Published On: 02-11-2023

Medicaid is a program run by the federal government and the states. It helps low-income people and their families get health insurance. Medicaid covers a lot of benefits and services, but some are up to the person. Most people who get health care through Medicaid are enrolled in managed care plans or get care on a fee-for-service basis. Some people get coverage through premium assistance programs. These agreements help people on Medicaid keep their costs down while ensuring they get good care.

Medicaid is a program run by the federal government and the states. It pays for medical and health services for people who qualify based on their income, such as children, pregnant women, the elderly, and adults with disabilities. It has long-term benefits for the students who sign up for it, like better health and less need for emergency care and hospital stays.

How each state pays for Medicaid is different. The federal government pays a fixed percentage of the cost. This is called the federal medical assistance percentage (FMAP), and the states pay for the rest.

The FMAP financing structure lets Medicaid adapt to economic and policy changes. This lets state programs meet the needs of their residents. But it also makes it hard for the federal government and the states to agree on how to split the costs. Over the years, states have used legal loopholes to get the most out of federal funds, sometimes by setting up financing plans that make the FMAP look bigger than it is.

Medicaid pays for a wide range of health care services, such as doctor and hospital visits, X-rays and lab work, dental and vision care, home health care, care in a nursing home, and prescription drugs. It also covers kids, pregnant women, older people, and people with disabilities.

Low-income people can get Medicaid if they meet certain income requirements that depend on how many people live in their homes. These people include children, pregnant women, parents, and adults who live below the poverty line. The law also says that Medicaid can pay for a wide range of extra benefits. These can include dental and vision care, hearing aids, and personal care services for people with disabilities and older adults.

Many low-income families get Medicaid coverage through managed care organizations (MCOs), which have contracts with states to provide full services. Others get care through Medicaid's fee-for-service program, which pays a set amount for each service. Managed care costs less per enrollee than fee-for-service Medicaid, which means that all Medicaid recipients can get the care they need.

Unlike Medicare and private health insurance, Medicaid pays for long-term care like nursing home care and many services in the home and community. These services help seniors or people with disabilities live independently and stay as active as possible. They include assisted living, adult day care, foster care, and other options. Different states have rules about who can get long-term care services, but it's usually based on how many ADLs a person needs help with. This can include bathing, getting dressed, eating, and getting around.

In New York, the state also offers managed long-term care (MLTC) plans that cover these services, as well as prescriptions, medical equipment, dental and vision care, and other health services. People who get MLTC can also choose their primary care doctors and pay for them with their extra Medicaid and Medicare benefits.

Some states also offer "institutional" Medicaid services that cover all of a person's needs while staying in a hospital, a facility for people with intellectual disabilities, or a nursing home. These services assume that the person in the institution has a place to live and food to eat.

Medicaid pays for many mental health services, such as in-person and online therapy. It also pays for the medicine, which can help people deal with their symptoms and feel better overall.

Low-income people may have trouble paying for mental health care, so the Affordable Care Act requires that all Marketplace plans cover mental health care. This includes counseling and psychotherapy, which can be important parts of treatment for many mental health disorders.

But things still make it hard to get these services, such as a small number of providers, laws that aren't followed, and high costs. To help people and their families deal with the effects of mental health problems, it is important to make it easier for them to get mental health services.

Members of Medicaid in states that have expanded coverage can now get help for mental health and substance use disorder (SUD). This can be a life-saving resource, but states must keep ensuring they have enough providers and money to pay for these services.

What is The Average Cost of Assisted Living in The State of New York?

Published On: 12-26-2022

Assisted living can be crucial to sustaining a healthy and satisfying lifestyle for the elderly. In fact, this is the primary motivation for many assisted living facility residents. However, it is essential to emphasize that Medicare will not reimburse these costs. Before making a final decision, it is necessary to conduct a sufficient study.

Numerous elements influence the cost of living. The essential expenses are housing, food, clothing, utilities, transportation, education, and health care. These costs can vary depending on region, zip code, and even city.

A cost of living index is one of the simplest ways to determine the cost of living in a particular place. This will help you determine whether your income is sufficient to meet basic expenses.

Typically, these indices employ a variety of variables to compute the total expense. The Consumer Price Index (CPI) is an example of a standard indicator. It tracks pricing variations over time and compares them to the national average. The index can also be used to determine if sufficient funds are available for retirement savings.

