Ask Mike - Finding attendants willing to travel to my rural residence and work for me

Dear Rural Resident,

This is a tough problem all over the country. Many programs do not provide mileage reimbursement,but you should see if it is available, and if not,see if an exception can be made for rural cases where this issue become critical. Additionally, many programs do not allow family members to be paid workers. The federal rules only prohibit spouses and parents of minor children from being paid, but many programs are much more restrictive. However, the federal (Medicaid) rules allow exceptions even to the spouse/minor children rule for cause, including lack of availability of workers due to ruralness.

Ask your case manager/counselor for your state's rules about who is allowed to be paid for work and about any appeal/grievance procedure. If need be, file an appeal to allow family to be paid to help you, if that's an option for you. (See the answer to another question for more complete details.)

Finally, and I cringe to bring this up, but some areas are just so rural and remote, that there are simply not people around to help especially if family is not available. In these tough situations, at my CIL, we have asked if folks are interested in relocating to an area where more options are available and if they need assistance relocating we offer help with doing so. Again, this is a very tough answer, but in the realm of all possibilities, it has been used by some as a better answer than going to a facility.

Best regards,
Mike