Steve Lorberbaum:
Well, good morning, everyone. Welcome to this month’s edition of What’s Your Plan? So my name is Steve Lorberbaum. I’m the owner of Assisting Hands Home Care, and along with Patricia Dubroof, who is our marketing and everything else guru, we each month present an important topic that we think would be helpful in the aging population. It’s resources. It’s other information. It’s in addition to what we do, where we provide aids in people’s homes, but this particular month, we’re going to talk about how a certain group of people can get funds to help pay for the care we provide. So we’re delighted to have Jules Abate is about day from The Arc at Montgomery County who’s going to speak with us today. So Jules, welcome.
Julia Abate:
Good morning, Steve. Good morning, Patricia. Thanks so much for having me here today.
Steve Lorberbaum:
Yeah, so Jules, first and foremost, The Arc is a large organization that does lots of things. So just, if you don’t mind, give us a quick overview of the many services that Arc provides, and then we’ll sort of dig into what your particular area is.
Julia Abate:
Sure. I’d love to talk about what The Arc does and we do many, many different things. First thing is that we have an all-inclusive before and aftercare program that’s located in Silver Spring, Maryland. It’s an inclusive environment for children with and without disabilities. Also in the Silver Spring Kensington area, we have a sprint store. It’s called Urban Thrift and I encourage everybody to visit. Richard is the manager down there, and he’s got a lot of good stuff for sale at very reasonable prices. We also have adult inclusive services where we support adults with intellectual disabilities and that could be in one of our 35 group homes throughout Montgomery County. It can be in the individual’s home and it could be in an employment and day settings. So we have about 150 people in our employment and day setting, probably around a hundred in our families that are living with their parents or living independently with some staff support. Then there’s probably about a hundred of those folks.
Julia Abate:
So we’re supporting over 500 people totally in all those adult inclusive services. Then we have respite. So The Arc Montgomery County has been awarded the contract from the Department of Health and Human Services to administer and coordinate the system of respite. So what’s respite? Respite is designed to give the full-time living unpaid primary caregiver a break. It’s not designed for long-term care, but it is designed to give a caregiver a break. Now, we support more seniors than any other population, but we focus on four specific populations and they are children with challenging behavior, children and adults with functional disabilities, such as MS, lupus, diabetes, and children adults with intellectual disabilities. Again, our biggest population we serve are seniors and the best thing about this program for seniors is there is no income requirement.
Steve Lorberbaum:
Let me interrupt you there for a second to set the table a little bit because the reason I know Julesƒa is because we provide home care Potomac to people in their homes, right? So that’s what Assisting Hands does. We work all over Montgomery County and we work with couples, we work with individuals and we provide help to those in need. Oftentimes folks struggle to pay for our services. It’s not an inexpensive service, but it’s very important. So Arc and Jules provide a great program because they help subsidize the care we provide in people’s homes. So Jules, give us an idea of who is eligible to get support from Arc in terms of their age, finances, that sort of stuff. Because not every family that we serve is eligible to receive our respite support.
Julia Abate:
Sure. The most important thing is there has to be a primary caregiver residing in the same household as an individual with one of those four target populations we just spoke about. So for example, you may have a spouse caring for a spouse in the same residence, a parent caring for a child with a disability, a sibling caring for a sibling with MS. We have several grandparents who are caring for their grandchildren with intellectual disabilities. So that’s just an example of the people we serve in Montgomery County. They’re all caregivers. We have partners who are caring for partners.
Steve Lorberbaum:
If you live alone, this program isn’t for you.
Julia Abate:
That’s right. Unfortunately, it’s not. Now we do try to connect those people with some other kinds of services. Montgomery County has probably a lot of great resources for seniors, but living alone, unfortunately, you’re not eligible because there always has to be a primary caregiver because that is really what the service is for, to give them a break.
Steve Lorberbaum:
So it’s a break for that person. It’s less about the client. Not that they don’t need help, but it’s about giving the caregiver a break by bringing in a professional caregiver to give them an opportunity to go out to the store, go have lunch, get their hair done, whatever it is they want to go do.
Julia Abate:
Exactly. That’s exactly what the purpose is for.
Steve Lorberbaum:
Okay. Gotcha Sure. For the senior population, is there an age limit that you have to be over a certain age as the caregiver or as the client or for us, the client, the person needing care?
Julia Abate:
The age for seniors is 60. So if you’re a caregiver that is 60 years old or older, or if you’re a recipient that is younger than 60, but caring for someone that’s over 60, you can apply.
Steve Lorberbaum:
Okay. So if I bring my mom who lived in Georgia and she’s going to move in with me, but I’m 50 and she’s 80, I’m not 50, but this is hypothetical. If she’s 80, as long as she was living with me and could establish that she lives with me, then that would be a qualifying use of the funds?
