Gail Ertel, who is in her 60s, is the primary caregiver for her great-granddaughter McKenzie, 7, who has autism, visual disabilities and other medical needs. But since Ertel receives $400 a week from Medicaid for McKenzie's round-the-clock care, she is ineligible for respite services. Advocates say their situation is the dilemma many families face -- balancing finances and caring for a child with disabilities.

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