The Social Security Administration calculates a yearly cost-of-living adjustment, which is not included in these estimates. Typically, this adjustment is made to benefits to account for price increases in products and services.

When people think about Medicare, they likely see health insurance for those aged 65 and older. Medicaid is a cooperative federal-state program that covers the medical expenses of low-income individuals.

Medicare and Medicaid are comparable systems, yet there are distinctions between them. Some states mandate a minimum income level in order to qualify for health insurance. In other states, waiting lists are lengthy.

Some elders can discover assisted living facilities that take Medicaid. The objective is to choose a facility that can provide the necessary care while remaining inexpensive.

You can conduct a facility search online. Or you might contact a local social service agency. The agency can assist you with any queries regarding eligibility, the application, or the procedure.

Long-term care insurance is another way to pay for assisted living expenses. The majority of insurance firms offer policies that cover a portion of costs. However, you may be required to pay for a part of your stay on your own.

Long-term care facilities where persons with disabilities can live independently are known as assisted living facilities. Typically, people live in apartment or house units with the assistance of caretakers. In other instances, the aides may help with cooking, cleaning, or medicine distribution. They can also offer social activities to stimulate the inhabitants' thoughts.

In New York, the state issues license to assisted living facilities. They must have a price schedule and be permitted to offer their services. New York, unlike other states, does not mandate a minimum staff-to-resident ratio.

Supportive group homes are another option for adults with special needs. These residences are typically purchased with private funds or through a government-sponsored program. Staff members monitor the residents, who may include counselors and full-time employees. Some group homes also provide live-in assistants.

Enhanced assisted living houses are comparable to group homes, but they are designed for disabled adults who require more care. A qualified physician can develop a care plan that meets the resident's needs.

Who in the USA Qualifies for Medicaid?

Published on : 12-02-2022 

In the United States of America, several people and families qualify for Medicaid coverage. These people include those who require medical care, are from low-income families, and have impairments. These people and their families must have a health issue that needs to be treated. Additionally, individuals must reside in a certain region where the Medicaid program is offered.

Children from low-income families, pregnant women, the elderly, and those with disabilities have historically had access to Medicaid coverage. Currently, the federal government covers a sizable share of the expense. The government match rate for those 65 and older in 2019 will be 93%, while the rate for adults under 65 will be 90%.

State Medicaid programs can adapt to shifting coverage requirements because to the federal matching program. Low-income residents can also get resources through this system. The Medicaid program assists people in covering the costs of medical care, hospital stays, and long-term care. It also offers additional services to those who are physically and mentally disabled.

The Social Security Act's Title XIX regulates the Medicaid program. The federal eligibility conditions are specified under this law. The program also establishes income caps for the various categories it serves. Each state has different restrictions on both age and income for each group.

The federal government covers 57% of Medicaid's expenses. The states cover the remaining costs. Based on state-based calculations, the national match rate is determined.

coverage for those in need of medical care
Numerous studies have demonstrated that Medicaid coverage for medically needy Americans saves lives. Most of these folks reside in nursing homes or other long-term care facilities. Older adults who cannot afford pricey medical equipment and prescription medications benefit from this kind of program.

It's possible for people with impairments and mental health issues to be eligible for the program. Some states provide extra state-only programs to assist those who do not meet Medicaid eligibility requirements.

States with a "pay-in spend-down" option include New York. This implies that a person can pay the government a portion of their medical expenses. Illinois is one of the states that does not demand a pay-in spend-down.

An individual must have sufficient medical expenditures to lower their income to the level of medically needy to be eligible for the program. However, neither income nor assets are included in these costs.

Disability can be a significant obstacle to obtaining health insurance, but Medicaid can assist you in getting the care you want. It covers a range of social and health services, including long-term care, acute care, and preventative care. Additionally, it is the main funder of necessary long-term services, including community- and home-based care.

Adults with disabilities and children with severe disabilities are covered under Medicaid. It offers services for those with mental health disorders and caring for those with physical limitations.

People with disabilities may also qualify for Medicaid's special benefits, which include long-term care and adaptive equipment. Additionally, it provides services that can aid with employment. Support services for disabled individuals interested in work are among these offerings.

For those with disabilities who require health care coverage but cannot afford private coverage, the Medicaid program is essential. Additionally, it's crucial for those with disabilities who do not have employer coverage.

