Wednesday, September 18, 2013

just keep swimming...

So after we found out that Dominic didn't qualify for the CES waiver, we figured that path of potential funding/therapy was a closed deal and we would just have to keep on doing what we've been doing.

About a week ago, I got a very strangely worded letter from the state of Colorado stating that Dominic had now been designated as disabled by Medicaid in the state.    I called our TRE case worker for an explanation and was told that she had not stopped the long term disability process even though the CES waiver came back disapproved because there might be another waiver that would work.  She referred me to another organization to see if we qualified for the C-HBCS waiver.   It would cover speech, OT and PT if he qualified.

We're rather organization weary at this point, but I called and spoke with a case worker.  Nice lady.  We met with her today and provided all the documentation we've done to this point (for CES) as well as their denial information. 

She was kind of flummoxed that we were denied because she believes Dominic should've been qualifiied for it.  She's going to speak to her supervisor, and the CES folks and get more information, and we will see where that goes.  I'm not actually sure if he qualifies for HCBS, but if he does (and she'll get back to me next week), the wait list would be 18 months or so.

We did learn, however, that there's a medicaid buy in program we could do if he didn't qualify for HCBS, that is a sliding scale (highest amount is $150/mo)which would cover  OT/PT/ST long term since the state has decided to qualify him as disabled.  Health insurance only really covers those things in an acute situation, where this really would be a long term requirement.   No idea if we will do that, but she did say you could not both be on the wait list for HCBS AND on the buy in.  Its one or the other.  At this point its just interesting possibility.

As an aside, it royally sucks to go through your childs day (using the worst days as an example) and highlight all the ways in which your child - who has made and is making very good progress - is disabled. 

No comments: