Mary met Rachel through her local advocacy and community work. Rachel, who has dual mental schizoaffective disorder and developmental disabilities, can be prone to violent outbursts. Mary is known for her expertise in mental health and de-escalation. She began working with Rachel, and when Rachel’s mother passed away, Rachel chose to live with Mary and her family. Mary’s husband is Rachel’s legal guardian.
Rachel receives self-direction through Medicaid, which means Mary is able to make decisions on how Rachel needs care based on her needs. Through Medicaid, Rachel receives therapies, preventative treatments, counseling services, and wound care. She has also been able to obtain a gym membership, helping her to lose weight and reduce her medical complexities.
Mary is employed as one of Rachel’s Community Service Workers (CSWs) through Medicaid. She helps Rachel bathe, keep up with her hygiene, preps her meals and assists in engaging Rachel with their community. Together, Rachel and Mary run a non-profit for caregivers and their care recipients as a community outreach effort.
A team of CSWs also assist Mary and Rachel. These other CSWs are Mary’s form of respite – when another CSW is with Rachel, she is able to take a break to do things with her kids or for herself. Without this team of CSWs, Mary would experience extreme burnout. If the CSWs were to be cut from their lives forever, Mary would not be able to keep Rachel at home with her. Instead, Rachel would have to go to a state-run institution. This team of CSWs is a family to Rachel. If Medicaid were cut, they would lose their livelihoods helping to care for Rachel.
Idaho doesn’t have dual diagnosis programs, and it is extremely difficult to find any insurance or programs that are able to correctly support the complex medical needs of Rachel. Medicaid self-direction means that Mary can make decisions for Rachel’s care that best support Rachel. Mary is also able to receive support in this challenging care situation. Without Medicaid, Mary and Rachel would be unable to stay together.
“Medicaid is a lifesaver. It will literally kill people to cut Medicaid. It’s that simple.”