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Zentz Law

Zentz Law

What is Caregiver Maintenance

Assessing whether a trial court has jurisdiction to order caregiver maintenance is the subject of a recent post in a Family Court Case in Indiana. In this article, we review the case and address issues which are likely to arise. In general, when an individual is living with others, who require care, such as assistance for a drug or alcohol addiction, this person is not considered the primary caregiver for the other individuals. However, if the person is not living with others, but instead only receives assistance from the other, then they are said to be the caregiver for the others. Whether this is true or not, there are situations where the Indiana courts have indicated that it is appropriate to order periodic maintenance for a person who is considered the caregiver for another.


The first issue that is raised in a trial court is whether the caregiver has been receiving adequate legal or medical care, and if so, whether the care provider is receiving necessary services. If either of these is found to be lacking, then it is likely the caregiver will not receive the proper care and may end up being declared mentally incapacitated. For example, if the person who is making the payments lives with the non-custodial parent, but is living with the parent, in a scenario such as this, the parent may file a motion to have the payments made to the other parent, stating that the caregiver is not a legal caregiver for the child. The court may find that the arrangement is fair, and order regular caregiver maintenance, based on need. However, if the arrangement is found to be unfair because the other parent is not receiving adequate legal or medical care, the court may find that the child is being kept on the welfare of the custodial parent, and therefore, a trial court order for caregiver maintenance may be ordered.


Some people wonder how the court decides whether the caregiver is receiving appropriate rehabilitative or therapeutic services. Many people mistakenly believe that the only consideration is whether the person pays the money or not. Unfortunately, courts do consider many other factors when determining whether or not to award financial support, including how the money was obtained, how much the person pays (or is unable to pay) and what type of environment the individual lives in, whether it is a safe or unsafe environment, etc. Another factor considered by courts is the age and health of the person, and whether or not they would need services that would alleviate their need for caregiver maintenance. The court may even consider the emotional well-being of the person, if they are depressed, as well as their ability to make decisions for themselves.


Unfortunately, some people mistakenly believe that HFA patients cannot also benefit from the same types of caregiver maintenance. Unfortunately, the reality is that most HFA patients are capable of maintaining good independent lives if they are given the proper resources. In order for an individual who is eligible for HFA benefits to receive care from a caregiver agency, they must meet a number of basic requirements. First, they must be "actively seeking" self-care services. An "active seeking" status means that the individual must actively engage in efforts to find care that meets their specific needs, without relying on services provided through an agency-whether a friend, family member, or another family member.


Secondly, the individual must be receiving Medicaid benefits. Medicaid will cover some or all of the cost of caregiver maintenance. Once the individual has met both of these requirements, they can begin receiving Medicaid benefits and seek rehabilitation maintenance. If the individual is not eligible for Medicaid, he or she should file a claim for coverage with the Substance Abuse and Mental Health Services Administration (SAMHSA). If the individual does qualify for Medicaid, the caregiver should file an application for Medicaid eligibility.


It should be noted that in order for a person who is eligible for Medicaid or Medicare to receive caregiver maintenance, they must be in a position that makes them a "qualified person with a severe impairment for whom home-care services would make him or her incapable of performing the functions of a normal person." In order to meet this requirement, the applicant must have a physical and mental capacity that is "irreparable or severe." Therefore, a person who is not eligible for Medicaid or Medicare, but is married, can apply for spousal incapacity insurance. In addition, if the individual is determined to be disabled, the state will pay for the majority of the cost of caregiver maintenance for the disabled spouse seeking care from a licensed facility. This type of coverage is usually referred to as an "average cost of care" coverage.

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