Tag Archives: Medicaid

Caregiver’s Golden Years, Between a Rock and a Hard Place

November 5, 2017 by
Photography by Bill Sitzmann

When Franklin Delano Roosevelt presented America with the Second New Deal, he created a national social safety net to prevent vulnerable senior citizens from dying in poverty.

Social Security came into being with the Social Security Act of 1935. Thirty years later, the federal safety net further expanded with the creation of Medicare and Medicaid during the presidency of Lyndon Johnson.

The system evolved to assist not only the elderly (with Medicare focusing on citizens aged 65 and older), but also the disabled and impoverished of all ages (with Medicaid), to become as self-sustaining and independent as possible.

Fast forward to the 21st century. Ever since 2010, President Barak Obama’s Affordable Care Act (aka “Obamacare”) dramatically widened the nation’s social safety net. In the first year of Donald Trump’s presidency, Republican efforts to undo and repeal the Affordable Care Act sparked concerns that 22 million Americans (according to the Congressional Budget Office) would lose their access to affordable health insurance.

With Republican control of the White House, House of Representatives, and Senate, the federal safety net seemed all but certain to shrink.

The Congressional Budget Office—tasked with determining how much any given piece of legislation will cost (or save) to implement, including reductions in tax revenue—concluded in a March 13 report that the American Health Care Act of 2017, popularly known as “Trumpcare,” would: “reduce federal deficits by $337 billion over the 2017-2026 period” with the largest savings coming “from reductions in outlays for Medicaid” and from elimination of Affordable Care Act “subsidies for non-group health insurance.”

While much of the 2017 health care debates have focused on repealing Obamacare, 74-year-old Marge Koley (of Bellevue) exists at the crux of Medicaid and Medicare. Koley is one of the many senior caregivers who attend to younger, disabled relatives.

She and her husband rely on the earned benefits of Social Security and Medicare, benefits that have made it possible for them to enjoy their golden years without working.

Watching the media spectacle unfold, Koley was most afraid for their 37-year-old daughter, Jenny, who has Down syndrome. Jenny qualifies for Social Security Disability Insurance, Medicare and Medicaid for health insurance, and receives support services to live and work independently through Medicaid and Nebraska Health and Human Services.

“Jenny has always had the dream of having her own apartment and living as independently as possible,” Koley says, speaking with Omaha Magazine in July on the eve of the so-called “skinny repeal,” the last ditch effort to repeal Obamacare by the Senate.

“What will happen to Jenny after I am not here to care for her?” she says. “That is my greatest fear. She has one sibling in Indiana. If the proposed caps and cuts in Medicaid are enacted, she could lose the services she needs to live and be part of the community. Also lost are the years of progress allowing people with disabilities to decide for themselves where they want to live and with whom. We may have for-profit insurance companies running programs and deciding the fate of our children. Will institutional living return? Will the waitlists continue to grow and grow?”

Jenny moved into her own place in September 2016; meanwhile, Koley still provides most of her transportation needs. Medicaid service providers take care of residential support and job coaching.

“Jenny currently works nine hours a week at the Ollie Webb Center,” Koley says, obviously proud of what her daughter has been able to accomplish with some compassionate assistance. “Jenny loves being responsible for herself, and now cleans her apartment and does her wash on her own without prompting, and has been able to decrease her outside support. Now, she has someone one day a week to help work on cooking, going out into the community.”

The current political environment is a source of anxiety for Koley, who says she has never before seen the American public so polarized.

“This is the most divisive political climate I have ever experienced. Neither side will listen to the other’s views,” Koley says, adding that if she had a chance to talk to lawmakers, her message for them is to save Medicaid. “I want them to save Medicaid and to get a full understanding of the consequences of their actions. Budgets should not be balanced on the backs of people with disabilities who are least able to defend themselves.”

Efforts to repeal the Affordable Care Act—for the time being—came to a screeching halt with the pivotal thumbs-down vote from Republican Sen. John McCain of Arizona, who flew to Washington D.C. for the vote shortly after being diagnosed with an aggressive form of brain cancer.

Months after the failure of the “skinny repeal,” in the week following the failure of another repeal attempt (the Graham-Cassidy Bill), Koley experienced a sense of temporary relief.

“I’m very happy that it did fail, knowing how it would affect Jenny,” she says. “But I know politicians will be revisiting this, and we’ll need to gear up again to defend Medicaid benefits at a later time.”