Medicaid, the Children's Health Insurance Program (CHIP), or Medicare, provides health coverage to around half of all children in the US. States offer a range under federal regulations.

To give health insurance to more low-income children, Medicaid coverage for children has increased in the USA in recent years. The Biden-Harris Administration has prioritized this expansion. Concerns exist, though, over how the Affordable Care Act (ACA) may affect families and children's access to healthcare.

Consumers, providers, families, and health care plans will be impacted by the ACA. The ACA will also affect how parents and healthcare professionals are spoken with. It is crucial to remember that the ACA will have an impact on consumer groups like tribal entities.

In Massachusetts, the proportion of Medicaid-eligible children without insurance fell by 9.7 percentage points. In contrast, the rest of the nation's child uninsured rate was essentially constant. This may indicate that the expansions in the states that received federal assistance did not result in a rise in the private coverage rates for children.

Assisted Living Programs in New York

Published on : 11/16/2022 

If you or a loved one needs assistance with daily living activities, you may wish to consider an assisted living program in New York. These facilities provide housing, meals, housekeeping, linen service, transportation, social activities, and some personal care. Additionally, they offer 24-hour supervision. If you are considering assisted living in New York, you'll want to understand the eligibility criteria.

The state's Assisted Living Program (ALP) is not an entitlement program. However, there are a limited number of subsidized rooms available in New York. This program is administered by the State Department of Health. Its eligibility criteria are based on the need of the applicant.

The assets limit for the Assisted Living Program in New York is $15,900 for single applicants and $21,400 for married couples. However, Medicaid will not count a home as an asset if it is owner-occupied. In addition, the asset limit does not apply to the primary residence, household furnishings, appliances, or vehicles. For married couples, the healthy spouse may continue to live in the primary home.

The qualifications for an Assisted Living Program in New York include the need for more help than can be provided by a standard senior residence. Individuals must need assistance with activities of daily living and assistance with eating, bathing, and toileting. In addition, applicants must undergo screenings and assessments before acceptance. These screenings include a physical exam, an interview, a functional needs assessment, and a mental health evaluation.

An ALR must have care staff available to provide assistance when needed. The facility must also hire a case manager or facility administrator to oversee ISPs and resident needs. The administrator or case manager must be present on-site at least 40 hours per week. As the size of the facility increases, additional staff must be hired to ensure the quality of care for residents.

Medicaid can help you pay for the costs of assisted living services. This state-sponsored program provides subsidized room and board to residents who qualify. It is a win-win situation for both residents and the assisted living facility. Assisted living programs in New York are significantly less expensive than nursing home care and allow residents to enjoy more independence. The quality of care is also higher than in nursing homes. So, it is important to choose a suitable facility before making a decision.

In New York, assisted living programs are licensed by the NYS Department of Health. They provide assistance with daily activities and supervision for individuals with age-related or cognitive disabilities. An assisted living program can run alongside an adult care facility or stand-alone. The operator of an assisted living program must organize the services required by residents, including case management and residential help. However, assisted living operators cannot provide medical or nursing care to residents.

Assisted living facilities in New York are available in a wide range of sizes and amenities. Choosing the right facility can be difficult, as there are thousands of options. A directory of assisted living facilities will help you narrow down the options and make a decision that works best for you.

There are certain qualifications to qualify for the program, including age and income levels. Applicants must not be bedridden, need round-the-clock nursing care, or be a danger to themselves or other residents. Applicants must also meet income limits, which are higher than those for regular Medicaid. In 2022, a single applicant may have an income allowance of $934 a month. Additionally, Medicaid may also allow a non-applicant spouse to receive an income allowance from the applicant.

 

The main house of a person qualifying for Medicaid in New York is considered an exempt asset. This implies that the whole earnings are tax-free if a person sells their main house. Furthermore, they will lose the capital gains exclusion of $250,000 or $500k, whichever is larger. They may, however, utilize an irrevocable living trust to keep other assets.

As previously stated, Medicaid is meant for those with low incomes and little assets. As a result, if a person dies without help, Medicaid cannot recoup from their estate. Furthermore, Medicaid cannot collect support from a spouse or children who die before the Medicaid recipient. Medicaid will only recover assets in which the recipient had an interest at the time of death.

