The Care at Home (CAH) Medicaid waiver program will be a state-run community-based program that allow severely disabled children to access home care and healthcare coverage within the community. The waiver program is based on the proposition that children with disabilities should have a proper support to enable them to become active participants in determining their future. The waiver program is a federally approved deferral of the Medicaid rules to enable disabled children to remain home and still benefit from the Medicaid coverage (Yingling et al, 2019).
Typically, such a waiver program disregards the guardian’s or parent’s resources and income when determining the eligibility for the means-tested program. This allows parents to benefit from services that they would otherwise not benefit from due to their low-income levels. The program the program is funded with a mix of both state and federal dollars and overseen by the state health agency. It allows physically disabled children to remain with their families at home while receiving healthcare, nursing and vehicle and home modifications.
This program benefits families that struggle with meeting their healthcare costs: drug coverage for disabled children and uncovered therapies. It especially targets autistic children and at-risk infants because of their low survival rates.
The program spans from financing home care for children with disabilities to ensuring an adaptive, healthy and safe home environment for the children. As such, nurses are directly involved in ensuring safety and wellbeing of the beneficiaries by designing their living environment and ensuring those environments respond to each child’s unique disabilities.
Depending on the child’s specific needs, the nurse is responsible not only for care delivery but also for home modification. Considering home modification may be overwhelming to some families, the nurses are directly involved in advising on the necessary changes that parents or guidance need to make within the home environment to guarantee safety and wellbeing of the beneficiary children.
Key to the nurses’ role is ensuring that the home environment is accessible so that those using wheelchair can easily and safely get in and out of the rooms. The nurse would then present these environment modification requirements to the program design committee to justify the waiver and support other crucial decisions regarding the program. For instance, disabled children whose home environment require more modifications are prioritized as beneficiaries compared to those whose home environment require lesser modification. The idea is that those who require more home modification would need more resources, and are therefore eligible for the program’s support.
The nurse also plays a key role in designing the respite component of the program. Because respite is provided at home by the nurses or other healthcare professionals, these caregivers will help in design the schedule for respite services as well as the resources required for those services. Typically, the respite services relieve families from the challenges associated with care or deliver the care when the families are not around.
Because the nurse services are the most needed and most difficult to access as a result of the shortage of nurses (Marć et al 2019), nurses’ input is required in terms of designing the care shifts depending on the needs of each beneficiary. More importantly, the nurses will play a significant role in the program evaluation stages, where they provide feedback to the program advisory committee on the program’s impact and any points for improvement.
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