Group Residential Housing (GRH) & MN Supplemental Aid (MSA) Housing Assistance

1. Group Residential Housing (GRH)&MN Supplemental Aid (MSA) Housing Assistance MN Age & Disabilities Odyssey June 18, 2013

2. Group Residential Housing (GRH) • Started in 1992. • Individual income supplement to purchase “room and board”, and in some cases – services • To prevent or reduce institutional residence or homelessness • 20,000 people currently using GRH in MN

3. 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

4. Individual Eligibility • Eligibility for GRH Housing Rate • At least 18 years old and • Meet a Basis of Eligibility for SSI or • Meet a Basis of Eligibility for GA

5. SSI Basis of Eligibility • Aged • Blind • 18 and Disabled

6. GA Basis of Eligibility • Permanent or temporary Illness (medical opinion) • Placement in a Facility (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) • SSDI/SSI Application or Appeal Pending

7. Individual Eligibility • Eligibility for GRH Housing Rate • Countable Income: Less than amount in 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)

8. GRH Housing Rate • GRH Housing Rate (Room and Board, Rate 1, Base Rate, MSA Equivalent Rate) • $867 ($877, eff. 7/1/13) • Rent, Utilities, Food, Household Supplies • Anything left: Other things necessary to provide room and board • NOT services, clothing, medical costs

9. GRH Housing Rate • GRH Housing Rate: How the Maximum Rate is Determined

10. Types of GRH Housing Statewide • Adult Foster Care (4486) • Board and Lodge (265) • Board and Lodge w/ Special Services (247) • Supervised Living Facility (58) • Non-Certified Boarding Care (28) • Housing w/ Services Establishment: Elderly (635) • Housing w/ Services Establishment: Homeless (719) • Metro Demo (38) • Tribe Certified (2)

11. 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

12. GRH Agreement • Between County and Vendor: • # of authorized beds • Monthly and per diem rates • Food Support language requiring $200 for purchase of food • Termination with or without cause, 60 days notice • Other at county discretion

13. Service Requirements • None required in Board and Lodge only or Tribe Certified • Examples of service funding include: • Waivers (DD, CADI, CAC, BI, EW) • ARMHS/TCM • Private Foundation Grants • GRH Supplemental Service Rate • Difficulty of Care (DOC)

14. GRH Supplemental Service Rate • Also known as: (Service Rate, Rate 2) • $459.85 ($482.84, eff. 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

15. 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

16. Individual Eligibility • Eligibility for GRH Service Rate • Only if not eligible or able to receive waiver or PCA services • 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 andreceive GRH Housing Rate

17. GRH Supplemental Service Rate • Board and Lodge only and Adult Foster Care settings are not eligible • Moratorium on new development, unless… • Banked Beds • Legislative exception • Individuals relocating out of certain shelters to Housing with Services (Homeless) setting • Shelter licensed and registered prior to 12/31/96

18. Difficulty of Care (DOC) • Not the same as GRH Supplemental Service Rate • $459.85 (maximum) • DHS does not structure rates or assessment tools, counties do • Only in Adult Foster Care (family) settings • Only if Waiver Services not available

19. GRH Application • Combined Application Form (CAF) or applies online at www.applymn.org w/ required verifications (income, assets, etc.) • Verifying basis of eligibility • Social Security Administration • SMRT • Medical Opinion • Service Plan

20. Application • Required to apply for other programs for which they appear eligible (SSI, MA, etc.) • Interim Assistance Agreement • County manages approval into MAXIS

21. Group Residential Housing (GRH) • GRH Client Obligation (Countable Income)

22. GRH Payment • GRH Payment Client Pays State Pays

23. GRH Payments • In Congregate Settings: Personal Needs Allowance $94 Client Client Up to $200 SNAP (only if residing in homeless shelter) $616 Vendor Food $200 $251 $667 State (DHS) Facility Operations and Household Needs = $867 = $867

24. GRH Payments • In Community-Based Settings: Personal Needs Allowance $94 Client Client Utilities, Household Needs, or Gift Cards Up to $200 SNAP $616 $267 Vendor $251 $600 Rent State (DHS) = $867 = $867

25. 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)

26. GRH Payments • Absent Days • Continue GRH payment 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

27. Group Residential Housing (GRH) • GRH Recertification • Counties recertify eligibility at least once every 12 months. • Individual reports changes during the year.

