How's South Carolina for a Quad? Or anywhere?

So Medicare is federal - 2 years after you’re determined to be disabled you pretty automatically get it. Basically it covers doctors visits and hospitalization stuff. Most big rehabs push you through the whole SSDI and Medicare process while you’re inpatient.

Most states have named their Medicaid programs - Medi-cal, Salud - and you qualify for them by income/savings or lack of. Many of the handiest programs like HCBS and the most flexible DME purchasing fall under various Medicaid waivers, for which you can qualify and then either get services or be waitlisted for services.

It’s really maddening and it’s completely unfair. It depends entirely on how much money your state government has got. I can go into DVR and get services tomorrow where I live now, but if I move back to the state I lived in when I was injured, there’s a 4 month wait for assessment and a 9 year wait for services.

Sure I now live in Colorado, which is where I did my rehab. When I was injured, I was living in New Mexico. New Mexico was a wonderful place and I was very happy there prior to my injury but it is also largely rural, very very poor, and the entire state (including the county with the 2 largest private hospitals, the medical school/hospital, and the VA hospital) is federally defined as medically undeserved. The state is incredibly underresourced.

Okay, let’s see - I’m sorry it’s taken me so long to respond.

The community is fantastic - there are many services and programs available, and it’s beem my experience that the local colleges are really proactive and accommodating. The rec programs at community centers are very accessible and helpful.

I qualify for Medicaid under a weird program, which is a special set aside for disabled working adults, and so it works slightly differently than regular Medicaid. They qualified me in 5 business days after I completed the application online. Folks I know who have regular Medicaid qualified as fast. If they have any questions they give you 90 days to answer them and they don’t hold it against you while you get those done. DVR is also very rapid to get set up with, they’re super helpful and really well connected.

I don’t qualify for HCBS caregivers right now. In the county I live in, there are only three agencies that provide HCBS caregivers, and they are rapidly responsive. I know folks who use them and they all report that they have never had a shift go uncovered. I haven’t used either care.com or craigslist to get caregivers or pcas. Within an hour of my house there are three nursing schools, a PT school and an OT school. I think there are 9 different CNA programs. If you post at the schools, you will generally get a lot of response. That’s how I have gotten aides and then they recruit their friends. It’s been pretty painless.

Also, we’re within 90 minutes of a top 10 spinal cord rehab hospital, there is another rehab hospital/LTAC about 40 minutes away, and a really lot of SNFs of varying quality all over the place up here. There is also a Center for Independent Living that has either two or three fully adapted apartment complexes and a home health agency serving their residents that includes PT and OT services and a warm water therapy pool.

If you stay in the areas of this and adjoining counties that are served by public transportation, the paratransit is pretty good. If you move into the sticks the way I did, things get trickier unless you’re on straight Medicaid.

The weather can be brutal - it gets really cold in the winter, although not like it did 15 years ago. When I get too cold it provokes my spasticity, and so I am persnickety about travel plans in winter. Again, though - I live in the sticks and so there’s shoveling involved for me and distances which wouldn’t be an issue if I lived in an apartment complex. Summers are great. The humidity is low, it cools off substantially at night.

I hope this helps and again - sorry it’s taken me so long to respond!