GROUP RESIDENTIAL HOUSING (GRH) SOPHAT JECSI & JOHN PETROSKAS MINNESOTA DEPARTMENT OF HUMAN SERVICES October 14, 2013

GROUP RESIDENTIAL HOUSING (GRH) Started in 1993 Individual income supplement to purchase “room and board” GRH can pay for services in some cases Goal is to prevent or reduce institutional residence or homelessness

FINANCES GRH is entirely state-funded GRH is administered by counties or tribal nations The total cost of GRH in FY2012 was $122,000,000 Average GRH payment is approximately $545/month

DEMOGRAPHICS Nearly 21,000 people receive GRH each month Around 17% are seniors Average age: 48 years 58% male (72% eligible as Over 65 were women) 15% report earned income, averaging $221/month Nearly 70% had mental health diagnosis in last three years One third had chemical dependency diagnosis in last three years

TYPES OF GRH HOUSING STATEWIDE Adult Foster Care (4104) Board and Lodge (235) Board and Lodge w/ Special Services (282) Supervised Living Facility (56) Non-Certified Boarding Care (16) Housing w/ Services Establishment (520) Housing w/ Services Establishment: Homeless (372) Metro Demo (15) Tribe Certified (0)

CHARACTERISTICS Nearly half of all people receiving GRH live in Adult Foster Care 17% live in Board & Lodge with Special Services 12% live in Housing with Services Establishments 20% live in other settings

GROUP RESIDENTIAL HOUSING (GRH) Definitions GRH client: individual receiving GRH income supplement Vendor: entity receiving GRH payment Service Provider: GRH Housing service provider: administers room and board (handles rent, utilities, food, household needs) GRH Supplemental service provider: provides supportive services and/or health-related services Waiver service provider: provides services eligible under an MA waiver

INDIVIDUAL ELIGIBILITY Eligibility for GRH Housing Rate Meet a Basis of Eligibility for SSI or Meet a Basis of Eligibility for GA

SSI BASIS OF ELIGIBILITY Individuals who are: Over 65 Blind Have a disability as determined by Social Security Administration Do NOT need to actually receive SSI

GA BASIS OF ELIGIBILITY Permanent or Temporary Illness (medical opinion) Requires Services in Residence (service plan) Unemployable (vocational assessment) Developmental Disability or Mental Illness (qualified professional) Advanced Age (55 or older & limited work ability) Drug/Alcohol Addiction (medically certified as material factor in disability) RSDI/SSI Application or Appeal Pending

INDIVIDUAL INCOME ELIGIBILITY Eligibility for GRH Housing Rate Countable Income: Less than maximum benefit (see GRH Agreement) Assets: SSI Basis of Eligibility: $2,000 GA Basis of Eligibility: $1,000 (can be additional $2,000 if Earned Income Savings program, effective October 2012)

GRH HOUSING REQUIREMENTS GRH Housing Requirements Must be Licensed or Registered MN Department of Health, or MN Department of Human Services, or Tribal Government Must have GRH Agreement w/ County

GRH HOUSING RATE GRH Housing Rate (Room and Board, Rate 1, Base Rate, MSA Equivalent Rate) $877, effective 7/1/13 Rent, Utilities, Food, Household Supplies Anything left: Other things necessary to provide room and board NOT services, clothing, medical costs

SERVICES Examples of service funding include: Waivers (57%) DD (28%) CADI (16%) EW (11%) BI (2%) GRH Supplemental Service Rate (27%) Difficulty of Care (DOC) (4%)

GRH SUPPLEMENTAL SERVICE RATE Also known as: (Service Rate, Rate 2) $482.84, effective 7/1/13 (or higher if Legislature authorized exception) Supportive Services (required) Assistance with transportation Arranging meetings and appointments Arranging medical and social services Medication reminders Up to 24-hour supervision

GRH SUPPLEMENTAL SERVICE RATE Health Supervision (optional) Assistance in preparation and administration of medications other than injectables Provision of therapeutic diets Taking vital signs Providing assistance in dressing, grooming, bathing, or with walking devices Requires licensed nurse on site 4 hours per week

INDIVIDUAL ELIGIBILITY Eligibility for GRH Service Rate Only if waiver or PCA services not available Must have illness or incapacity which prevents from living independently in the community and require services in the residence Must have county-approved service plan Must reside in eligible housing type and receive GRH Housing Rate

GRH SUPPLEMENTAL SERVICE RATE Board and Lodge only and Adult Foster Care settings are not eligible Moratorium on new service rate beds, unless… Banked Beds Legislative exception Individuals relocating out of certain shelters to Housing with Services (Homeless) setting

GRH APPLICATION Combined Application Form (CAF) or applies online at with required verifications (income, assets, shelter verification form, etc.) Phone interview is okay, an in-person interview is not required

APPLICATION/RECERT IFICATION Required to apply for other programs for which they appear eligible (SSI, MA, etc.) Interim Assistance Agreement Counties recertify eligibility at least once every 12 months. Individuals report changes during the year (10 days to report changes that affect eligibility)

GRH PAYMENTS Pre-Pay Issued at the beginning of an eligibility month Post-Pay Issued after the end of an eligibility month Required when: Residence is expected to last 30 days or less Clients are monthly reporters (earn more than $100/month)

GRH PAYMENTS Absent Days GRH payment continues for up to 18 days per absence, not to exceed 60 days per calendar year County approval required for non-medical No county approval required when crisis, illness, or injury

CLIENT OBLIGATION GRH Client Obligation (Countable Income) GROSS INCOMEGA exampl e SSI exampl e RSDI exampl e SSI Standard (FBR)/RSDI + $ Other Unearned Inc.+ $ Earned Income+ $ DEDUCTIONS Personal Needs- $94.00 Other- $ CLIENT OBLIGATION= $

GRH PAYMENT GRH Payment EligibilityGA Exampl e SSI Exampl e RSDI Exampl e Total Days31 VND2 Rate Limit PAYMENT GRH (State) AMT Client Obligation TOTAL PAYMENT= Client Pays State Pays

GRH PAYMENTS In Congregate Settings: Vendo r Clien t $616 State (DHS) $261 $200 Facility Operations and Household Needs $677 = $877 Food Clien t Personal Needs Allowance $94

GRH PAYMENTS In Community-Based Settings: Vendo r Clien t $616 State (DHS) $261 $141 Rent $736 = $877 Personal Needs Allowance $94 Up to $ 200 SNAP Utilities, Household Needs, or Gift Cards

OTHER GRH-RELATED CONTACTS: DHS Vendor Helpline DHS Financial Operations DHS Ombudsman for Long-Term Care or MN Ombudsman for Mental Health and DD or

QUESTIONS? MN Department of Human Services John Petroskas Sophat Jecsi