My Blog
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Shirley Tabb: Posted on Tuesday, August 23, 2011 3:41 AM
Well, it is almost official. The Elderly and Persons with Disabilities (EPD) Medicaid Waiver Program, that provides personal care assistance and home health services, including respite hours for caregivers, to people ineligible for Community Medicaid due to income/assets, will go to a “first come, first served” system and prospective program recipients will go on a waiting list. The problem with this system is that people can wait years for care. Hospice patients do not have that luxury, nor do some other sick and elderly people. We must raise awareness around the need for priority groups, including hospice patients and others more at risk. Maybe we won’t need hospice, but someone we love could need passionate care at home, sooner or later, if not already. Let’s save expedited hospice care with a reserved number of slots to ensure that care is available for end of life care at home and create priority categories for other fragile groups. Our petition is receiving national support, but we need others across the country to join this grassroots movement and begin dialogue around this federal guideline to ensure better care and quality outcomes for hospice patients and other fragile groups in need of Medicaid home health care. |
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Shirley Tabb: Posted on Sunday, August 14, 2011 6:39 AM
Write your post here.  Dying People are at Risk of Losing Home Health Care in DC The District of Columbia is the forerunner among states and other jurisdictions in providing home health and good long term care services , but that is about to change. The city reached its maximum of 3990 “slots” for personal care services under the Elderly and Persons with Disabilities Medicaid Waiver Program for Home and Community Based Services and the city’s priority is to recertify current service recipients to ensure continued care. Some states use a waiting list and perspective recipients wait for years. Many jurisdictions use a “first come, first served” system and hospice is not a priority category. The DC Department of Health Care Finance (DHCF) demonstrated a desire to make hospice patients a priority, among EPD Waiver applicants, and expedited hospice reviews/approved home health care for hospice patients within days to ensure the rights of people to die at home, in familiar environments, and surrounded by people who love them. Home care for people over the income/asset limits for State Plan Medicaid is in serious jeopardy. We must find a way to continue setting the standard for home health care in the nation and keep hospice a priority, as the Medicaid Waiver process is restructured, by allocating a specific number of slots for hospice patients. Please email me if you want to join advocacy efforts. If you don't feel dying people should receive priority status to preserve their right to die at home and have a better idea, please help educate me and those of us who strongly believe this is the right thing to do. |
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Shirley Tabb: Posted on Wednesday, July 06, 2011 5:54 AM
 I interface with elderly and disabled people regularly who express their frustrations and disappointment in the amount of food stamps they receive monthly. Some people feel it is not worth the time and effort. In addition, it appears that it could cost the government that much just to process the meager monthly benefit. I was incredulous when an elderly client, with very little income, who lived in the projects with no known resources or assets, told me she only received $10 in food stamps each month several years ago. This poor woman was gracious and appreciative that she got anything, at all and I suppose this is one way of looking at it. Of course, this was about 7 years ago. Other clients save the small allocation up for several months and, then, shop for food items. These people have become accustomed to living in poverty and are finding creative ways to "make ends meet". States use various names for this supplemental food program, including Supplemental Nutrition Assistance Program (SNAP), Food Supplement Program, Food Stamp Program, and Food Assistance Program. A few other states use a different name and the District of Columbia's program is called SNAP; but the locals still call the program "Food Stamps". No matter the name, the program is essential to ensuring that elderly and disabled people (without minor children) receive nutritious meals to keep them healthy. The people with whom I work have no significant assets, no money in the bank, nor stocks and bonds; yet, they are only getting $10 a month in nutritional food support. This is where the advocacy of social workers, elected officials, and the community is much needed. These archaic assessment tools, eligibility requirements, and benefits "calculators" require major adjustments in 2011. Send your ideas and comments to shirley.tabb@iamthecasemanager.org and let's begin a real dialogue around this and see how we can help those in need of more assistance with food and nutrition assistance. |
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Shirley Tabb LICSW: Posted on Sunday, June 19, 2011 6:21 AM
It is awesome to have been nominated for a Media Award in Excellence, let alone receiving the coveted Award in Excellence for Social Work and Case Management related shows with a focus on making the best of Medicaid Home Health Services and community resources. This information empowers the community and ensures that elderly, chronically ill, and hospice patients remain comfortable, with quality care in their homes. My goal is to produce more shows featuring hospice patients who are able to remain home and surrounded by people who love them, as well as additional programs on how Medicaid/Medicare, and private pay arrangements enhance the lives of people as they "age in place". |
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Shirley Tabb: Posted on Monday, May 09, 2011 5:52 AM
