Episode 41: Cohosting with Sam Moore, plus all about Medicaid waivers

Demand and Disrupt

Chances are, you or someone you know would be a prime candidate for the Medicaid Waiver Program. Sam Moore interviews Sarah Duncan, Director of Waiver Services with Green River Area Development District. Sarah discusses Eligibility requirements and the process of becoming enrolled.

This episode originally aired on Sam’s all-about-Kentucky podcast, Blabbin’ in the Bluegrass.

Thanks to Chris Ankin for use of his song, “Change.”

The book "A Celebration of Family: Stories of Parents with Disabilities." is available from Amazon here.

Visit Moving Forward, the Advocado Press blog.

Send comments and questions to [e-mail]

Demand and Disrupt is sponsored by the Advocado Press and the Center For Accessible Living.

You can find the transcript in the show notes below when they become available.

Transcript Welcome to Demand and Disrupt, the Disability Podcast.

Here we will learn to advocate for ourselves and each other.

This podcast is supported with funds from the Advocato Press based in Louisville, Kentucky.

Welcome to Demand and Disrupt, a Disability Podcast.

I am your host, Kimberly Parsley, and today I am here with someone very special.

I am here with Sam Moore.

How are you, Sam?

Well, I'm glad somebody thinks I'm special, Kimberly.

I'm doing great, and it's an honor to be back here on Demand and Disrupt for my second time.

Yes, this is your second time.

Now, for those who might not remember, Sam is a, well, he's a WKU graduate.

That's the most important thing.

Go tops.

Go tops.

He's from Henderson, Kentucky, and he does a podcast called Blabbing in the Bluegrass, which is one of my go-to podcasts that I listen to every week.

Love it.

If you haven't already, you should check that out.

And a couple of weeks ago, as I was listening to Sam's podcast, he did an episode on Medicaid waivers.

So, Sam, tell me how that came about.

Tell me about that episode.

Well, you know, I try to keep an open mind to pretty much everything on my podcast as long as there's a Kentucky connection there.

And Sarah Duncan is the lady's name.

She was actually my special guest.

And I enjoy interviewing health care professionals that have made a difference in people's lives here in the state from time to time.

And Sarah is the Director of Waiver Services with GRAD, which is a Green River Area Development District.

I know you're somewhat affiliated with GRAD down there in Bowling Green, aren't you?

That's correct.

That's the Barron River Area Development District.

So same kind of thing, different place.

Yeah, same kind of thing.

So I thought it'd be cool for her being, you know, because that program, the waiver program has really been a godsend to a lot of people.

So I thought I would ask her to come on and talk about the different types and the qualifications.

And yeah, she was great.

It was, it was, I mean, it was so informative, just so much information for me.

I work at the Center for Accessible Living and stuff I didn't know and just also for our listeners.

So that's why what you're going to hear here shortly is just a re-airing of Sam's episode that he did with her.

I always enjoy hanging out here in the podcast world with Kimberly.

And I've even had her and Lisa McKinley on my show and we talked about there.

So we've had a few joint efforts going on, but like she said, my podcast is blabbing in the blue grass.

And I like to feature restaurants and musicians from Kentucky, authors, athletes.

Like I said, I try to keep an open mind to pretty much everything.

You know, as long as there's a connection centered around Kentucky there.

And I've also done educators and health care professionals.

And so I've got the podcast that I do and I also here in Henderson host trivia at a couple of different pizza places.

So Kimberly, if you're ever in Henderson on a Monday or a Thursday night, chances are I will be hosting.

Monday nights I host at Rock House on the River and Thursday nights I host at a place called Fire Dome here at Henderson.

So Kimberly, I think you'd like both places if you like pizza and wings, which I'm sure you did.

I tell you it pub trivia.

That just sounds like that sounds like so much fun.

And people take it very seriously, don't they?

Oh yeah.

You'd be surprised even though they may be friends of that are, you know, talking and mingling amongst themselves before the game, but then they split up and form their teams and they're, they're competitive during the games.

And you, you emcee that, right?

Right.

And I come up with the different questions each week, which is a challenge, but a fun challenge that I enjoy.

And so how many questions do you have to come up with?

Well, there's four different rounds and they're, they're generally random categories each week and then four questions in each round.