Visit olliewebbinc.org to learn more about the Medicaid service provider that plays a crucial role in the lives of Marge and Jenny Koley.

From left: Marge and Jenny Koley

This article was printed in the November/December 2017 issue of Omaha Magazine.

Nebraska Masonic Home

October 14, 2016 by
Photography by Bill Sitzmann

The building known as “The Castle” is hard to miss while driving through Plattsmouth on Webster Boulevard. Its imposing grey stone structure boasts Elizabethan towers and arched doorways fit for a Scottish king. For its 100 or so residents, however, The Nebraska Masonic Home is a warm and caring place to spend their retirement years.

“This is their home,” executive director Mary Stockton says. “And the Masonic Home is like a home to me after working here 12 years.”

As a continuing care retirement community, the facility provides a range of options that can change with the needs of residents: independent apartment living, assisted living, nursing care, and special care for residents with Alzheimer’s and other types of dementia. Residents enjoy a range of activities and outings as well as amenities and services from housekeeping to state-of-the-art dining facilities.
nebraska-masonic-home-2But not just anyone can take up residence at the Nebraska Masonic Home. It has exclusively served eligible members of Masonic organizations—like Scottish Rite, York Rite, and Shriners International—and their eligible female relatives (wives, widows, mothers, daughters, sisters, grandmothers, and granddaughters) since 1903. It is the only Masonic retirement facility in the state.

“Masons support their brothers, and Masons take care of their families,” Stockton says. “Masons, on the whole, are a very generous, caring group of gentlemen. They are the most philanthropic that I’ve ever seen…Whatever they can do to help, they’re there.”


That generosity manifests through The Nebraska Masonic Home Foundation, which provides support for both the facility and individual residents who require financial assistance; the facility does not participate in government funding through Medicare and Medicaid.

Employee turnover is unusually low compared to the norm for retirement communities and nursing homes, Stockton says, and the staff includes employees at all levels who have reached 10, 15, or 20-year anniversaries. Some have been on the job even longer.

nebraska-masonic-home-1Marilyn McLaughlin, a CNA/CMA, will reach 30 years with the Nebraska Masonic Home next spring.

“The staff and residents are nice, considerate, and respectful. You feel as soon as you walk in that you just want to be here and help,” McLaughlin says, adding that a manageable workload allows direct care staff like herself to provide quality care. “I couldn’t go and work anywhere else after working here.”

Chris Abbott, the facility’s administrative assistant and admissions coordinator, joined the Nebraska Masonic Home 26 years ago and says she had a positive impression immediately.

“I had never been in a nursing home, and I was just amazed when I walked in the door. I could smell good food cooking. The people were wonderful, the residents were well-dressed and clean…26 years later I’m still at it and I’m not going anywhere,” Abbott says. “Residents get care not like anyplace else; it’s a place where people are made to feel wanted. We care about residents, and we care about their families.”

Stockton agrees: “It really is a privilege to know and care for them.”

Visit thenebraskamasonichome.org for more information. Sixty Plus

The Reality of the American Dream

March 25, 2014 by
Photography by Bill Sitzmann

The apartment’s living room is warm. Blankets are on the couches, an old TV is playing cartoons, and 5-year-old Hana is mimicking the enthusiastic English of the monkey onscreen. Her grandmother, Zinab Abdelmote, watches from the couch, quiet and smiling.

Amna Hussein tells her daughter to lower the sound. “Zuza!” she calls her by nickname. Amna sets down a silver tray with one glass of juice. “From Egypt,” she says, gesturing to the delicate tray. Dinner, she says, is cooking.

She’s experiencing her first full winter in Omaha. She arrived in February 2013, after a circuitous route from her home country of Sudan that spans several years. Six of those were spent in a refugee camp in Egypt. Though Amna lives in a small apartment with Hana, her mother, Zinab, and her younger sister Elham, three of her siblings are still in Egypt. Two sisters, Najwa and Suzan, live close by in Omaha. Two other siblings are in Libya, two are missing in Darfur, and the eldest is living in the U.K.


There were 16 of them once upon a time. Amna laughs at the shock the number incites. “How did she do it?” she asks, gesturing at Zinab.

Amna is obviously proud of her mother. She, Najwa, and Elham take turns watching out for Zinab throughout the day. Her heart is bad, she has kidney problems, and high blood pressure. Her current dream, Amna translates, is to learn English. “Her willingness to study has stayed with her to this moment.”

