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Virginias

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Divert 55 individuals who are at imminent risk from nursing home ... Mathews. Middlesex. Northumberland. Richmond. Westmoreland. JABA. Total Enrollment 25 ... – PowerPoint PPT presentation

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Title: Virginias


1
Virginias
  • NURSING HOME DIVERSION
  • MODERNIZATION GRANT
  • The Community Living Program

2
Goal 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

3
Objectives 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

4
Expected 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

5
Menu of Services
  • Service Coordination
  • Respite
  • Companion/Homemaker
  • Personal Care
  • Chore
  • Home Delivered Meals

6
Menu of Services continued
  • Adult Day Care
  • Transportation
  • Assisted Living
  • Senior Apartments
  • Personal Emergency Response System
  • Assistive Devices
  • Disposable Medical Supplies

7
Menu 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.

8
Provider 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.

9
Payment 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.

10
Pilot Planning and Service Areas
  • Area Agencies on Aging (AAA)
  • Bay Aging
  • Jefferson Area Board for Aging (JABA)
  • Valley Program for Aging Services (VPAS)

11
Enrollment 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.
12
Bay 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

13
JABATotal Enrollment 25 Tel 434-817-5222 Fax
434-817-5230
  • City of Charlottesville
  • Counties of
  • Albemarle
  • Fluvanna
  • Greene
  • Louisa
  • Nelson

14
VPASTotal Enrollment 5 Tel 540-949-7141 Fax
540-949-7143
  • City of
  • Harrisonburg
  • County of
  • Rockingham

For the pilot VPAS is serving only Harrisonburg
and Rockingham
15
Eligibility 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

16
Eligibility 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

17
Eligibility 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

18
Eligibility 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.

19
Forms 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.

20
Services 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

21
Virginia 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
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