And it's, it's, it's random, random trivia categories pretty much.

It's a random knowledge.

I'll have four different ones.

The only time we ever have like an overarching theme is like on the trivia before Halloween, we'll do a Halloween trivia usually.

And then last one before Christmas, we'll do a Christmas trivia.

I know by now a lot of people are probably sick and tired of hearing about the election, but one, one trivia category that I did Monday night centered around, you know, election short comers.

And they were people who had run for either president of the United States or governor of Kentucky that came up short.

Maybe they were runner up or shorter up than that, but the bottom line, they just didn't win.

And, and we tested the, the participants knowledge and recollection of that.

So, and did they do well?

Did people know a lot of that or was it all new?

Yes, a sort of a mixed bag.

I think some of it went back a little far for people.

I'll, I'll test one on you, Kimberly.

Do you remember who Bill Clinton defeated on the Republican side when he ran again in, in 96 for the second time?

Yes, I do.

I'm old, so I have to think about it.

But you were, you had graced the world with your presence.

I was voting.

I was, I was a voter then.

That would have been my first election, actually.

The first election that I voted in.

Yes.

That was my first time to vote.

And Bill Clinton defeated Bob Dole.

There you go.

Yeah.

I think, yeah, that was not my hardest one, but I think, I think some people had to think about that for say, and it might've been a little harder since, you know, the, the game was sort of on the line, but, but you know, Bob Dole did lose that election, but a definitely a proponent for people with disabilities overall.

I was still, I was only eight years old at the time.

So I really didn't get to know him too well.

Yes.

Yes.

He, he, he was, I believe there was even a, an adapt to sit in, I believe, I believe one of our recent guests on the podcast talked about in Senator Dole at the Times office.

And so they weren't going to leave until he threw his support behind the ADA and, which then did come into law in 1990.

So I'll tell you what, he definitely gets props for me for, you know, being all for and all supportive of the disability community.

Right.

Yes, exactly.

So very timely that you, you, you threw that question out of me, just out of, out of thin air.

Thanks for that, Sam.

I'm all about curve balls, dealing them and taking them.

Did not prepare me for that at all, but Hey, that's, that's how we roll.

So thank you, Sam, for joining me for the work that you do on Flabbing in the Bluegrass.

And guys, you're going to be hearing more from Sam Moore in the future.

And if you want to reach out to Sam, you can always listen to his podcast, but you can send an email to demand and disrupt at gmail.com and I will pass those emails along to Sam.

Absolutely.

Yeah.

The man that disrupted gmail.com or bluegrass blabbing at gmail.com, whichever CC is for you to remember.

There, there you go.

All right.

And now, so Sam intro, intro this episode for us.

All right.

Well, as Kimberly said, this is Sarah Duncan.

She is the director of waiver services.

She was a guest on my show about a month or so ago.

And we talked about the Medicaid waiver program.

And so she's going to describe the different aspects of it and the qualifications.

Some of you might qualify and, and maybe not even be aware of it, or maybe you know somebody who would qualify and maybe not be aware of it.

So we're going to talk to, to Sarah here and this is a full show.

So there'll be a bluegrass brain buster, my, my trivia question at the beginning.

And then you hang out while Sarah and I are talking and, and you'll get the answer at the end.

So I hope you enjoy and thanks so much for having me back on here, Kimberly.

All right.

Thanks guys.

Thanks for listening.

Here's our interview.

The hard work and dedication of our healthcare professionals throughout the state certainly deserves more recognition and attention than it often gets, which is why we do a little thing around here every so often called the healthcare hero spotlight.

And in it today, yes, mischief, my cat is all excited yet again, you know, when she's excited about my topic, she always climbs up here, tries to climb on my lap or gets close beside me.

But anyhow, we are going to talk to Sarah Duncan.

She is the director of Waiver Services from GRAD, G-R-A-D-D. That stands for Green River Area Development District.

And the Waiver Services program has been a real blessing to many people, yet there are still many that undoubtedly would qualify for the program that aren't familiar with it.

Now it includes two types of waivers.

There's a home and community based waiver, and then there is what is called the Michelle P.

Waiver.

What are the similarities and differences?

Sarah will take us through those.

She will also describe what inspired the Waiver Services program in the first place, and she will touch on eligibility requirements and the process of enrollment.