The government has imposed restrictions on the number of assets a person may possess when applying for Medicaid. The asset limit is set at $2,000. This does not include cash put aside for funeral and burial expenditures. Individuals may keep up to $1,500 in a separate bank account for this reason. Assets, on the other hand, cannot be given away or sold for less than their fair market worth. This would violate the Medicaid look-back rule, resulting in a term of Medicaid ineligibility.

A house is one of a person's assets. A person with a life estate may own the home, but it must be put in a NY Medicaid asset protection trust to be safeguarded. If a person cannot afford a Medicaid-approved life estate, the property may be transferred to a Medicaid asset protection trust.

While this might be a complicated matter, some techniques can assist a family saves their assets while gaining Medicaid eligibility. Disqualifying loved ones is often simpler than keeping them. There are, however, techniques you may use to safeguard your assets and qualify your loved ones for long-term care. Again, it is an issue of preparation. If you have any extra cash, you may use it to pay for long-term care.

Cash, stocks, investments, vacation houses, savings, bank accounts, and other sorts of property are all countable assets. However, certain purchases are excluded. These include IRAs in payout status, 401Ks, and personal property. There is also a special exemption for the applicant's principal residence, as long as it has less than $955,000 in equity (after debt).

In New York, Medicaid is provided to help folks who need assistance with their everyday tasks. To be eligible for Medicaid, a person must have sufficient income and resources to support themself. Furthermore, an applicant may have at most $16,000 in assets, which includes bank accounts, annuities, and cash values in life insurance plans. Although this condition is stringent, it will allow a person to get care in the comfort of their own home. When a person dies, Medicaid will attempt to reclaim the residence. However, specific techniques, including hiring an elder law attorney, may help you prevent recovery.

The Medicaid Excess Income Program is an excellent approach for persons with significant medical bills to become income eligible. For example, in New York, a single applicant is limited to $934 each month, while a couple is limited to $1,367. Applicants may also utilize the "spend down" amount, which is the gap between their monthly salary and the income limit for medically needed people. This sum is comparable to a deductible and must be fulfilled to be eligible for Medicaid.

The qualifying and expenditure limits will differ by state. Consult a Medicaid planner, estate attorney, or local social services agency to see whether you qualify. A Medicaid planner can assist you in identifying the specific eligibility criteria if you want to apply for Medicaid in New York. This is a highly involved procedure, and a professional may be able to help you throughout it.

Trust is another possibility. It has the potential to minimize the amount of time and money spent on estate administration. It may also save on income, gift, and inheritance taxes. Another advantage of Medicaid Trusts is that they are irreversible, meaning any assets placed in the trust cannot be returned to the founder.

Published on : 10/11/2022 

Medicaid eligibility in New York is based on a person's income and resources. The single-person income limit is $16,800. For couples, the income limit is $24,150. There is a 60-month "look-back" period, and certain assets are exempt.

Medicaid is a government program that provides health insurance for low-income people. There are certain income and asset limits that must be met before you can apply. This income limit applies to all income from wages, Social Security income, pensions, and other sources. The limit changes each year, but it is always low.

Your income may be lower than the income limit for Medicaid, but this does not mean that you can't qualify. Some states will allow you to set aside some of your assets to avoid the income limit. For example, if you have pre-paid burial space, Medicaid will not count that amount toward your assets. However, if you have any remaining funds after paying for a funeral, you'll have to turn them over to the Medicaid agency.

In addition to the income limit, there are also asset-transfer rules. If you transfer assets to a spouse or another person, the agency will consider this when determining the asset limit. In addition, your bank transactions for the past five years will be examined.

There are some strategies you can use to reduce your assets and avoid violating the 60-month "look-back" period of Medicaid in NY. These strategies may include paying off debts or investing in assets that are exempt from the look-back period. A good example is paying off a mortgage. However, this is not a simple process and should be discussed with an experienced Medicaid planner.

To make sure that no Medicaid applicant is harmed by the lookback requirement, local social services districts must provide clear guidelines and screening tools to help identify who is likely to qualify for the program. This will help reduce administrative burdens and prevent unnecessary service delays. This will also allow agencies to track how long it takes to process an application, which is a key aspect of the Medicaid application process.

Medicaid in New York has strict guidelines for the look-back period. If an applicant violates the look-back period, he or she will face a penalty. This penalty can lead to ineligibility, and that means that a person may be denied services for months or even years.

