My 19-year-old daughter was hit by a car while crossing the street on her way to the grocery store. Now, I can’t leave her alone when I’m at work because she’ll forget to turn off the stove or lock herself out of the house. I have used up all my FMLA leave from work and medical insurance won’t cover a home aide. I am a single mother and don’t have anyone else to call upon for help, and I can’t afford to pay for her in-home care out of pocket. Is there anything I can do?
Home-based residential care following a traumatic brain injury is provided in many states under the category of Traumatic Brain Injury Medicaid Waiver services.
The Americans with Disabilities Act recognizes that individuals suffering from physical and mental disabilities must be provided with services in the least restrictive manner reasonably possible. People with traumatic brain injury are frequently inappropriately confined to nursing homes or assisted living facilities because of the inability to have services provided within the home.
Recognizing that the needs of people with brain injury can often be met with home-based services, eliminating the need for institutional confinement, many states have instituted programs that will provide services to individuals with traumatic brain injury within the community.
The criteria for waiver services and the services that are provided vary from state to state. Perhaps the best known and oldest TBI waiver program is found in New York State and is administered by the New York State Department of Health. Services are provided to permit individuals to live in community-based settings and achieve maximum independence. Participants may also be eligible for rent subsidies and housing supports. The basic criteria utilized in New York State, and typical of most programs, is that the individual must be diagnosed with TBI or a related condition; is eligible for nursing facility level of care; is enrolled in their State’s Medicaid program; is between 18 and 64 years of age; and was injured after the age of 18. Similar programs exist for brain injuries that occur in individuals before the age of 18.
To obtain further information on eligibility criteria, support services provided, and how to make an application, contact your State Brain Injury Association.
Michael V. Kaplen, Esq. is a partner in the New York law firm De Caro & Kaplen, LLP. Mr. Kaplen is a professorial lecturer in law at The George Washington University Law School, where he teaches a course in traumatic brain injury law. Mr. Kaplan serves on the board of directors for the New York State Academy of Trial Lawyers.