It's going to be fun, it's going to be informative.

So buckle up for Blabbing in the Bluegrass Season 10 Episode 17.

Kentucky features so much more than basketball and horses.

We're home to scenic spectacles and one-of-a-kind golf courses.

If boating, fishing, dining, or music is your pleasure, we'll guide you to the sights and sounds that you will truly treasure, cause we're blabbing in the bluegrass.

There's nothing here to hide cause we're saying it with pride, just a blabbing in the bluegrass.

With knowledge of the state you're sure to appreciate, yes we're blabbing in the bluegrass.

Where musicians furnish talent and great whiskey cools your palate, just a blabbing in the bluegrass.

With a fit for every taste, precious time is not to waste.

From Prestonville to Prestonsburg, Princeton to Pride, we do what we do each week with pride and enthusiasm.

We fit this great commonwealth just like a glove.

If not better, hear it only here on Blabbing in the Bluegrass as we explore and celebrate all people in all things Kentucky.

With me, Sam Moore, got the steaming hot cup of coffee to my immediate left in case you were worried about it.

I tell you, you need it on a day like today when there's a little crispness in the air, but I'm not complaining because tis the season and you know when you combine cool weather with hot coffee, it is truly an all American combination to say the least.

Now we talk about doing what we do with pride and enthusiasm, but we also have great guests on a weekly basis who help me to make this show a reality and this week's guest is no exception.

She's great.

No, don't tell her I said that.

Her name is Sarah Duncan and she serves as Director of Waiver Services.

Now if you're not familiar with that or what it entails, don't feel bad.

