By Carol Meredith, Executive Director

A couple of years ago, Colorado learned from our federal partners (Centers for Medicare and Medicaid Services) that personal care services should be provided through the State Plan under Early Periodic Screening Diagnosis and Treatment (EPSDT). For many years, Colorado had only provided personal care services as a waiver benefit. To make matters more complicated, the service definitions for “personal care” across all of CO’s 11 waivers were different so everyone had different ideas about what these services covered.

Basically, personal care is a service that assists someone with a disability to accomplish activities of daily living such as: eating, dressing, bathing, hygiene, and the like.

I was able to serve on the Benefits Collaborative Committee that helped develop this benefit. It was a very long and slogging process, but I am happy to report that we now have some very nice tools to figure out who is eligible for what service and how much service they will qualify for/need. These assessment tools are used by home health care agencies and personal care agencies to determine if your child qualifies for skilled care (like nurses or certified nursing assistants) or personal care (unskilled providers according to the Department of Regulatory Agency – DORA).

This got me to thinking…how would I use these services if they had been available for my son when he was a child?

The first thing that came to my mind was our morning routine!

In our house, mornings were a nightmare!  Everyone had to be bathed, dressed, fed breakfast, teeth brushed, backpacks packed, homework checked, coats and shoes secured. Then fly out the door in time for the school bus. Of course all families with young children have to do this every day, but my son was very uncooperative with these tasks. He would fight you at every level. Just getting him to eat breakfast was a wild and crazy affair with offers of food – most rejected – then cajoling him into taking a bite – take another bite – drink your juice – on and on and on. By the time I got him on the bus, I felt like I had just run a 5 K without the runner’s high. I was completely frustrated and exhausted.

So if personal care had been available to my son, I would have jumped at the chance to have someone else come into our house and do all these tasks for him, so I could pay attention to my other son, husband and myself (a little caregiver wellness).

The takeaway:

• EPSDT is a Medicaid benefit available to children and youth ages 20 and younger (who are eligible for Medicaid).  EPSDT protections end on the 21st birthday.

• Your child does NOT have to be on a waiver like Children’s Extensive Support, Children’s HCBS (Katie Beckett), Children with Life Limiting Illness, or Children with Autism.  However, IF your child is on a waiver, that means your child is eligible for all Medicaid services including personal care. To find out if your child can access this benefit, please contact one of the providers on this list.

Do you have more questions? Let’s chat. Leave your comments below.