Julia Abate:
Yup.
Steve Lorberbaum:
Okay. Gotcha.
Julia Abate:
Yeah, and that’s a good point to bring up. That is one requirement we cannot forgo. You have to demonstrate that the primary caregiver and the individual being cared for must reside in the same household 12 months out of the year. They need to prove that with an ID, a driver’s license or social security award letter, or a Maryland tax statement. So that’s key. We must demonstrate that to our county auditors.
Steve Lorberbaum:
Okay. So if someone’s coming to spend a month for a vacation, that doesn’t qualify them. Both people have to be a resident living in that home.
Julia Abate:
Yeah. That’s the most important thing and that’s really the only requirement, unless you receive some kind of Medicaid waiver, or if you’re receiving some kind of another form of paid funding for caregiving. For example, the VA has a program for caregivers so if you’re receiving some other kind of funding source, you may not be eligible for respite.
Steve Lorberbaum:
Gotcha. Okay. So basically it’s simple. The person receiving care has got to be over the age of 65.
Julia Abate:
60.
Steve Lorberbaum:
Over 60 rather. Two people have to be living together in the home and they have to fill out an application.
Julia Abate:
Right. That’s it.
Steve Lorberbaum:
Okay. Pretty darn simple.
Julia Abate:
Yeah.
Steve Lorberbaum:
So what’s the benefit? What do they receive once they get approved through Arc? What do they get?
Julia Abate:
Well, the first thing is that you need to fill in an application, which is on our website. But as you know, we have had an overwhelming amount of applications so we’ve had to stop taking applications because our funding is limited and we’re getting ready for our renewal season, which means that everybody already enrolled in the program has to renew their application so we focus on getting them renewed for the new fiscal year. But once you’re approved for respite, you’ll get a phone call from me and I provide the family an orientation about the guidelines of the program to make sure that they understand what the guidelines are, what their eligibility is, and what kind of services to expect.
Julia Abate:
So we tell all the families that The Arc does not provide respite itself, the direct care, but we have a large consortium of home health care agencies, respite facilities, adult medical day programs, and therapeutic programs that they can use their respite hours at these settings. Assisting Hands is on our consortium and has been for many, many years. So after I have the orientation or during orientation, I assess the needs of the families. There may be a need for a caregiver that speaks another language. There may be a need for a caregiver who has specific skills, for example, lifting. So there may be a need for a male caregiver, which, as you know, Steve, can be challenging to find.
Julia Abate:
So I kind of connect them with an agency that can meet their needs and typically we do this orientation in person, but since COVID 19, we’re doing it over the phone. So we will connect them with an agency like Assisting Hands and if the family says, “Yes, I’d like to work with Assisting Hands,” then what we do is start sending the authorization form over each month, approving hours, and they’ll continue to use their hours until they have exhausted all their respite hours. So families are eligible for 140 hours in a fiscal year. So our fiscal year starts in July and ends in June. So depending on how the family uses their hours will determine how long they will have respite hours for. Many families will use 40 hours in July, 40 hours in August, 40 hours in September, and then they’ll have 20 hours left for October. They want to use their hours and then many of them will just pay out of pocket or wait until the next fiscal year.
Steve Lorberbaum:
Gotcha. Okay. So if I recall, you got approval to increase the reimbursement amount so that now the reimbursement amount as of April 1 went up to $26 an hour. Is that correct?
Julia Abate:
Yes, that is correct. I’m always in touch with our consortium members and I knew that it’s been a struggle with COVID 19 to get caregivers. It’s costing the agencies a lot more money to find caregivers, to attract them to their organization. I saw there was a need and I advocated for an increase and, as you know, for the last five years, the minimum wage has been going up and it impacts our home healthcare agencies a lot.
Steve Lorberbaum:
And we appreciate it. So just to give an example, if we charge between $28 and $30 an hour, you’re going to reimburse $26 an hour, so the clients, for those 40 hours in that month, are effectively only paying $4 an hour or $3 an hour for the cost of care.
Julia Abate:
Right. That’s exactly correct. So it’s a big cost saving for the families. The family will determine what agency they want to work with. As long as they’re on our consortium, and there are, I think, 170 home health care agencies in Montgomery County. We don’t work with all of them. In fact, we have quite a large consortium. It used to be that I’d have to go out and recruit people beyond the consortium. Now I’m getting phone calls weekly. “I need to join your consortium.” But we just don’t take anybody. sometimes the family has been using an agency and if they can meet our requirements, we’ll onboard them, but we do have a lot of senior providers on our consortium.
Steve Lorberbaum:
Gotcha. All right, great. So I know you said that at the moment, you all have stopped taking applications. So is it that when the new fiscal year starts July 1, that’s when you’ll open up for applications again?
