buried_lede

buried_lede t1_je87jnz wrote

There is something way off with the insurance calculations. Does the exchange know what your income was? You made less in 2022, right? And the health exchange was updated on your income, right? And you downloaded the tax credit form that the exchange generates each year?

It might be worth it to go to an actual cpa to sort this out for you this time and get you on the right track for next year. A cpa- certified public accountant.

You can try the online tax programs yourself first to see if anything obvious pops up but it sounds like a cpa would really help you. Ask around for recommendations for a cpa where you live.

Is your husband self-employed?

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buried_lede t1_je6e67t wrote

I like Painter’s idea in the second story that we have smaller, home-like facilities.

Also in the second story, I caught the part about private equity ownership, which could use a major story all by itself. I think CT should go out if it’s way to put in disincentives for private equity - how it does that while maintaining enough facilities, I don’t know, but PE is the worst. It will be a nightmare.

“The influx of private equity money into the nursing home field has caught the attention of legislators who are proposing a transparency bill, seeking to make providers reveal quarterly where state funds they receive are going.”

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buried_lede t1_je61rl7 wrote

If I recall correctly it was maybe $60 a payroll, so if you pay twice a month, $120 a month. It might have been cheaper. And ADP is the granddaddy of payroll services in the country so competitors might be cheaper. I did all the research for my family which was using an agency but we didn’t switch because at that point siblings didn’t want to.

https://www.adp.com/resources/articles-and-insights/articles/n/nanny-payroll-services.aspx

They call it “nanny payroll services,” but explain that it’s for household employees.

When I went to find this link by googling, I saw that there are a lot more companies doing it now. One key element you want is for the service to handle all the irs end of year forms and accept liability for errors

Another thing to plan for when you oversee this yourself is to line up substitute caregivers when yours takes vacations or calls in sick. That takes a little work and there was an agency that was willing to provide short term like that. You just have to call around. I can’t remember the agency and there are so many, and they change a lot.

I really wanted to make the switch myself but it was a family decision

Edit:

Just some additional thoughts. “Homemaker Companion agency,” a term that is defined in statute and are companies overseen by the Consumer Dept, not the health dept, add a huge amount of overhead cost. So, for example, my family member required really major assistance because he was partially paralyzed. The agency charged over $90k a year. And almost anyone can open a homemaker agency- no credentials.

Our caregivers were paid garbage. The mark up had to be roughly 60-percent at least.

We could have given a caregiver a massive raise and still cut tens of thousands off the yearly cost of care even with the cost of a payroll service to cover payroll. To me it was a no brainer, especially if a family member is close by and can take care of managing it.

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buried_lede t1_je3tkju wrote

Yale’s patient relations Dept has gone way down hill too. It’s nothing more than bare risk management at this point.

Also, some of the floors seem to be big on cycling through new, recently graduated nurses with few more mid career or senior nurses floating around and that just doesn’t work, they aren’t up for it when they are that thin on mentors present for at least most of the time. Other depts though this is not the case. I don’t know how they prioritize it

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buried_lede t1_je3spfq wrote

Even the best facilities have issues. And they are cost cutting. One place eliminated their entire medical staff and contracted out to a practice in CT that does gobs of nursing homes here. So the doctors and APRNs actually work for this practice. The educational credentials of the personnel don’t compare at all with prior staff

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buried_lede t1_je3c1pt wrote

I also have experience with self-paid live in home care and just want to leave one important piece of info for people:

There is a big difference between a home health agency licensed by the health dept and a “homemaker companion” agency that is licensed by the consumer dept. Know the difference and supervise, don’t be supervised, by the latter. Also, don’t let them work beyond their license, which they can easily slide into, and don’t think the quality of care will remain fine if you don’t stay involved.

Edit: oh, another thing, for those families that can stay on top of it who hire in home aids to do non medical care such as meals, bathing etc, you can hire aids directly instead of going to an agency.

You must pay them as employees, not 1099 but lucky for us, payroll companies now cater to home help. ADP, for example, has a relatively affordable payroll service for families who hire home help and take care of the taxes, etc.and cut the checks. Others like Paychex, might too, not sure

I mention this because agencies get paid a lot but the workers get paid very little. If you have the ability to be hands on and get recommendations for experienced aids, you can hire one directly, pay them a truly livable wage and still save money over an agency.

In my experience, lots of aids are pretty honest and caring while some agency reps might not be and can be a pain

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buried_lede t1_je3b5yr wrote

I know someone who tried to take advantage of the home care program and should qualify but the process was endless, application submitted in August, zero action past an interview with him. Tried to resuscitate it in something like December or January. They say oh yes yes, we’re going to help you Two months goes by then a call asking him to submit a whole new application.

