A Process for Developing Service Plans and Individual Budgets

1. New Hampshire’s Area Agency of Greater Nashua, Inc.Real Needs-Real CostsWith an Eye Toward the Future A Process for Developing Service Plans and Individual Budgets Leslie Boggis Manager, Consumer Directed Services  Peter Van Voorhis, Director Community Services

2. Summary • Drawing on 6 years of prior experience in developing Consumer Directed Programs for adults, the Area Agency of Greater Nashua has brought 52 families into the In-Home Supports for Children with Developmental Disabilities (IHS) HCBC program since July 2003. • We work with families in a down-to-earth, hands-on, “kitchen table” planning approach. • We call our program: • Real Needs-Real Costs -- with an Eye Toward the Future.

3. Service Planning and Budget Development • We approach Service Planning and Budget Development as concurrent activities. • Our process is like a hiking trip: We set out with the parents with only a map of the area (the HCBC In Home Supports program with its opportunities and rules). • We don’t bring a preconceived notion of where we’ll end up, only that it will be within the landscape covered by our map.

4. Service Planning and Budget Development • Our “hike” is undertaken in step with the family: • 1: The first step is to identify needs. • 2: Next, we work to educate the family on the program’s parameters. For example, we discuss the five support categories offered under NH’s IHS Waiver: • Personal Care, • Respite, • Professional Consultation, • Environmental Modification, and • Family Support/Service Coordination.

5. Service Planning and Budget Development • 3: Together, we discuss the real costs of the supports envisioned. • 4: If necessary, we move back and forth through the steps: needs, education, and cost. • At the end of our hike, we arrive at our goal: an Individualized Plan and Individualized Budget.

6. Guiding Principles • We adhere closely to the following principles: • Frugality: We emphasize that these are public funds and needed to be treated as such. • Payer of Last Resort: Other generic resources must be utilized first. • Compliance: We remind all parties of the program’s standards and expectations.

7. Guiding Principles • Education: People come into this process with a wide range of knowledge and experience. We work with them to help fill in any gaps. • Hands-On: With calculator in hand, we sit down at the family’s table and develop an individual budget. • No mystery surrounds the process. Information is shared directly and openly with families; we do not negotiate back and forth with our office.

8. Guiding Principles • Informed Decisions: We guide people in making informed decisions about supports that will last and or will have positive impact on their child’s future. For example, we want parents to think about employee retention as a goal. Long term employees add to service quality, reduce replacement cost, and prevent time lost in bringing a new worker “up-to-speed”. • No Script: We serve in a consulting role; every family is different so there can be no script.

9. Training for Savings • We help parents understand how they can make choices to save money in one area so that more may be spent in another. • We encourage the use of family recruited employees, people who require little or no training, and may be trained by the parents at no additional cost. • Parents are trained to be supervisors and provided with our handbook. They do all of the necessary paperwork to submit payroll, evaluate and manage their employees.

10. Information is Power • Each family receives monthly financial reports on their own budget. • All expenses authorized by the parents are detailed. • This direct feedback is a powerful management tool for families. • Parents see in black and white the funds being utilized. They determine relative value and know they can choose to conserve, reduce, reallocate and/or otherwise fine tune their child’s supports to maximize the allocated funds.