I have noticed that there are considerable gaps in our knowledge of the Waiver Services program, which is why we are spotlighting it today and of course Sarah works with Grad, Green River Area Development District, which is based in Owensboro, but these services are offered all throughout the state so even if you are not located in Grad's territory, you can take the info that you gain from Sarah and apply it to your area because chances are even if you don't qualify for this program you probably know someone or multiple someones who would qualify for the program whether they be in your family or friends because I tell you this program has has benefited countless individuals but not nearly enough due to the the knowledge gap but we're going to do what we can to change that this week and we're so glad you're here because you're going to learn a lot and enjoy the heck out of the learning process so we're going to get to Sarah in just moments but before we do I do have as per usual a bluegrass brain buster we try to do one of these on a weekly basis so you'll get the question now while Sarah and I are doing our thing you can think on it but don't think too hard we don't want you getting distracted and missing pertinent information that you would definitely regret missing and we will clear up any confusion with regards to the answer in the program's final segment so since we are spotlighting a health care hero this week I wanted to know what is the oldest hospital in the state of Kentucky again which hospital has the distinction and it's still in operation by the way which hospital has the distinction of being the oldest in the commonwealth of Kentucky you get the wheel spinning we will let you know in the closing minutes of the show Sam Moore now presents a kind and courageous health care hero the Medicaid waiver program has really meant a lot to a lot of people and it could mean a lot to a lot more if they only knew about it that is a big reason why we invited this special guest on to the the program today she is the director of waiver services with grad and if you don't personally qualify for this program like we told you up top odds are you know somebody or a bunch of some bodies that would whether they need you know special in-home services respite care supported employment you know this this program may be just the ticket to what you or those people you know are after and need so here to tell us all about how the program first came to be and the two waivers encompassed within the program and how we might qualify let's make welcome from the grad office in Owensboro KY none other than Sarah Duncan thank you thank you for having me this is a great program Sarah and I'm so excited to enlighten our listeners on it now you you proudly service its director director of waiver services over there at grad now it's based in Owensboro obviously but for those that don't know why don't you tell us the the counties that the Green River area development district includes Sarah okay we cover seven counties across the region where um kind of the the northwestern area of Kentucky and we cover Henderson Union Webster and Davis I think I've impressed you right with real those also so easily I'm sure you've done it plenty of times but anyhow this is a position you probably didn't know would exist in your early life but tell me about your career interests as a as a child and describe what fueled such career interests Sarah so really I had to think back on this Sam it's it's hard because I'm older but um really I remember wanting to be a marine biologist whenever I was a kid and then I realized I'd have to move somewhere else and I didn't want to leave Kentucky or Henderson so I decided to to just forget about that and then as I was at the community college getting my associate's degree and they gave me or let me take one of those career tests and that test told me that I should look into the helping profession so any profession that could help others is is where that led me and then of course that led me to my degree in psychology um from USI yeah so not too many marine biology openings in the uh greater Henderson area so you know it's nothing wrong with dreaming big but I'd say but I'd say that you uh ended up where you needed to end up for sure and that's a springboard into our next item here as you just alluded to you uh went to University of Southern Indiana as a college student after you graduated from uh from high school you said you majored in psychology so uh let's talk a little bit about that more so and elaborate on your studies there on the west side of Evansville along with the career exposure you gained to supplement the books there miss Duncan okay so you know I went to the community college for my first two years and transferred to USI and I got a bachelor's in psychology and then a minor in sociology and while I was taking a class at the at the college there and we had a man come in and speak to us about the southwestern Indiana mental health center and he talked about some of the jobs that they had available one of those was a mental health technician and so I applied for that position and got that and worked part-time while I was getting my degree and pretty much what that was is we worked in group homes for people that had been released from the state hospital and had mental illness and that that job really showed me my passion for working with those that needed extra help and support and to be able to stay in their home and community as long as possible now talk a little bit about your uh career endeavors you said you worked with um southwest indiana mental health while you were in college so talk about your career endeavors between that and your current gig with grad as director of labor services so once I graduated with my degree from usi I stayed with southwestern indiana mental health center and was a mental health case manager so that was a little more um where uh the individuals lived in the community in their own homes and they would have a case manager come in and check on them kind of help guide them help make sure that they they had everything that they needed so they could continue to stay in their home and after that position uh and I had a friend whose dad was on the board of the community or henderson county senior services and so I had applied for that position so I would be closer to home and I got that and in that job I coordinated senior services for henderson county through the gathering place okay so you stayed home that position yes and so that position is how I was connected with grad because grad does senior services and they are kind of the oversight for the gathering place and they provide the funding for that program so I became a case manager with grad to go in and get the assessments and home home services set up for them and that would help with like the meals on wheel and other in-home supports um for those that need it so that's kind of how I came came to grad