Sometimes I think it’s a fake program, like the fake state money set aside to reward essential workers that nobody seemed to get, or the applications for assistance with rent or bills if you were affected by Covid that were never given case numbers and received no response.

I’d understand this kind of performance if we were a poor state like Mississippi and overwhelmed, but we have very well paid state workers with pension and health care benefits that dwarf the benefits of federal employees, albeit, with a good deal of nepotism in the ranks with a straight line to the legislature and governor. We are one of the highest taxed states in the country. I would like benefits to the poor expedited and not bogged down and wasted by inefficient state agencies.

My friend gave up on his home care application for now. He needed the help yesterday and is scrimping along hiring help here and there but the state exhausted his energies and equanimity. He can’t take it anymore, even rejecting help from his friends. Life is short and he doesn’t want it dominated by their dysfunction and mediocrity.

Unfortunately, he would not be interested in talking about it so that’s not much help for ct mirror.

Edit: I just want to add that if the state is leaning towards aging in place ( and I support that) it really has to get it together. The guy I described above is on Medicare and Medicaid and CT Medicaid a while back decided to support care at home. But when someone gets home from rehab in August and still has no ongoing services in January, that’s not a program ready for an influx of new people.

To be clear, he had the medically prescribed home health nurse visits after rehab ( they failed to make the Medicare deadline but they did check in by the third day); the months long delay was for other home supports that are part of this program that Medicaid is supporting now. I don’t have a list of the tasks they do, I am afraid. I had a basic outline. I think it was typical of what a CNA provides and also what is referred to in statute as a “homemaker companion” so they could clean the apartment, make meals etc.

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buried_lede t1_jdblgut wrote

Have friends on both sides of the river who all bought their homes there in the same decade. It’s an area with neighborhood spirit and a lot of beauty along the water. It was an Oyster Village originally and much of that is preserved. All those walk out basements on the front of houses on Front Street and on Q Ave have oyster shucking stations just inside - usually a counter and sink.

You can get to know people pretty quickly in the neighborhood and they care a lot about the neighborhood and take pride in it.

For some reason it’s never been able to support a neighborhood gourmet grocer but has had a nice wine shop for years now. The restaurant on the Q Ave side that opened recently is well reviewed.

On the Front Street side, there is the famous (or notorious) Waucoma Yacht Club, a marina, which you should definitely join if you move there. You’ll meet everyone that way. ( I like to call it the Glaucoma or just, the Coma Yacht Club.) it’s not expensive and has a bar. There is also a nice breakfast place over there.

You’ll meet lots of interesting people and it has that village feel you get in Westville too.

I would avoid south of the waterfront on Quinnipiac but up the hill from the water on the Q side has many options.

Front St traffic is less crazy than Q Ave traffic. Rush hour on Q Ave sucks.

Up the hill off East Grand there is a wonderful Friends Meeting House.

There are some nice houses all over the hill and of course on the Front St side too.

If you don’t find anything in that whole area, people have been piling in somewhat less so, into the Chatham Square area for quite a while now and it’s sort of a sister neighborhood.

Rocco’s Bakery is good too and there is a supermarket in Grand near Front.

Bring your canoe

Edit: There is a farmers market in the park along the river. Forgot to mention that.

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buried_lede t1_jd9rzxn wrote

With that lifestyle you would probably benefit from weatherizing/insulation. Working from home too - utilities are more

Your best bet is turning down at night and adding a blanket. If you are at a desk during the day, not moving around, you want to be cozy. So, when you’re sleeping might be your best opportunity. Try 69 during the day ( no pun intended, lol)

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buried_lede t1_jcvpgxo wrote

You pointed to crime and health conditions at the camp

You said Elicker had no choice but to bulldoze the camp.

You said your partner worked with the camp and posted a story about the head of Cornell Scott’s homeless outreach director ( confused - your partner? It wasn’t clear)

All suggesting this might be the position of the homeless healthcare outreach program, so maybe you could clarify that

1

buried_lede t1_jcvkwtf wrote

Here you go

Edit:

Shoot. It wouldn’t post the results page. Here is another link, choose the state but skip the county or city, hit run and it will give you the results

https://www.huduser.gov/portal/datasets/fmr/fmrs/FY2023_code/select_geography.odn?data=2023&fmrtype=%24fmrtype%24

MIT says it updates its pages once a year during the first quarter, so maybe by the end of the month

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