Zinab’s daughters living in Omaha are already deep into studies at Metro Community College: a few hours a day of ESL, per the requirement to receive temporary aid for needy families (TANF). Their knowledge quickly outgrew the English classes provided by Southern Sudan Community Association, where they still receive some case management.

“We’re comparable to Lutheran Family Services,” says Marni Newell, SSCA program coordinator. “Just a lot smaller.” Newell explains that as a federal resettlement facility, they have 90 days to offer in-depth information on a wide variety of complex topics: Medicaid, food stamps, banking, job searching, English classes, cultural orientation, and driver’s ed. Other assistance includes helping to apply for relatives’ resettlement, applying  >for citizenship, and demonstrating how to ride the bus.

Amna reflects on how much she’s learned just in the year she’s been in Omaha. She and Elham entered the U.S. through Miami. The use of Spanish everywhere in the airport threw her off. “I asked a caseworker, are we really in America?” Amna recalls. She can laugh about it now. After a stop in Washington, D.C., the sisters arrived in Omaha. “I was thinking…I have been to small villages before but…” She chuckles again.

But she says, “Omaha’s like a land of knowledge. A land of peace. It’s a friend to all refugees to find a right beginning for their life. To resettle correctly, this is the right beginning. Leave the dreams for a while. Then later on, you can go.”

Elham sets down a plate of beans with tomato paste and spices, some thin bread, and two slices of American cheese. Amna excuses herself to get Hana her dinner.

Elham’s English is only slightly less fluent than Amna’s, but the confidence is there.

“Refugees see America as a dream,” Elham says. “But when they start their life, they face real problems. Many become, like, lost. Because their families back in the refugee camp think they will send money. And people in refugee camps think life in America is very easy. You can find money and jobs anywhere. But since February [2013], I haven’t got a job. I’ve interviewed many, many places.”


It’s a difficult life—going to school, finding work. “Najwa,” Elham says, referring to her elder sister who lives with three grade-school children, “is father, mother…everything. Here, you have friends to help you with these things.” But if you’re new to the country, she says, who do you have? She shrugs. “You can’t get a car without a job. And you can’t have a job without a car.”

Amna returns, saying it’s time to have tea. Her conversation is gentler than Elham’s as she stands over the stove, but she mirrors her younger sister’s opinions.

For example, she’s learning how to drive, but money has a lot of other places to go first. “At the beginning when we came,” Amna explains, “the organization does it for us. But three months is not enough. After three months, they require us to find a job. Some people can’t start school for two years because they’re running here and there to support the family. Even now, for me to go to a job and to school, it’s a problem.”

Still, she says she hopes to start work at Walmart soon as a cashier. The goal is to study at Metro and work at the same time. Of course, daycare is a problem. Due to Hana’s September birthday, she missed the cut-off date for kindergarten. Transportation, as always, is a headache.

But studying is important. “Here, there is no limit to education,” Amna says. “No matter your age, we can study what we like. We’re greedy to learn as much as we can.” She and her sisters hold college degrees in a variety of fields, but “the technology that America has reached, we feel that we are behind. In technology, development, education…”

Amna, for example, has a bachelor’s in English and sociology from India, as well as a diploma in health and social care from the U.K. She’s thinking of eventually taking up nursing studies.

“We will study according to what the market needs,” Elham chimes in. “If I studied geography, maybe I’ll do nothing. You must start with what the market needs. That is first.”Amna sets down a glass of hot tea with a single clove for fragrance. “You can take it with you,” she says, nudging the mug. “You will come back. It’s fine.”

Another winter day, another trip to the small apartment. A variety of pastas and glasses of nonalcoholic liqueur cover the dining room table. The atmosphere is intimate. The headscarves have come off, and the talk becomes frank.

“I lost my job,” Amna confides. Her voice is still gentle but frustrated. The buses, she explains, can’t reliably get her to Walmart on time and home again.

“I must work,” she says. “Someplace where I can walk to.” She mentions a few places she’s thought of and is unfazed when told it would take an hour to get there. “It’s good exercise for me.”

But here, in the small, warm apartment, frustrations are put aside for a moment. Elham brings tea to the living room, and Amna produces a small bottle of homemade perfume. “For after dinner,” she explains. “To cover the scent.”

Arabic and English swirl around the room as six women chatter about anything and everything and nothing in Omaha, Nebraska.

Editor’s note: As of late January, both Amna and Elham have found employment.