 The continued struggle of Cassandra Kelsey, the homeless Howard University graduate and Alpha Kappa Alpha (AKA) sorority member, prompted this post. Cassandra is unable to find housing in the District of Columbia, due to being just an "ordinary citizen" as opposed to having a criminal record and recently out-of-jail, substance abuse history, or mental illness. There are very few programs available for people who go to work every day and fall upon hard times, as in Cassandra Kelsey's case. Why is this? The social programs, not reserved for ex-cons, drug users, and people with mental illness, are reserved for senior citizens, children, and their caregivers. This is a sobering fact of life and we must work harder to create and fund programs for people who just need a chance to get their lives back on track. Some people have shown Cassandra Kelsey extraordinary kindness and generosity, including offers of housing, advice, money for laundry and toiletries, resume editing, and even the offer of a laptop computer (when she leaves the women's shelter). Unfortunately, the housing offers have been in private homes with stairs and steps that make it difficult to navigate due to degenerative arthritis. Ideal housing would include a home with first floor access or an elevator and near a bus/metro stop. Affordable housing in the District of Columbia is scarce and hundreds of people remain on the list for housing vouchers and government assistance. We also have a wonderful program, Money Follows the Person, which is an initiative to move people out of nursing homes into their own apartments/homes in the community. However, again, this is a program for people who have been in nursing homes for long periods of time, and is another catagory of need, in which Cassandra Kelsey does not fit. Programs that support people in the criminal justice system, our children and the elderly, as well as those fighting drug abuse and mental illness, are much needed and very important. We just need programs to include those of us who are, otherwise, un-noticed without community and government support, when we need the benfits of taxes we paid when were were one of the "ordinary" people who go to work everyday and pay our taxes. Cassandra is blessed to have Medicaid, but cannot take generic forms of the medication she needs for her degenerative joint disease and is becoming very ill. This adds a whole new level of grief to what is already a total night mare. |
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Shirley Linda Tabb Licensed Independent Clinical Social Worker: Posted on Saturday, April 02, 2011 9:47 PM
A long term goal and advocacy effort is finally about to become a reality here in the nation's capitol and I am so grateful to the Department of Health Care Finance (DHCF) and the staff of the newest director, Wayne Turnage, who is obviously on the same page as I am when it comes to prompt service for critically ill people. For almost (7 ) years, I saw many of my hospice patients die long before home health care was approved and no one saw a need for expedited care. After much advocacy and just continuing to press the issue, DHCF is working with me and we are getting services for dying people within days, if all eligibility requirements are met. This is a huge milestone and one, for which, I am extremely grateful. Now - the next goal is to get expedited care for elderly and chronically ill people. Yes, I storngly believe that we still need a priority system to process home health care applications based upon advanced age, extent of illness, and level of need. I assess people in their eighties and nineties and feel they should receive priority status, when it comes to processing their applications for home health care. Just today, I saw a woman who is 93 years old and last week, I assessed a 99 year- old client! These prospective home health care beneficiaries deserve priority status based upon age - alone. What do you think? I would love to hear from people in other jurisdictions to see how you handle expedited care if, in fact, you do. Shirley Tabb LICSW Case Manager |
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Shirley Tabb LICSW: Posted on Tuesday, March 15, 2011 7:21 PM
I have facilitated hundreds of Medicaid Waiver assessments to provide home health resources for the elderly, chronically ill, and persons with physical and intellectual disabilities in the District of Columbia since 2005. My mother was in the program and it was such a blessing for us. I was able to continue working on a job where there was very little concern or support for my elder care issues during the death of my father, brain stroke and subsequent death of my mother. Inspite of employers who had no compassion for what I was up against, the Medicaid Waiver program provided 16 hrs of care for my mother - seven days a week. Other services included among my mother's Medicaid Waiver services included: - 20 respite days a year - when my mother could get care up to 24 hrs a day in my absence, as primary caregiver;
- a Medicaid Waiver Case Manager who was wonderful and visited monthlh to ensurequick and easy access to eligible services and resources;
- the personal emergency response system (PERS) that provided 24/7 safety monitoring; and
- a nurse, who, visited monthly and provided collaborative care to ensure best practice care.
Upon the deaths of my parents, I was fired from my job of 14 years at DC Child and Family Services afrer trying to pursuade Director Brenda Donald Walker to treat children in the agency's Child Protective Services with dignity and respect. The verdict is literally still out on my termination from a job I loved, but working with Medicaid Waiver beneficiaries and those seeking assistance is some of the most rewarding work I have done in my career as a Social Worker. I am also in a great position to advise other caregivers of ways to protect themselves with the Family and Medical Leave Act so unkind managers and supervisors are restricted in their efforts to punish them for time spent caring for ill family members. Information on How to Get the Most from Medicaid Waiver Home Health Services and caregiver issues will be discussed on the premier of my upcoming weekly cable access show, Case Manager, where I will discuss various aspects of home health care, how to manage services when issues arise, and how to access community resources. The weekly show is availabe to over 800.000 households via these cable companies on the channels listed below: - Comcast - 95-96
- RCN - 10-11; and
- Verizon FIOS - 10, 11, and 28.
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Shirley Tabb: Posted on Tuesday, March 15, 2011 7:13 PM
 Hello and welcome! I am looking forward to bringing good information on community and government resources in the DC metropolitan area for the elderly, chronically ill, and people with physical/mental disabiliities in Washington DC. My goal is to host a 30 minute show - weekly - on DCTV - Washington DC, and provide health and community resource information to over 600,000 viewers in our area. I will also give recognition to outstanding caregivers and service providers who stand out from the rest and hope to help those in need with community support and tax deductible community donations. I enjoy helping people who need community resources to remain in their homes and communities and find that a large number of people are unaware of some of the wonderful resources available. The goal is to link the show's web site to community/government agencies and contacts for greater access to people. Please feel free to email your thoughts and ideas to make the show a good vehicle for the desimination of good information about community programs, resources, and people in need. Shows will air beginning in April 2011 in Washington DC and Internet sites including Face Book and You Tube for people to see outside the DC area. |
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