Paid Family Caregivers in Indiana Face Steep Cutbacks

Kacey Poynter doesn’t have to commute far to clock in for work. She’s a paid caregiver and simply rolls out of bed to tend to her charge: her 2-year-old son, who sleeps in a portable playpen right beside her.

Sonny was born with a congenital malformation that impaired his brain development and needs near continuous care simply to breathe and eat. Ms. Poynter left her job at a call center when she brought him home from the hospital and has nursed him ever since rather than relying on aides or institutions. Indiana’s Medicaid program has paid her for this labor of love.

“It’s just been honestly life-changing, being able to be here with him and not worry about someone else trying to take care of him,” she said.

But her ability to keep looking after him is now in doubt. Indiana’s social services agency has announced plans to end the caregiver program, citing a nearly $1 billion shortfall in the state Medicaid budget. By July 1, parents and guardians caring for children and spouses caring for their partners would have to enroll in a different program for far less pay.

The fear, for people like Ms. Poynter, is that they will have no option but to return to work and search for home care help in the midst of a deepening national labor shortage of aides and nurses.

During the coronavirus pandemic, states received a huge infusion of federal money — money that’s now drying up, leaving Indiana, and many other states, facing tough choices about how to plug the gaping holes in their budgets.