and was introduced with grad and then I have been at grad for 19 years 2006 is when they started talking about this new program which was the consumer directed options program for medicaid waiver and that is that is how I got involved with program I volunteered in addition to my aging case management cases and it just exploded after that we you know we continued to get new people it was a program that was very needed in our region and it gave people a lot of flexibility as far as who they could they could have provide their care and so currently we are serving 750 participants in our seven county region so it's pretty crazy to think we started with just a few and now we we've grown to 750 yeah that talk about explosion so you've so you've been involved um with um you know the waiver program in some form or fashion since its inception at um let's say that was 2006 how long have you been its director as director and that's more recent that's been within the last three years we um we were part of another department social services and we currently have 24 staff that do the waiver services through grad so once we got up to a certain number they decided to to break off and let us have our own department so that's how that was created about three years ago well I'd say you're more than qualified with your wealth of experience in in case management and work with senior citizens I mean it pretty much uh runs the the whole gamut to say the least so uh way to go I know what you know monitoring 24 employees gets uh you know I'm sure it makes your head spin from time to time but it's it's well worth it and I know it's I know it's rewarding for you in the end now Sarah before we dive into the nuts and bolts of the waiver program and its potential candidates uh you know we talked about this a little before we went on the air your typical day-to-day responsibilities as its fearless leader I know those very you know sort of depending on the day but that's that that's a good thing because it it prevents boredom and as they say variety is uh is the spice of life so uh you know talk talk about the variations that uh that you enjoy uh you know from day to day often in your role as director of waiver services well fortunately I have amazing staff um if I didn't have the people that I have my my day-to-day responsibilities could be a lot more difficult but um you know we together as a group we problem solve a lot there's a lot of supervision and you know we will have different situations come up that that may be new that we've not dealt with before or it may be something that we you know deal with all the time so it's a lot of of just working together problem solving helping each other and we work as a as a team you know if somebody needs someone to go out and do a home visit then anybody's willing to jump in and do that so um I have to say I'm very blessed um with the staff that I have because they're all amazing and we wouldn't be able to do it without them for sure it just goes to show that uh team chemistry is uh important in the workplace uh as much if not more so than in sports right definitely definitely yep and uh your office is is proof and it's great that you have that uh camaraderie you know among the employees and that everybody is is willing to make each other's lives easier with a a common goal in mind that's that's what it's all about Sarah so why don't you discuss uh the in the inspiration behind this medicaid waiver program and the manner in which it first came to be back in 2006 so the the purpose of the medicaid waiver has always it has existed longer than 2006 but it didn't have that consumer directed options portion that I had mentioned so traditionally the medicaid waiver is to provide in-home services to those that would need to go into like a nursing home or possibly go into a facility if they didn't have someone help them with their day-to-day task so medicaid was looking at it and realized that people should be able to make choices in their lives they should have freedom and who and how and when and where the care that they receive is provided so that's how in 2006 they got the they started consumer directed options which is now referred to as participant directed services so sometimes you may hear people refer to it as pds but what that does is that allows the participants to hire who they want to provide their care and our agency takes care of that payroll processing making sure that they pass the correct background checks and then making sure they're paid for the time that they've submitted through the medicaid program so it it has it's been a blessing to many people because you know there's a lot of people that didn't want an agency to send somebody into their home they would prefer it to be someone they already know and are comfortable with so that has been the the biggest part of this program has allowed that flexibility for participants to get the services that they need so they can stay home yeah stay home a lot longer than than maybe they would be able to otherwise so they choose who they want your organization gets them paid and you know it's it's a great hand-in-hand joint effort there so 2006 is when the you know the participant directed option first presented itself how far how far back do waiver services go do we have any idea on that one sarah you know i honestly i should have looked that up but i feel like they've been around for a long time they just weren't accessed as much because people just didn't they didn't have that comfort with being able to choose somebody to come provide the service for them yeah but we do still have people that that works well for so we also have clients that receive in-home services from agencies we do case management for that as well so i want to make sure that people know it's it's not just you know one way we can we can make sure some people switch back and forth between the two they may have an employee that's not working out for them and they don't want to mess with it and they want an agency to send somebody and so we can do that for them as well okay so so if they want an agency to send somebody you know you can you can handle that as well either way if they want to choose their own or or uh you know take their people as chosen by you either way is is fine and either way works now um do we do we have a a general gist of the average age for your participants there at least in the grad region sarah oh gosh we have and that's one thing that's great about this program is it's not based on age this program we will have infants um all the way to i think at one time we had a hundred and in in the program so there isn't an age i would say probably the the majority depending on what and the traditional services which is what where that agency sends a staff person in typically that's a little older age group because they don't want to have to hire somebody and oversee the payroll and submit time sheets for payment and then the participant