Title: Virginias
1Virginias
- NURSING HOME DIVERSION
- MODERNIZATION GRANT
- The Community Living Program
2Goal of the Project
- Divert 55 individuals who are at imminent risk
from nursing home placement and Medicaid
spend-down through consumer direction of services
provided within a designated monthly allotment of
up to 1200
3Objectives of the Project
- Design program policies, protocols and tools
- Identify and enroll 55 eligible individuals from
three pilot Area Agencies on Aging (AAAs) - Offer consumer direction and assistance of a
fiscal intermediary - Evaluate the program
- Expand consumer direction to other AAA regions
- Educate policy makers
4Expected Outcomes of the Project
- A minimum of 55 individuals will be served
- 80 will be diverted from nursing home placement
and Medicaid spend-down - 85 of participants and/or their caregivers will
report an improvement in their QOL - 85 of participants and/or their caregivers will
report and excellent or good experience with the
project
5Menu of Services
- Service Coordination
- Respite
- Companion/Homemaker
- Personal Care
- Chore
- Home Delivered Meals
6Menu of Services continued
- Adult Day Care
- Transportation
- Assisted Living
- Senior Apartments
- Personal Emergency Response System
- Assistive Devices
- Disposable Medical Supplies
7Menu of Services continued
- Home Modification/Housing Rehabilitation
- Dental Care (Bay Aging only)
- Nutritional Supplements
- Groceries
- Prescription Medications
- Recreational Devices
- There is no participant co-pay or partial pay
for these services. However, the project will
only pay up to the 1,200 maximum monthly
allotment. -
- A participant may save part of their monthly
allotment up to 5,000 to purchase a more
expensive service, such as a ramp.
8Provider of Services
- As this is a participant (consumer)-directed
program, the participant is able to choose who
provides their service. - Providers may be
- A person hired directly by the participant
- An agency
- The AAA
- Some services have provider qualifications.
- There is no limit on personal attendant hours
within the 1,200 monthly budget. -
9Payment for Services
- Payments are being handled through a fiscal
intermediary, Public Partnerships, LLC (PPL) - PPL will track the participants budget
- All participant payments will be processed by PPL
- For personal attendants hired directly by the
participant, timesheets will be submitted to PPL
and payments will be made to the personal
attendant. For all other services, the AAA will
process invoices through PPL.
10Pilot Planning and Service Areas
- Area Agencies on Aging (AAA)
- Bay Aging
- Jefferson Area Board for Aging (JABA)
- Valley Program for Aging Services (VPAS)
11Enrollment of Participants by AAAJuly 1, 2009
through October 31, 2010
As participants are discharged from the project,
the pilot AAA may identify another participant to
fill the slot if funds are available.
12Bay Aging Total Enrollment 25 Tel
804-758-2386 Fax 804-758-5773
- Mathews
- Middlesex
- Northumberland
- Richmond
- Westmoreland
- Counties of
- Essex
- Gloucester
- King and Queen
- King William
- Lancaster
13JABATotal Enrollment 25 Tel 434-817-5222 Fax
434-817-5230
- City of Charlottesville
- Counties of
- Albemarle
- Fluvanna
- Greene
- Louisa
- Nelson
14VPASTotal Enrollment 5 Tel 540-949-7141 Fax
540-949-7143
For the pilot VPAS is serving only Harrisonburg
and Rockingham
15Eligibility Criteria
- Age 65 and older
- AND
- Informal Support System Status A caregiver
demonstrating difficulty meeting the needs of
their family member or an individual that lacks
informal support - AND
16Eligibility Criteria continued
- Functional Dependent in 2 4 ADLs
- OR
- Cognitive/Emotional Status Cognitive
impairments including - Need for prompting or supervision
- Impairments in decision-making ability
- Inability to avoid injury in emergency situations
17Eligibility Criteria continued
- Health Status May have
- a health condition that requires at least monthly
monitoring (e.g. diabetes, heart disease) - medical/nursing (skilled care) needs
- recent hospitalization or prior nursing facility
stay
18Eligibility Criteria continued
- Financial
- INCOME at or below 300 of SSI for the
participant and likely to be denied Medicaid
eligibility due to excess resources - RESOURCE LEVEL must be no less than and no more
than these ranges - Single individual 21,912 -43,824
- Individual with spouse 43,824-219,120
- The project only considers liquid resources.
This would be cash or in any other form which can
be converted to cash within 20 work days (such as
checking, savings, bonds) - If a person is eligible for Medicaid or Medicaid
Wavier programs, they are not eligible for this
project.
19Forms for Referring IndividualsSend Forms
directly to the AAA Begin July 1, 2009
- Nursing Home Diversion Project AAA Referral Form
- AND
- Uniform Assessment Instrument
- OR
- Nursing Home Diversion Project Quick Form
- AND
- Copy of the consent form used by the
Pre-Admission Screening Team - If it appears a person is not Medicaid eligible,
an NHD referral can be made without the person
being denied for Medicaid.
20Services After the Grant
- The grant ends March 31, 2010
- The AAAs are committed to continuing services to
existing NHD participants - If continued funding becomes available, VDA will
advise interested parties
21Virginia Department for the Aging
Contact VDA 804-662-9333 Toll Free
800-552-3402 Kathy Miller Peggy
Nieder kathy.miller_at_vda.virginia.gov
peggy.nieder_at_vda.virginia.gov