rights materials in English and Spanish. Team members
also work with caregivers, support groups, advocacy groups and community
organizations who help seniors to provide information on Medicaid long-term care,
Additionally, FHJP works with individuals who are interested in sharing their stories.
Story sharing is one of the most powerful advocacy tools available for helping to
educate the public and decision makers about barriers to receiving home health
services and the need for more resources. You can read some of the stories on
long-term care on our website. If you know of someone who may be interested and in
need, please feel free to forward them this link to share their story.
Seniors have disproportionately borne the brunt of the pandemic, enduring greater
deaths, complications, hospitalizations and separation from family members. According
to the Centers for Disease Control (CDC): “the risk for severe illness with COVID-19
increases with age, with older adults at highest risk.” Now, as vaccination is underway,
hope for a better future is possible for seniors and their families, whether they choose to
stay home, need to go to assisted living facilities or simply return to senior activity
centers to reunite with friends and enjoy stimulating activities.
FHJP is here to help. We look forward to continuing our advocacy work to achieve
healthcare equity for all Floridians.
Share Your Story: https://www.floridahealthstories.org/share-your-story