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Questions About Eligibility for Home Care Resources? Ask a Lawyer.

I am 68, live alone, and have mobility problems that may cause me to go into a nursing home soon. I really want to remain in my home. Is there a program that can help me get the care I need to do that? If so, what are the requirements? I’m worried that my income may be too high to qualify for public support, but too low for me to afford home care on my own.

The District of Columbia offers a Medicaid Home and Community Based Services (HCBS) program for people who are age 65 or over, or who are 18 and over and have physical disabilities. Participants must need the same level of care as someone who resides in a nursing home, and must also meet certain income and resource requirements.

HCBS can provide a personal care aide to help with daily activities that have become difficult to handle alone. An individual may qualify for up to 16 hours per day of personal care services for activities such as bathing, grooming, toileting, meal preparation, trips to medical appointments, shopping for food and health-related items, some housekeeping duties and more. Participants also receive individual case management services to ensure they are receiving the appropriate type of care based on their particular needs. Some may qualify for other types of services, including respite services, homemaker services, chore aide services, help with adapting a home to allow for greater accessibility, personal emergency response system services, and even payment for services in an assisted living facility.

For 2009, the individual income limit for program participation is $2022 per month. This ceiling increases yearly. An individual can also have no more than $4000 in countable resources. (Note: Different income and resource rules may apply for couples). Countable resources may include things like cash on hand, money in a checking or savings account, certificates of deposit, stocks, bonds, and certain other valuable resources. However, the District of Columbia excludes many assets from consideration, such as household furnishings, personal goods like clothing, watches, and jewelry, burial plots, and most funds specifically set aside for burial expenses. Most importantly, the home one owns and lives in generally does not count as a resource, except for those whose home equity exceeds $750,000.

Even if your income exceeds the $2022 per month limit, there may be steps you can take to qualify for the Medicaid Home and Community Based Services program. You should be informed of these steps when you apply. Recently, some over-income individuals have been denied on their applications or recertifications of eligibility for the program without being informed of their options. If you have been denied participation in this program on an initial application or recertification, or if you have general questions about your ability to qualify for this program, please call Legal Counsel for the Elderly at (202) 434-2120. For more information on the Medicaid Home and Community Based Services Program, call the DC Department of Human Services Income Maintenance Administration 202-727-5355.