Texas Medicaid gaps can trap disabled Texans in hospitals

Kaitlyn Cunningham sits in her wheel chair in the hallway of Cedar Park Regional Medical Center in Cedar Park, Texas on March 13. Cunningham and her mom Kathy Cunningham would walk down the hallway to look outside of the hospital windows at the birds.After surviving five surgeries and near organ failure, Kaitlyn Cunningham just wanted to go home. Instead, she would face another trial — fighting her way out of the hospital.

Trying to secure that care, though, would send the Cunninghams into a dizzying circle of siloed programs — an experience not uncommon for medically complex Texans, especially those who are on Medicaid waivers, specialized programs that offer services like caregiving and therapies. Her Medicaid waiver program, Community Living Assistance and Support Services, or CLASS, made those therapies and access to caregivers possible. But she hadn’t used nursing services offered through CLASS before.

It’s a “problem across waiver programs,” Corbett said, although CLASS, as an example, is a more difficult program to get medical services through. “There has to be more done, to help people who are getting services to remain at home. This idea of having to be trapped either in a hospital or a nursing facility — it’s just awful,” Corbett said., the state funds these organizations — and when they may report higher costs of care, the state may increase how much it pays them.

Now that they’re home, she’s taken over all other medical care for her daughter because they still don’t have a consistent nurse. They had worked out a unique deal to finally leave the hospital: their insurance would cover a contracted nurse to visit twice a week to help care for Kaitlyn Cunningham’s wound until they found someone through CLASS.

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