Eligibility Criteria2

Eligibility Criteria Emily Williams Capella University SWK5006: Social Policy and Planning in Human Services Dr. Phillip Farmer July 28, 2022
Program explanation When considering entitlement programs there are many options. Entitlement programs are federally funded and are required to make payments to any individuals or government unit that meets eligibility requirements (Chambers & Bonk, 2013). Entitlements are a federal obligation that if not fulfilled, eligible individuals can seek legal repercussions (Glossary of the U.S. Senate, 2018). The entitlement program I will discuss and analyze the eligibility criteria for is Medicaid. More specifically I would like to talk about the Long-term care program under Medicaid. This program provides assisted living accommodations or caregiving assistance in the home to eligible individuals. I chose this program directly as it relates to the care needs of many hospice patients. Eligibility Criteria Medicaid utilizes categorical grant funding meaning everyone who is eligible will receive benefits regardless of amount of money being utilized through out the fiscal year. Additionally, this program is income based, individuals who are of lower socioeconomic status will qualify while others who have a higher income will not. In order to qualify for Medicaid assistance, they not only take into consideration income levels, but they will also look into the cash in the cash in bank accounts, as well as the equity in your assets. The qualification limits an individual to having less than $2,000 in their bank account and less than $130,000 in countable assets not including the client's primary home. Also included in the financial criteria for eligibility an individual's monthly income cannot exceed $1,166 (Cobb, 2022). In addition to the eligibility requirements for Medicaid the Long-term care program also requires an individual to be 65 years of age or older or be officially deemed disabled and require assistance with their activities of
daily living. The amount of assistance needed with their activities of daily living changes the amount of funding for Long-term care assistance one is eligible for (Cobb, 2022). Potential Problems One of the potential problems with entitlement programs listed by Chambers and Bonk (2013), is Stigma. I would like to say there is no stigma around the use of Medicaid assistance, however that would not be accurate. Medicaid assistance comes with a stigma insinuating that the individual will be hard to deal with, have poor living conditions, or be a burden on the agency acquired to help in their care. This stigma is not always an accurate look at the persons situation and thus becomes a problem for individuals seeking assistance. This stigma also encourages Alienation, another problem listed by Chambers and Bonk (2013). This stigma leads to alienation by making it increasingly difficult to find Medicaid spaces at facilities or acquire quality caregivers. Individuals providing caregiving services would rather work for someone who can pay privately, and facilities would rather move in a private pay resident, thus alienating individuals from the help they need and qualify for. Chambers and Bonk (2013), define off-targeted benefits as benefits that are allocated to clients who do not need them, thus preventing some of those who do need these benefits from receiving them. This did not appear to be an issue prior to COVID19. Individuals who were eligible received these benefits and were required to reapply for them on a biyearly basis to keep their Medicaid active. Since COVID19, individuals who have applied for Medicaid are given continuous enrollment and no longer are required to reapply to maintain benefits (Medicaid, 2021). This becomes an off-targeting issue as individuals who would no longer qualify for these benefits are receiving them ongoingly. Continuous enrollment has also increased costs for the
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