1. SILP Transition Planning Process & Time Lines

2. Major Stages & Timelines of SILP Transition
Preparation For Transition Initiative
County/regional orientation of local teams about transfer, roles, responsibilities. State RFP for Choice and Benefits Counseling (June-July 2006)
Individual Screening
Information gathering in each County to determine waiver eligibility, target movement option and determine level of counseling support needed. (May-August 2006)
Customer Preparation, Initial Choice Counseling & Possible Referral for Benefits Counseling
Local teams expected to be doing initial group meetings with customers about choices with user friendly tools presenting the pros and cons of choices. Contracted resources available (scheduled) to assist as needed. Individuals needing more intensive counseling support must agree to participate. (September–November 2006)
Provider Preparation for Brokerage Services
Local brokerage or trade association may assist residential providers with limited experience with Support Services. (July-November 2006)
Individual Transitions
Movement to Supported Living targeted November 2006-January Brokerages may initiate individual planning with targeted customers in October 2006, with Brokerage start dates December-April 2007.
Intensive Benefits Counseling Completed for Individuals
Individuals needing Benefits Counseling are expected to be transferring in March and April 2007.
Clean Up 2

3. SILP Transition: A Team Effort
Activity
Lead Responsibility
Screen Medicaid Eligibility
County
Review Monthly Budget & Living Expenses
SILP Provider
Review Present Supports
Team
Employment Status
Review & EPD Screening
Employment Provider 3

4. SILP Transition: A Team Effort
Activity
Lead Responsibility
Review of Present Potential Rates
County
Identification Need
Choice & Benefits Counseling
Team
Tools & 1:1 Support Available
Brokerage Planning
Brokerage 4

5. Screening Phase I: Review Medicaid Eligibility
Medicaid Review
Counseling
Possible Options 1. a. No
Meets Level of Care Criteria
(Based on Title XIX Form or SC Review)
Review LOC with
Kathy Richards, SPD
GF Level Only
Brokerage Support Services Waiver
Basic Benefit ?
Yes 2. b.
Meets Medicaid Resource Eligibility Criteria
Countable Resources below standard $2000
On Waiver or below $5000 EPD
County Review and Follow Up Resource Strategies (no employment)
Trust
Spend Down OR
Choose ? No
Yes
Comprehensive Services
SL with higher rate
Maintain DD 54 rate
Project possible residential off-
set prior to choice counseling 3. c. No
Meets Medicaid Financial Eligibility Criteria
Income up to 300% SSI
SSI, DAC, or Pickle OK
SSDI only and SSDI plus work income above $ will need choice and or benefits counseling
County Review and Possible Benefits Counseling Strategies for Employment
EPD
PASS
Residential Offset ?
If ALL 3 Criteria are met,
Possible SL Placement 5

6. Screening Phase II: Review of Monthly Budget and Living Expenses
Complete Individual Budget Form
Identify basic living expenses, i.e., present use of earned & unearned income
Screening Phase II: Review of Monthly Budget and Living Expenses
Step 1:
Complete Monthly Budget Worksheet based on actual income and expenses in the most recent “typical” month.
Step 2:
Analyze monthly budget
Q1.: Is income above $1809 (300%)? If yes, individual requires eligibility and other counseling and may then only be eligible for Brokerage Services.
Q2.: Are basic expenses presently above the $603. (100% SSI) allowed for room, board, personal allowance?
YES NO
Individual may adjust expenses to within the limits and consider Supported Living
Decreasing expenses
Section 8 subsidy
Considering allowable medical expense deduction
Okay to consider
Supported Living OR
Individual can maintain present budget and go to Brokerage Support Services
Q3.: What adjustments be made in expenses to a) Bring costs to $603. And b) Lessen service contribution
Go to Benefits Screening & Counseling 6

7. Screening Phase III: Review Present Needs & Supports1.
Identify Health & Safety Issues
(review information
from 12/05 screening)
Notes: 2.
Identify Residential
Supports Needed
Notes: 3.
Identify Employment
Supports Needed
(complete)
Notes: 4.
Identify Issues Related
To Choice & Decision Making and
On-going Case Management
Support Needs
Notes: 7

8. Screening Phase IV: Focus Present and Future Employment Goals
Present DD 54 Provider or other team member completes
Employment Status Review and EPD Screening
Note: Employment and Budget Forms are available electronically so they can be shared with Choice and Benefits Counselor at a later stage, if approved by individual 8

9. Screening Phase V: Review Present & Potential Rates or Benefits1.
Present Supports
DD 47 $_______ + DD 54 $_______ =
$_______ 2.
Comprehensive Rates
Possible DD 51 rate $_______ + DD 54 $_______ =
Residential rate does not include vacancy factor, no increase in DD 54. 3.
Brokerage Support Services Benefit Level
[ ]
General Fund Only
$320. Per month
Not Medicaid Eligible
Basic Benefit
Medicaid Eligible
Difference between expected benefit and present supports?
+ $_______ or
- $_______
Are there other employment related work incentives to consider?
(Employment Screening Tool)
_____ Yes
_____ No 9

10. Screening Phase VI: Identification: Level of Choice/Benefits Counseling
Level I: Simple
Brokerage
[ ]
Individual SILP only meeting, all waiver eligibility criteria
(Maintain or increase in budget with move to Brokerage)
Supported Living
Individual meets all waiver eligibility criteria and can make an informed choice about SL
(no or very low residential offset)
Level II: Choice Counseling and Mid Level Benefits Counseling
Working individual meets all criteria for EPD (Level III Employment Screening Tool) and that brings residential off-set to an acceptable level
Brokerage/SL
Individual above resources, not employed or interested in working, will use “typical “spend down” or trust approaches to address Medicaid eligibility.
Level III: Intensive Individual Benefits Counseling (may involve writing a PASS Plan)
Present fixed monthly budget expenses exceed 100% SSI or $ creating a conflict between living expenses and residential offset
Working individual whose “residential offset” may be lessened through PASS plan (meets criteria Part IV of Employment Screening Tool)
Working individual who is expected to have a benefit level of $320. Individual has issues related to monthly support needs, resources, and or financial eligibility.
Individual desiring to work and presently will have Support Service General Fund benefit level 10

11. Setting The Local Transition Schedule
This is done in conjunction with SPD contact
Factors that will influence the schedule
Which transfers are relatively easy?
What works with the Brokerage?
How much Benefits Counseling do we need and when will it be available? 11

12. Individual Preparation For Transition
General Preparation
By September 2006 tools for assistance
Script for local meeting
Pros and Cons
How to “talk about Benefits planning”
Assistance with Individual Choice and Benefits Counseling
Phone
Onsite
PPSS Plan development 12

13. Building Brokerage Plan (Residential & Employment)
Community Inclusion
Type of service
Hours of support per month (face to face staff time)
Outcomes achieved
Future goals
In Home Supports
Type of service
Hours of support per month (face to face staff time)
Outcomes achieved
Future goals
Employment
Type of service
Hours of support per month (face to face staff time)
Outcomes achieved
Future goals
Review of Present Service Plan (ISP)
Define services based on categories for Brokerage Support Services 1.
Identify Health & Safety Issues
May be information that was gathered for review in December 2005 2 13

14. Provider Preparation

15. Residential Provider Preparation for Supported Living1. 2. 3. 4. 15

16. Residential Provider Preparation for Brokerage Services1. 2. 3. 4. 5. 16