directed services may be a little younger younger ages and then it also kind of depends too if you're in the michelle p waiver or if you're in the homing community based waiver um because those are a little different requirements based on um you know based on what that person's diagnosis is qualifications are are a little different and we'll get to those here uh in just minutes as well but it's great to know that you know between zero and and 110 you know that's a a wide and flexible age range and you always have outliers but it's you know there's always exceptions to you know the average ages of people that need certain services so it's great that in many cases this waiver services program is able to accommodate these individuals now within this commendable program sarah as you alluded to we find two different waivers for which individuals may perhaps qualify so why don't let's first describe the impressive variety of services available we'll talk about the michelle p waiver momentarily but let's start out with the home and community based waiver okay um one thing is there are actually grad only does the home and community based waiver in the michelle p waiver but there is also other waivers that the state does that different agencies do and one of those is called the supports for community living waiver one is the acquired brain injury waiver and then another one is model two waiver which is for people that are event dependent and that's done through more of like a private duty nursing agency so there are a few more waivers but grad just doesn't provide the case management for those we do the home and community based waiver and the michelle p waiver but the home and community based waiver for people that are diagnosed with physical disabilities and and and that disability has to result in them not being able to perform daily activities in their home so they may need help with grocery preparing meals medication management help with bathing grooming transportation and and and with you know with that program their caregiver can provide all of those different tasks for them within that home and community based waiver okay well that's neat and they can of course choose their their caregiver if they want to or have it provided now you said over 700 some otter in the waiver services program altogether there grad do we know about how many of those uh benefit from the home community based waiver is it about 50 50 or slightly more honestly the home and community based waiver is where most of our growth comes from because up until recently there's not been a waiting list for that so just anyone that needed that service was able to to get that through the um eligibility enrollment process so i am i'm thinking we're probably around probably around 450 in the home and community based waiver um you're gonna make me do math sam i'm not good at math um no i would have thought that math was your ultimate the only reason you didn't major in it sarah's because you didn't want to show up your fellow classmates you're correct you're correct the michelle p waiver we've got around 200 and then the traditional home and community based which is where that agency staff comes in we've got around 100 in that program okay so the vast majority of your clientele falls within the home and community based compartment which is great that that it's thriving and it definitely you know justifies the the existence of that particular waiver for sure but let's switch gears now shall we to the michelle p waiver which even though you know those participants are in the slight minority at this point that could change especially as uh as word gets out about this particular waiver and uh it's many noteworthy benefits so let's talk about the services available through the michelle p waiver there sarah okay so the michelle p waiver is for those that are diagnosed with either an intellectual or a developmental disability um a lot of those also may have a physical disability but the primary diagnosis has to be intellectual or developmental um with the intellectual their iq does have to be below 70 um in order to be eligible for that so it's a little more stringent requirements than the home and community based waiver is um they they honestly have very similar services between the two waivers but michelle p kind of focuses more on the community living side of it so the the purpose of the michelle p waiver is to help help individuals learn and grow and um teach social skills by taking to the movies or taking out to dinner and work on finances and how you pay for your meal how you tip how you communicate with the server so um it it also provides behavior supports which um would be if there are any behavioral issues there is a behavior support specialist that would be able to either come to the home or that client could go into that agency and they will assist with um you know trying to figure out why those behaviors are occurring and help train the family to learn how to how to change those behaviors or how to work with those and then supported employment is another service that's offered um through michelle p which is a great service um to help individuals you know get in the community and help help them learn learn a job and be able to work that is very valuable indeed so whether they be business or pleasure this michelle p waiver helps work with the clientele on proper etiquette to yes they'll be able to not only enjoy those but communicate effectively and have the essential skills and tools they need to live life to the fullest bottom line so um anyhow you know you you've basically touched on the the qualifications and they they vary between the two waivers obviously and so you know depending on which waiver you're trying to investigate or that you're aiming for you'll you'll need to meet different criteria but um how does how does one assess whether or not they are eligible for for one of the waivers how do they go about determining whether or not they meet the criteria so and the waiver programs are based on both the income and the need so pretty much medicaid realized that there are individuals out there that's income may be higher than regular medicaid would would assist with so they developed the waivers to where if you have your income within a certain certain amount and your um you have that need it puts you in a different category and it just goes by that one individual's income so a lot of the time we will have kids in the program whose parents you know are not on medicaid but that child is medicaid eligible because they have a need for in-home services and their income it goes based on that one person's income which with most children is zero so um what i always suggest for people to do is to call our office um and talk to our aging and disability resource center and we have a 1-800 number and then we also have just a regular number for for people to call in and speak with that person so if that person just talks to them about