28. Group Residential Housing (GRH) • Other FAQ • GRH and Couples • GRH and MFIP • Quality Assurance • Private Pay vs. GRH • Tenant/Landlord Law • County Transfers/Servicing

29. Group Residential Housing (GRH) Department of Human Services GRH Policy Kristine Davis 651-431-3845 kristine.davis@state.mn.us dhs.adultincomesupport@state.mn.us

30. Group Residential Housing (GRH) Other GRH-related contacts: • DHS Vendor Helpline, 651-431-4153 • DHS Financial Operations, 651-431-3752 • DHS Ombudsman for Long-Term Care, 651-431-2555, 1-800-657-3591 • MN Ombudsman for Mental Health and DD, 651-757-1800, 1-800-657-3506

31. Minnesota Supplemental Aid (MSA) MSA Definition: (MN Statute 256D.34) • (3) provide an integrated public assistance program for all MN residents who are recipients of supplemental security income or who, except for excess income, would be receiving supplemental security income and who are found to have maintenance needs as determined by application of state standards of assistance…

32. Minnesota Supplemental Aid (MSA) • Monthly cash supplement to Supplemental Security Income (SSI) payment • Average monthly caseload of 30,000 people receiving MSA in 2012 • Over 75,000 Minnesotans between the age of 18 & 65 receive SSI • Roughly 45,000 people potentially eligible for MSA not receiving it

33. MSA Eligibility Criteria To be eligible for MSA a person must be: • Over age 18 (or under 18 and blind), and • Receiving Supplemental Security Income (SSI), OR • Would be receiving SSI except for excess income. If not receiving SSI must be: • Age 65 or older, or • Blind, or • Disabled

34. Typical MSA Monthly Benefit $81 (individual) (MSA=$111 for couples) (additional $ for special needs)

35. MSA Special Needs • Special Diets • Restaurant Meals • Guardian/Conservator Fees • Representative Payee • Housing Assistance • Home Repairs • Household Furnishings & Appliances + $200/month

36. MSA Housing Assistance Eligibility • A person must: • Be eligible for MSA, and • Be under age 65 (grandfathering allowed), and • Relocating from institution, or • Eligible for self-directed MA PCA services, or • Waiver recipient living in their own place • Have monthly shelter costs in excess of 40% of gross monthly income • Apply for rental assistance Continued on next slide

37. Typical MSA Housing Assistance Benefit $710 (SSI FBR) + 81 (MSA) +200 (MSA Housing Assistance) $ 991 Total Income • + Supplemental Nutrition Assistance Program (SNAP)

38. MSA Housing AssistanceThe Benefit • Recipients can choose where they live – no “licensed or registered setting” requirement • They can use the money in whatever way they choose • Great tool to assist people who want to live in a less restrictive setting (leaving nursing homes, group residential housing, intermediate care facilities, prison, etc.)

39. MSA Application & Renewal • Combined Application (CAF)or online at www.applymn.org • Eligibility begins on the first day of the month • Eligible for entire month if eligible 1 day in month • 60 day processing period • Annual recertification • Benefits paid on EBT card

40. MN Supplemental Assistance (MSA) Department of Human Services GA& MSA Policy Beth Grube 651-431-3839 Beth.grube@state.mn.us dhs.adultincomesupport@state.mn.us

41. Other Resources WWW.DHS.STATE.MN.US Click “People We Serve” “Adults” “Economic Supports” WWW.DB101.org Senior Linkage Line 1-800-333-2433 Disability Linkage Line 1-866-333-2466