While you have the right to keep your assets, Medicaid will count them against your income. The exception to this rule is real estate. If you own your primary residence, and it is worth less than $893k, you can exempt it from the income limit. However, Medicaid may be able to recover the equity in your residence if you die. Because of this, many people take steps to protect their residence against Medicaid estate recovery. This often involves hiring an attorney.

In order to qualify for Medicaid, you must have assets and income that are sufficient to cover the costs of your care. Countable assets include cash, stocks and investments, vacation homes, savings and checking accounts, and personal belongings. However, many assets are exempt, including retirement accounts and 401Ks. You can avoid penalties if you place these assets in "payout status" or take minimum distributions on them.

The income limit for Medicaid in New York is based on the assets and income of the applicant. The current income limit is $24,600. The new guidelines will raise this limit to $37,908 for those with non-exempt resources.

If you are a disabled person 65 and older, you may qualify for Medicaid if you have pooled-income trusts. To qualify, you must meet certain requirements set forth by the Social Security Administration. Your disability must be severe and last at least one year. You must also have a nonprofit association that is established under state nonprofit statutes.

A pooled-income trust is an irrevocable trust created and managed by nonprofit associations for the benefit of disabled people. These trusts invest the funds of the trust to provide benefits for others who may need Medicaid assistance. Most states require the creation of these trusts before a disabled person reaches age 65, although a disabled person over age 65 can create one.

The income limit set by Medicaid is $825 per month. However, in some cases, the income limit is lower. If John has income exceeding this limit, he will have to deposit $1175 into a pooled-income trust in order to qualify for Medicaid. While these trusts have administrative costs, they will also cover bills.

Published On: 09-12-2022

In-home care is a broad term for several different services in a person's home. These services are meant to help seniors while letting them keep their independence. They range from effortless help to a more detailed care plan. There are a lot of good reasons to hire a home care provider.

Personal care services help with daily tasks and can keep people from having to move into an assisted living facility or nursing home. Some of these services might include bathing and cutting nails, while others might be more complicated, like taking care of catheters or tracheostomy devices. Long-term wounds can also heal faster with the help of in-home care services. In-home nurses can also help make medication schedules and monitor bowel movements.

Companion services bring people together. These services include light housekeeping, driving to the doctor, and grocery shopping. Homemakers can also help with personal care tasks, like making meals and cleaning up after them. Some are hired by the older person directly, while others work for a home care agency. A registered nurse has a two-year degree in nursing and is trained to help people with different health problems.

A person who gets care at home might need help with everything from making meals to keeping track of medications. For example, if an older person takes many different medicines, they may need help keeping track of them. People who get better from an illness or surgery can also get short-term care. Older adults may need help with daily tasks, personal hygiene, and home cleaning. They may also need help getting around, significantly if they can't drive themselves.

In-home care services can be expensive, so families need to make sure they have enough money set aside. Private insurance and insurance for long-term care can help pay for the service. Medicaid also pays for care at home, but coverage varies from state to state. Depending on the patient's needs, the patient's family may need to hire a home care agency to ensure their loved one is safe.

People who are getting older often choose to get care at home. Many people choose to be cared for by a child or family member, but some may find it hard to trust a stranger. A home care service can help by getting people together. For example, a person who helps with companion care can take a client for a walk or let them watch their favorite TV show.

Seniors with a wide range of needs can benefit from in-home care. For example, a caregiver can help them with daily tasks, and a nurse can help them deal with a long-term illness. A team of home health care workers can also help seniors get better after a stay in the hospital. In the U.S., in-home care is becoming more common and is the fastest-growing part of the health care industry. Even though it might seem scary, the benefits are much bigger than any worries.

Most of the time, private insurance will pay for home care services. Some Medicaid-funded long-term care programs also have specific rules about who can join. The main requirement is that you must be eligible for Medicaid. Personal care can be given by a private company or by Medicaid. People with disabilities who qualify for Medicaid can use these programs.

Published On:- 08-24-2022 

A home health aide provides health care services to patients in the privacy of their homes. These aides perform the same tasks as a medical professional, such as monitoring a patient's condition and recording vital signs. They must also teach patients about their condition and ensure their safety in the home. They also coordinate and supervise the patient's care with a medical professional. They must also be familiar with the patient's medical condition and record this information.