what their needs are and they may be eligible for other things that grad knows about or that grad serves does through through our office and they can actually refer them to any of those programs to to help them get services that's neat so there's an 800 number they can reach out that way talk to an expert so there's not necessarily um a case manager that comes out and and does an assessment thing i know you got case managers but i guess they don't technically perform assessments yes so our agency does not do the assessments for the programs that is done by um the home and community-based waiver assessments are done by the state so they have a nurse come from medicaid that does that assessment and that's so it's it's um conflict free they don't want us to do the assessments and then also do the case management so once that assessment's done it's done for the home and community-based waiver by a nurse at the state and then the michelle p waiver is done by our comp care center which is river valley behavioral health so they have an assessor that comes out and does that and then once that assessment's done and they've met the criteria for the program based on their needs then that's when they would reach out to us and we could assign a case manager to come out and get get the services started i see so once the assessment is complete whether it be from river valley in the case of michelle p or the state in the case of home and community-based then uh the uh the clientele would contact grad and get the ball rolling with the services and you know personnel that they need to assist them with their their day-to-day tasks and is there uh an application or anything else in the enrollment process that we need to be aware of yes so they will have to apply for medicaid through the department of community-based services and they'll make application there which when they contact our office our agent and disability resource center staff would let them know that if they don't currently have medicaid they need to contact the dcbs office and then they give them their phone number to reach out and go ahead and start that application process and that's where they're going to ask for their resources their assets it gets confusing because sometimes they um you know if it's a household what they're going to do is they're going to ask for all that information for the household and then they're going to determine they don't qualify because they're over income but then they're going to look at oh this this individual in the household has has extra needs and needs in-home services and is going through the waiver program so that person is going to qualify for medicaid alone so it gets kind of confusing in the beginning by having to do that but um they would definitely you know need to reach out to the department for community-based services and then while they're doing that portion grad can be doing the the needs portion where we do an application and kind of ask them what types of services are you needing what what are your needs at home and then those two things kind of meet up at the state level and then that will give them a slot for the waiver program now unfortunately as of right now both of the waivers have a waiting list so what that means is the state only has a certain number of slots available for funding for these waivers and right now all of those slots are full and um i know that they did allocate additional funding this year so they've added an additional 250 slots i believe for both of the the waivers that we work in but there still is um we probably have 300 people that we're working with right now on on getting their application entered and getting them on that waiting list so it's it's very difficult to to determine that time because it is based off of as people drop off of the waiver programs then the state adds new people so it really just kind of depends on and it's based on the state so you could have somebody move out of Louisville and that slot opens up and it comes to somebody in our region because that person is the top one on that waiting list so it's you know hard to say exactly how long these 300 some odd people will be on the waiting list but the bottom line you just have to have those applications complete one with grad and if you're as part of that particular district and one with the the state and of course if you're not on medicaid like Sarah said contact department for community-based services and they'll get you rolling on that and you know after you know that monotonous but well worth it process is complete you can get on the waiting list and you know with any luck your opportunity to you know exit the waiting list and start receiving services in case management will be a lot sooner than that you might think well Sarah I know this has been very educational and informative we've all learned a great deal and I know that a lot of our listeners will investigate this further either for them or one or multiple somebody's that they know and we're going to talk about now how you might suggest listeners educate themselves further on this program you did mention the aging and the disability resource center that's a part of grad and there is an 800 number there do you have that 800 number handy Sarah I do it's 1-800-928-9094 or you can call 270-926-4433 and speak with someone from the aging and disability resource center okay so I guess that second number the local number there is just the general grad number correct correct okay and you can ask to be transferred to the the aging and disability resource center and one of their experts will help you now I will also link listeners to the waiver services page on the website which by the way is grad dot com and if you'd like to reach out to Sarah with any questions that you may have I know she'll either be glad to answer them or refer you to the appropriate individuals to answer them and your email address is sarahduncan at grad.com right that's it and it's sarah with an h sarah with an h yes and all one word no spaces or caps anything like that s-a-r-a-h d-u-n-c-a-n at grad.com well thanks so much for coming on with us and enlightening us on this program that has meant so much to so many and will mean so much to so many more in the future it is thriving and I know that for that reason it's not in danger of going anywhere well I have thoroughly enjoyed it Sarah I hope you've had fun yes thank you so much Sam I appreciate it well it's great to educate ourselves through you on this program is this your first podcast there I'm just curious it is it's my very first see so we're making a little history I love making history with with my guests it always makes me feel just a little more warm and fuzzy inside well Sarah will let me in how's that okay sounds great Sam Sarah Duncan is a blast and filled with great information now please ladies and gents by all means share this show with those you know who may be potential recipients of this waiver services