Unfortunately, not every family member or friend for whom care must be provided may have independent resources.  In fact, this can be immensely distressing in the event of need for medical care.  Though the Affordable Care Act (ACA) has extended certain benefits and privileges to sectors of America that in years past had no access to healthcare, it does not mean that everyone has either taken advantage of the health insurance marketplace or were able to.  Indeed, in Texas, as there was no expansion of Medicaid, there are many Texans who remain without insurance coverage.  That being said, what do you in the event of needed medical services for a loved one who has no health insurance, no resources or benefits, or limited resources or benefits? Here are a few suggestions:

1. Find a Health Center near you.  A health center provides health and dental care to people of all ages, whether or not they have health insurance or the money to pay for health care.  The US Department of Health and Human Services maintains a database of such health centers: http://www.hrsa.gov/gethealthcare/affordable/index.html  
2. Early Childhood Intervention.  For a baby or young child who may have intellectual or developmental disabilities, the Department of Assistive and Rehabilitative Services (DARS) has a program called the Early Childhood Intervention.  Call or Visit: DARS Inquiries Line at 1-800-628-5115 or https://dmzweb.dars.state.tx.us/prd/citysearchto learn more.
3. Ask if reduced or no fee services are available.  Consider public or non-profit hospitals and clinics who offer repayment plans and/or reduced fees for low-income patients.Some private hospitals offer such reduced fee or no fee services as well.  In fact, some private hospitals are required to offer such services called Hill-Burton Free or Reduced-Cost Care.  In 1946 Congress passed legislation that gave grants and loans for construction to various kinds of health facilities.  Though the program stopped providing funds in 1997, about 150 healthcare facilities nationwide are still required to provide free or low-cost care. To locate such a facility, follow this link:http://www.hrsa.gov/gethealthcare/affordable/hillburton/facilities.html .
4. Resources for HIV/AIDS.  The Ryan White HIV/AIDS Program assists low-income individuals diagnosed with HIV/AIDS who do not have health insurance.  Assistance includes healthcare and some other services.  To learn more, visit:http://hab.hrsa.gov/gethelp/index.html
5. Get to know a social worker.  Hospitals, nursing homes, agencies like MHMRA, all have social workers who navigate the system of healthcare, insurance, public benefits, and placement.  Finding a social worker at a facility near you (ideally, one that provides care for your loved one) can be a valuable asset as a care provider.
6. Find a home health agency. Sometimes a family member or loved one requires additional treatment or attention beyond what is offered at a hospital or out-patient facility.  A home health agency provides healthcare for an on-going injury or illness in the home.  Not every home health agency is made a like.  The Centers for Medicare and Medicaid Services (CMS) has developed a checklist to help in the selection of a home health agency:https://www.medicare.gov/what-medicare-covers/home-health-care/Home%20Health%20Agency%20Checklist.pdf.
7. Ensure you have legal authority.  A care provider should always ensure he or she has the legal authority either by the patient, by law, or by a properly drafted and executed directive by the patient or court of appropriate legal authority to make decisions.
8. Create a care plan.  A care plan is a living document that encapsulates the life of your loved one including items like a list of medical providers, statements of the preferences and desires of your loved one, a calender of renewal deadlines and re-certification periods, and copies of relevant advanced directives and powers of attorney, to name just a few items.  This document should periodically be reviewed to be updated or revised because it changes as you and the person you care for change.  It should assist you and the person who might have to step into your role make decisions and provide care.  The care plan is critically important for a loved one who does not have independent resources or benefits, because eventually, the person may become eligible for benefits or receive resources.  And, assessing how resources may interact with the benefits and vice versa are critical to maintaining eligibility.

Future posts will cover some of these topics in more detail and include other areas helpful to being a care provider for your family or loved one.

This post is the first in a series called "Family as Caregivers."  It is true of so many families today that family members are acting as a caregiver for their young, disabled, and elderly, loved ones.  However, what is also true is that many are not adequately prepared to step into these roles when necessary.  There can be a huge learning curve in stepping into a caregiver or provider role, which may include things like assessing a loved one's level of care, discovering and selecting care providers, discontinuing patterns of unproductive or unhealthy conduct and relationships, creating a care plan, navigating available public benefits, finding funding sources, and establishing or modifying proper legal authority to act on behalf of a loved one.  Indeed, this topic encompasses many components and can be overwhelming; however, by creating a plan and finding community supports and resources, the caregiver or potential caregiver role can be made much more manageable.

Mr. Henry has completed a seminar presentation series on this topic, which will be available in many venues.  To request Mr. Henry to present this series, or others onestate planning, probate, or incapacity planning, contact the Law Office of John B. Henry, III, Attorney & Counselor at Law.