Julia Abate:
Well, actually we’re going to open up applications on July 6th. One of the reasons is we always don’t get our funding on July 1st. So I can’t really approve hours for the new fiscal year until I get that purchase order in my hand to proceed with approving hours. That information is on our website, so it’s always good for families to check our website periodically to find the latest and greatest news about our program. We were going to initially stop taking applications on April 30th, but we just got so many we knew that we were not going to be able to support the family because the funding is limited.
Steve Lorberbaum:
Gotcha. Not that I want to set the bar high for you. You have worked absolute miracles in getting people approved. I mean, there are times when I feel like they’ve made a phone call and an hour later, I’m getting the authorization if they’ve submitted all this stuff. But what’s the realistic timeframe that someone should expect from the time they submit the application that they can get funding?
Julia Abate:
We say 30 days, but it usually doesn’t. But if we’re doing billing, it slows down things. Sometimes we make one application in a week. Other times we could get 20 applications. So it really depends on the time of year. It also depends … We got a lot of referrals from adult protective services. So those are bumped up as a critical need and we get child welfare cases that come to our office. So those are our priorities. We also support many families that are enrolled in the hospice program. So we try to expedite those, but we’ve been so busy lately that we haven’t been able to turn them around as quickly as we’d like, but we do our best. But we’re very thorough about getting all the information. There’s a checklist on that application, so we really ask families to look at that, review it before submitting it, because if we don’t have everything we need, we will not process your application. You’ll get a notification and we’ll work with you to get the information that we need to process your application.
Julia Abate:
It’s been challenging for seniors because many of them do not use technology, but we’ve been working with them. Sometimes we’ll have to take an application over the phone and work with a caseworker if there’s a caseworker assigned to walking them through it. But many of our consortium members, such as you, Steve, will help families. They may already be connected with you using them, and Steve, you do an awesome job in referring all of your clients who are eligible for respite to our program. So from a business perspective, you’re really helping these families out and it’s a win-win situation for everyone and so many families will call me and say, “Hey, I didn’t know about this program and Steve told me about it.”
Julia Abate:
I’m like, “Well, that’s great.” We look to our members to refer them to our organization because we want to help as many seniors as possible. As you said, caregiving is a demanding job and it’s expensive. So when families can hear they have a subsidy for care, it’s just great news to them and they feel a sense of relief. So we always are looking for our consortium members to refer families to us.
Steve Lorberbaum:
Oh, good. I know I have gone out to people’s houses and helped them fill out applications and brought them back and scan them so I could get them into you.
Julia Abate:
Yeah. We really appreciate that because it’s been tough for seniors even to get out at all, feeling comfortable getting out and scanning and faxing. They don’t have the ability to do that. So we rely on our consortium members to help them out and it’s been very beneficial this past year.
Steve Lorberbaum:
It seems to me that … I mean, the application is really pretty easy, and I’ve been through it. The only thing that really is challenging is that you’ve got to get a doctor to fill out a form.
Julia Abate:
Right. Right. That’s the physician help forum. Part of that is to … when we put that physician help form together, we asked a group of nurses to help us with that. But we always have this problem with physicians thinking that a family member needs skilled nursing when they really don’t. They need assistance with activities of daily living, preparing a light meal, engaging in a conversation, or an activity with the senior. So we’re looking to change that to help families out and the doctor’s out. So it has been a little challenging, but we’re always looking at ways to make things easier for families. We’re trying to figure out a way that we can help seniors get that physician help form. I’ve heard from so many seniors that their doctor’s offices aren’t are not calling them back, but these are very challenging times for physicians, anybody in healthcare, so they’re just swamped.
Julia Abate:
So we’re trying to do our best to help them out. Sometimes, if a family has been in your program for many years, if the nurse feels comfortable and you’ve had a relationship with them, we’ll ask them to sign off for it. We had that problem recently where a very senior couple, very elderly, just could not get her doctor to sign this form. So we were trying desperately to get them help. He just came out of the hospital. So we can get creative and we do our best to help everyone.
Steve Lorberbaum:
Well, good. For us, we find that the people that need your support the most are our clients where the primary caregiver is just exhausted, right? They haven’t left the house enough because of COVID, in particular, they’re caring for their loved one, it’s tiring. They don’t feel that they can leave their loved ones alone, even for a few minutes. So getting approved for respite so that they can go even go to the grocery store, go get their drugs at the pharmacy, take a walk on the canal, all of those things are just … it’s the blessing that you all help provide so we can be they’re caring for their loved one and making sure that they’re being kept company and safe, having a meal. A lot of it is not high-end complicated care. It’s just giving someone a break so they can go recharge themselves because being a caregiver is exhausting.