program or perhaps they may know potential recipients more so than you do and I will link you to the waiver services program page on grad's website as well I'll link you there in my show notes so that all you will have to do is hit that link and you can find out additional information to you know supplement maybe even reinforce what we discussed today and I will also include Sarah Duncan's email address in the show notes as well sarahduncan at grad.com and you can reach out to her there as well with questions that you may have or if nothing else just to let her know that you heard her on blabbing in the bluegrass I know that it would make her day because she certainly did not have to come on there are plenty of other ways that she could have been spending her precious time so I'm so glad she spent some with us today now if you know a health care professional and I know you do who has meant a lot to maybe not just your family but plenty of others you need to let me know about this individual or these individuals because chances are there's a great story there that we all need to hear and you can do so via email my address is bluegrassblabbing at gmail.com b-l-u-e-g-r-a-s-s b-l-a-b-b-i-n at gmail.com and you can use that same email to let me know about your favorite local restaurants or musicians authors athletes educators healthcare professionals I mean our topics may be sort of all over the place but the common thread is they all have connections to the commonwealth of Kentucky and they all help to make it such a great place so don't hesitate to reach out to me if you don't via email please do via the blabbing in the bluegrass facebook page and while you're there make sure you like and follow it if you're not already because any show that I've ever done is there and if there's a special guest that I've had in the past you'd like to hear but maybe you can't find the show because we've done so many and maybe it is hiding from you deep in the archives there well that's no trouble just let me know about that via email as well bluegrassblabbing at gmail.com let me know about that special guest give me the name of the guest or perhaps the show if you can and I will respond to you with a link to that particular program and I'll do it for free of course you're listening for free bottom line you don't need to be concerned about money okay and while you're on that facebook page keep your eyes open for teasers that we put out for future show plans we uh do that about once a week or so and of course you can make comments and leave those messages so next Wednesday is October the 23rd many of you will be shopping for Halloween candy and costumes and getting yourself in the spirit but while you do make sure that you take us along because you are the glue that keeps this show together and when you are absent it is noticeable trust me so make sure that you come on back keep my guest and myself company we value your presence more than you'll ever know troops so before we put this thing to bed because mischief is getting a little restless over there let's reveal the answer of the bluegrass brain buster which we brought to you up top at the beginning of the show it is of course a health care themed question because we had a health care hero spotlight on the show today and I wanted to know which hospital has the distinction of being the oldest hospital in the commonwealth of Kentucky well it's u of l hospital u of l hospital has a a rich rich history dating back 201 years actually all the way to 1823 it was originally known as a Louisville marine hospital and uh it its purpose was to treat the sick and the injured who were on their way down the Ohio river those crew members were forced off their boats in many cases due to falls of the Ohio and they were left there with uh you know no home no place to go and so uh this Louisville marine hospital treated them with uh you know whatever they needed and to help to provide them with uh you know a place to get on their feet if you will and uh get themselves established if they needed to but anyhow a little later down the road in 1911 this hospital housed the world's first emergency room how about that that was 1911 that 30 years later in 1942 it was renamed Louisville general hospital wonder if that was the inspiration behind the soap opera general hospital probably not but anyway it was Louisville general hospital from 42 up until 83 when it moved into a new facility and became the university hospital and it was later renamed u of l hospital that's where we stand today but that is the oldest hospital in the commonwealth of kentucky originally named Louisville marine hospital when it first opened in 1823 now u of l hospital the oldest one in the commonwealth so come on back next week for another fascinating brain buster a whole lot more fun and excitement with a great great guest in the meantime make sure you listen and subscribe to the show without paying one thin dime via numerous podcast directories these include apple spotify verbal amazon music iheart radio boom play even a few others and i tend to be amazed at how often new directories are popping up so if we're not yet a part of your favorite directory i may not be familiar with it so let me know what that is via email and or facebook rest assured i will do all i can to make sure that blabbing in the bluegrass is accessible to you via that particular outlet as soon as humanly possible so until next time you know darn well what i'm gonna ask of you keep laughing keep smiling make sure you investigate the waiver services program and keep blabbing in the bluegrass because we're blabbing in the bluegrass there's nothing here to hide because we're saying it with pride just a blabbing in the bluegrass with knowledge of the state you're sure to appreciate yes we're blabbing in the bluegrass where musicians furnish talent and great whiskey cools your palate just a blabbing in the bluegrass with a fit for every taste precious time is not to waste if you like the podcast remember to follow or subscribe so you never miss an episode if you really like the podcast we'd love it if you could leave us a rating or review on apple podcasts or spotify or wherever you get your podcasts that helps more people to find us if you really really like the podcast then please tell someone about it either in person or send them an email or just share the link on social media thank you all every bit helps and it makes a huge difference for us if you'd like a transcript please send us an email to demandanddisrupt at gmail.com and put transcript in the subject line thanks to chris unken for our theme music demand and disrupt is a publication of the advocato press with generous support from the center for accessible living located in louisville kentucky and you can find links to buy the book a celebration of family stories of parents with disabilities in our show notes thanks everyone

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