A home health care provider comes to the patient's home and provides personal care. The provider follows the doctor's orders and updates the physician on the patient's progress. The frequency of visits varies depending on the needs of the patient. For example, some patients require round-the-clock care, while others may only need short visits once or twice a week. Depending on the type of care required, a home health care provider will create a personalized plan for the patient.

In the late 1920s, many home care agencies closed, and many patients were forced to move to the hospital. With the development of hospitals, patients could no longer afford private home health care services. During the Great Depression, Blue Cross tried to offer coverage for visiting home health care, but this was not universally available. In addition, many people with chronic illnesses did not need to be in a hospital, and home health care was not as expensive or convenient.

Home health care services can be provided by nurse practitioners or other healthcare professionals, augmented by telehealth. Telehealth involves transferring medical data and information from patients to health care providers in another location. Most of these services use wired or wireless peripheral measurement devices. They are typically used between routine office visits and after a patient is discharged from the hospital. Some of these systems also allow video interaction between the patient and a health care professional. In addition, these systems can prompt targeted questions, provide educational materials, or instruct the patient to seek treatment at their nearest emergency room.

Telehealth is an excellent way to reduce the cost of health care while ensuring that patients receive the highest quality of care. Telehealth is an affordable way to provide medical care to patients who cannot travel to a physician's office. It is also more convenient for patients and more convenient for health care providers. As a result, telehealth is gaining ground in home and medical settings, with Medicare and Medicaid making significant investments in telehealth. Telehealth services may also reduce costs for health care providers, such as travel and staff time.

The job of a home health aide requires a high level of time management and attention to detail. Since they are responsible for the health of others, aides must always be on time and use their time wisely. Not only is being on time vital for happy work life but being late can be potentially dangerous. Home health aides must also pay attention to the smallest details, as minor changes in the patient's behaviour can signify a more serious health issue.

Home health aides must possess strong interpersonal skills to communicate with patients and their families effectively. Their work may require communicating with medical teams, patients, and other healthcare staff. This requires good communication skills and the ability to multi-task and keep track of details. Additionally, they must have the patience to understand the patient and their family, which may require them to pay attention to small details throughout the day.

Almost 60 million people are covered by Medicare, the government program that pays medical bills. But one rule governing home health care is problematic and causes an obstacle for people who need it. The Center for Medicare Advocacy filed a lawsuit against the CMS to clarify this issue. While Medicare does not require doctors to provide home health care, it does pay for some home health services. A prescription by a doctor is one example of home health care.

Home health care includes medically necessary skilled services delivered by a professional caregiver in the patient's home. These services are customized to the needs of each patient and may consist of checking vital signs, assessing pain, monitoring food intake, and administering medications. Some home health care providers may also help with basic hygiene and safety in the patient's home. In addition, they can be helpful for those unable to perform these activities independently, including the elderly and the disabled.

The Medicare demonstration is a federal program in which home health agencies receive payment for each episode or visit of home health care. Under the program, agencies are reimbursed for the reasonable costs incurred during the home health visit. Payment rates for home health visits decrease and increase with the volume of visits. The rates are also linked to the importance of visits and mortality. The Medicare demonstration is designed to improve the quality of home health care services while reducing public expenditures.

The traditional Medicare program's home health benefit is designed to cover up to 60 days of intensive care. Unfortunately, this is not a good approach for the growing demand for more intense care. But new and innovative programs are being developed to address this gap. But the current system is not set up to incentivize those seeking more intensive care. Fortunately, a few steps can help ensure that home health services receive the support they need to be effective and efficient.

In Rhode Island, Medicaid-managed care organizations (MCOs) are now obligated to meet specific criteria, including identifying and addressing enrollee health-related social needs through their services. This initiative aims to improve the health of Rhode Island residents enrolled in Medicaid-managed care plans. AEs must identify three areas of social deprivation and work to address them, as identified by state-approved standards.

These programs help patients manage their health care costs and improve patient outcomes. They are responsible for reducing avoidable health care costs, supporting evidence-based clinical decision-making tools, using consensus guidelines and best practices, and collecting specific quality measures. They are also accountable for improving patient outcomes, minimizing medical errors and improving health outcomes. Responsible entities in home health care are a vital component of these efforts. However, these programs are not yet available in all communities.
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