Julia Abate:
Yeah. Many times I’ll speak to a family and so I’ll say to them, “So what do you see yourself doing with this time for yourself?” I always hear this pause and they often say, “I haven’t done anything for myself for years and I have really never thought about it.” So then I’ll ask them, “So what do you like to do?” So often I hear that many caregivers don’t have the opportunity to go to their services on the weekends, whether it’s Saturday or Sunday. They would enjoy the company of others in their religious community and missing out on their service was a big part of their life and they really miss that. So many times families will use their respite hours so they can go to service on Saturday and Sunday, and then maybe afterward they’ll have brunch or lunch with friends in their community.
Julia Abate:
They might take a few hours for themselves to go to the library or do some shopping. Then we have seniors that they don’t leave their house, but they sleep. They just need to sleep. They know someone’s with their spouse or their sibling and they just sleep. As you know, many seniors with Alzheimer’s are up in the middle of the night and keeping their caregivers up as well. So they just need time to sleep and they love that. I want to take a four-hour nap and that’s great. Or they don’t have the opportunity just to read. So many of them I’ve talked to used to belong to book clubs. They don’t have that opportunity because they’re constantly caring for their loved ones. So people use it for various reasons.
Steve Lorberbaum:
Gotcha. So I don’t know if we’re drawing to a close. Patricia, I don’t know if anyone posted any questions or if anyone has any questions for Jules or for me for that matter, please feel free to ask away.
Steve Lorberbaum:
All right. Well, it seems that you’ve done an exhaustive job, Jules, in making it pretty clear how you can get involved with the program. Again, go out to The Arc website. It’s Arc in Montgomery County. It’s got great information and it’s got the application that you can print out and make available. If you need a combo, you can work with both Jules and me simultaneously, which is fabulous, or Patricia.
Julia Abate:
Yup, exactly.
Steve Lorberbaum:
You can always give Patricia a call and she can help you started the process of getting support for someone you know or a friend. Then when Arc opens back up … and I’ll bet, but I’m not going to say publicly, that there must be … maybe I am saying publicly, that there’s some secret stash that Jules is hiding for those truly in need. Now I don’t know for sure, but I think that-
Julia Abate:
We do our best. I mean, we are now serving 658 people. Our youngest person being served as six months and our oldest is 107. We have 20 seniors that are over 100 years old in Montgomery County, enrolled in our program.
Steve Lorberbaum:
That’s amazing.
Julia Abate:
Taking care of 90-year-olds.
Steve Lorberbaum:
I know. That’s the thing. Go ahead, Patricia.
Patricia Dubroof:
I was just going to say, there’s been a bunch of thank you’s on the chat, just so you know. Everybody’s thrilled to know that The Arc Montgomery County is alive and thriving. One of the questions that came up was just how can other folks who don’t need respite care or these services help The Arc? I know you’re a 501(c)(3). Is there a fundraising thing coming up? Do you have any announcements you want to make to people before we shut down?
Julia Abate:
If you go to our website, there’s an upcoming fundraiser, coffee, and conversation. We’re looking for sponsors. This has been a difficult year for all nonprofits, including The Arc. At the beginning of the pandemic, we just didn’t have enough PPEs for our staff that support our adults with intellectual disabilities. Our After All program, before and aftercare for children, was definitely impacted by COVID-19. So there’s always room to make a donation. We welcome them all the time because we are non-profit and we’re always looking for generous donations from our community in Montgomery County. We thrive because of donations and we can continue to help support people with and without disabilities. So donations are always welcome and appreciated.
Steve Lorberbaum:
Great. Well, Jules, thanks again for joining. This has been really helpful and really appreciate you taking the time. I know you’ve got probably 50 calls in the half-hour you’ve been online with us.
Julia Abate:
Yeah, I shut that phone off for 30 minutes.
Steve Lorberbaum:
Good. So next month we have Kay Loughry. She’s a nutritionist who is really going to help us as well get on the path of eating better as opposed to eating a lot, which is what I’ve been doing during the pandemic. Now it’s time for me to eat healthy again and get back out. It’s swimsuit season for all of us. So in any event, have a great rest of the week and weekend, and, Jules, again, thanks so much. Patricia, thanks as always for your help.
Julia Abate:
Thank you. Take care. Bye-bye.
Patricia Dubroof:
Thank you, Jules. Bye.
Julia Abate:
Alrighty. Take care. Thank you. Bye-bye.
If you would like to schedule an appointment to discuss your Alzheimer’s and Dementia care needs or to set up a free in-home evaluation with one of our nurses, call us today in Potomic at (301) 363-2580, or VA at (703) 556-8983. We are located in Bethesda, MD, (301) 363-2580, and Reston, VA, (703) 556-8983.
