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Caregiver Basics- What You Need to Know

The following information, forms, and documents will assist your loved one to have a voice in their care and an equal opportunity in work, treatment, school, and everyday life as they live with a mental illness. As you encourage your friend or family member to use the tools below, they will become more involved in their treatment, feel more in control and become more independent.

Legal Rights
 

Psychiatric Advanced Directives

A psychiatric advance directive is a document that allows an individual with a mental illness to determine what type of care they would like to receive in a crisis. It is filled out when the individual is mentally stable, and they are encouraged to carry it with them. It is also recommended to discuss and share this document with the individual’s primary care physician, therapist, and other medical personnel they regularly meet with. Copies should also be given to any informal caregivers so they can act as an advocate for the individual’s requests during a mental health crisis.

Health Insurance Portability and Accountability Act (HIPAA) 

Understanding the role of HIPAA is important for both the individual with a mental illness and their caregiver. HIPAA regulations give a patient the right to share or keep their information private and  explain what information providers can and cannot disclose to people other than the patient. As caregivers understand HIPAA regulations they will be better able to help their family member/friend.

Family and Medical Leave Act (FMLA)

Under the Family and Medical Leave Act (FMLA), a caregiver is allowed up to 12 weeks of unpaid time off in a 12 month period to help a parent, child, or spouse who has a serious illness. All employers covered by FMLA are required to grant this allowance and job protection to individuals who apply. All public agencies (Federal, State, local and schools) and private sectors (who have 50 or more employees for at least 20 workweeks in the current or preceding calendar year) are covered by FMLA1. Employers must also give this allowance to employees who are personally affected by a health condition that restricts their ability to fulfill work duties. If you or a family member could benefit from the Family and Medical Leave Act, check with your employer or the United States Department of Labor website.
 

Conservatorship

A conservator is someone who is mandated by court to be in charge of legal, financial, and healthcare decisions when an individual is considered mentally incapable of making decisions for themselves. . Most often a conservator is a spouse or adult child. If a family member is not considered able to take on the position of the conservator, a professional may be hired. An individual can avoid the possibility of having a conservator legally assigned if they formally declare a power of attorney.

Financial Aid
 

Paying for Care

Mental health treatment can be expensive and often people do not get treatment for this reason. Regardless of your insurance and income, there are ways to receive treatment.

  • Many people with a mental illness are able to apply for disability benefits through the government. Click here to see if you or a loved one may apply.
    • Social Security Disability (SSD) provides monthly benefits to individuals who worked a certain amount of time and made payments to Social Security. For comprehensive information about these benefits work and how much you may be eligible for, checkout this Social Security Disability Benefits Guide.
    • Social Security Income (SSI) is based off financial need and does not require prior contributions to Social Security.
  • There are also health care coverage options from the federal and state government.
    • Medicaid helps low-income individuals pay for medical care and prescriptions.
    • Medicare is through the federal government and provides coverage based on age or disability. 
    • Children’s Health Insurance Program (CHIP) is low-cost insurance for children whose family do not qualify for Medicaid.
  • In addition to insurance programs, some clinics and organizations provide inexpensive treatment dependent on the consumer’s income. Prescription Assistance Programs help individuals get needed prescriptions which they cannot afford.
  • Learn More About Paying for Care 
     

Achieving a Better Life Experience Act (ABLE)

The ABLE Act applies to the family of an individual who has developed a severe disability before the age of 26. It allows them to create a non-taxable savings account and still receive disability benefits. This account is to be used for improving the quality of life for the individual with a disability. This includes accessing resources which maintain health and increase independency. In order to qualify for an ABLE account one must qualify under the Social Security Disability SSI- Eligibility Requirements and Criteria.

Work and Education
 

Workplace Discrimination

The Americans with Disabilities Act (ADA) was enacted to protect individuals with a disability; it requires employers with 15 or more employees to not discriminate against current or prospective employees due to a disability. While there is no guarantee of receiving accommodations, an employee or job applicant can apply if they have a common mental health condition. The mental health condition does not need to be considerably debilitating to receive an accommodation. [1]

Some examples of reasonable accommodations may include flexible work schedules, time off for treatment, teleworking, or adjustments to supervisory procedures. Employees, employers, and health care providers are free to suggest and implement other accommodations to benefit the employee. It is often best to ask for a workplace accommodation early to ensure there is no lapse in the quality and timeliness of the employee’s work.

The U.S. Equal Employment Opportunity Commission (EEOC) ensures individuals with a mental illness are not discriminated against in the workplace.
 

Individualized Education Program (IEP)

An Individualized Education Program (IEP) is a written document describing a child’s personal educational goals and how the school will help the child achieve these goals. An IEP is created by a team which typically includes the child, parents/legal guardian, school teachers, school district representative, and an expert on the child’s disability. There are strict regulations on who applies for an IEP, and the goals must be reevaluated annually to continue the service. The main parts of an IEP are the current status of the child and their disability, yearly goals, and which resources the school will provide to help the child achieve these goals.


504 Plan

For children who do not qualify for an IEP, a 504 Plan is a good alternative. A 504 Plan is not as detailed as an IEP, and the definition of a disability is broader. Typically, a child with a 504 Plan will continue to be in a general education classroom full-time. Each district has different regulations on 504 Plans; some accommodations are allowances to deadlines, test taking adjustments, and counseling. Check with your individual school district to see how to start a 504 Plan.

Recovery Tools
 

Wellness Recovery Action Plan (WRAP)

Wellness Recovery Action Plans are helpful for all people living with a mental health disorder or serious mental illness. It helps an individual take a thorough look at how they feel and react when they are doing well, things they need to do to stay well, identify warning signs that their condition may be recurring/relapsing, and how to recognize when they are getting worse. It also helps to set goals that will help improve and maintain mental wellness. A WRAP is designed to be as detailed or general as the individual wants. It guides them in setting daily wellness goals, recognizing triggers, learning how to respond to a crisis, and what to do after a crisis occurs.

Sources

1.  United States Department of Labor. FMLA Frequently Asked Questions Wage and Hour Division WHD. Retrieved from http://www.dol.gov/whd/fmla/fmla-faqs.htm.

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