Virginia

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• Virginias Money Follows the Person
• Jason Rachel, Money Follows the Person Project
  Director, DMAS
• Governors Housing Conference
• November 19, 2009

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Overview Money Follows the
Person Demonstration Project

• Four-year Medicaid Demonstration Project to
  assist seniors and people with disabilities who
  currently live in institutions to move to the
  community if they choose to
• Person-centered Over 1,000 individuals in
  Virginia to move to the community, each with an
  individual plan, supports they need, and someone
  to work with them before and after they move
• Community-based Partnerships among human
  services and housing agencies (local government
  and private) are key
• State-planned and administered Department of
  Medical Assistance Services (DMAS) (Virginias
  Medicaid agency) working with many other
  agencies, including state housing agencies
• Federally-sponsored Centers for Medicare and
  Medicaid Services (CMS) (federal Medicaid agency)

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Community Supports for Individuals Who
Transition

• Each individual will enroll in a Medicaid home
  and community-based waiver or a Medicaid
  program called PACE
• All Medicaid waivers and PACE pay for a variety
  of services available to people enrolled, based
  on their individual needs for each service
• Non-Medicaid services will also be available

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Housing for IndividualsWho Transition

• Each individual must move to a qualified
  residence in the community
• Home owned or leased by the individual/family
  member
• Apartment leased by the individual/family member
• Setting in which no more than four unrelated
  individuals reside
• Group homes (4 or fewer beds)
• Sponsored residential settings
• 4-bed Assisted Living Facilities
• Adult Foster Care

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New Medicaid Services Under Money Follows the
Person

• Transition Services
• Up-front household expenses when setting up a
  household
• Being added to five waivers
• 5,000 lifetime maximum per person
• Transition Coordination
• 2 months before and 12 months after the
  individual moves
• Added to Elderly or Disabled with Consumer
  Direction Waiver

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Demonstration Services UnderMoney Follows the
Person

• Environmental Modifications
• Assistance with making modifications to homes and
  primary vehicles to make them accessible
• Added to the Elderly or Disabled with
  Consumer-Direction and AIDS/HIV Waivers
• Assistive Technology
• Devices that enhance ones ability to function
  and communicate, such as specialized toilets,
  braces, chairs, and computer hardware and
  software
• Added to the Elderly or Disabled with
  Consumer-Direction and AIDS/HIV Waivers
• 24-Hour Emergency Back-up Through 2-1-1 VIRGINIA
  for the first 12 months following transition to
  the community

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Non-Medicaid Services UnderMoney Follows the
Person

• Supplemental home modification funding if amount
  needed exceeds Medicaid 5,000 maximum
• Bridge rent for up to 90 days after signing a
  lease if needed for home modifications to be
  completed before the individual moves
• Funding for each provided by the Virginia
  Department of Housing and Community Development

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Waiver Services That Help People Find Community
Housing

• Depending on the waiver, one of the following
  providers is available to assist individuals
  moving to the community from institutions
• Case Managers (MR, DD and AIDs Waivers)
• Transition Coordinators (EDCD Waiver)
• Health Care Coordinators (TECH Waiver)
• These are the people who will be contacting
  housing agencies when rental assistance is needed

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More Information on MFP

• Operational Protocol (Project Manual) contains
  extensive section and Appendices on housing
• Transition services, environmental and
  supplemental home modifications, and bridge rent
• Qualified residences
• Owning your own home
• Renting a home or apartment (including HUD
  subsidies)
• Living in adult foster care, assisted living
  facilities, sponsored residential programs, and
  group homes
• Transportation information also included

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The Housing Challenges

• Lack of accessible housing stock
• Housing and human services plan in different
  systems
• Inability to afford housing
• People living in institutions often have no, or
  extremely low, income.
• Sole income of many will be SSI, currently 638
  per month.
• Some gave up homes to receive services in
  institutions because they could not access the
  services and supports they needed to stay in the
  community.
• While some may obtain employment, they will not
  have sufficient income at the time of transition
  to afford rent.
• Medicaid program cannot pay
• No state-funded programs exist
• Federal housing rental vouchers are scarce, and
  those available are not dedicated to individuals
  transitioning

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MFP Annual Housing and Transportation
Action Plan

• STRATEGIES
• Increase the affordability and availability of
  community housing for seniors and people with
  disabilities
• Increase the availability of accessible
  transportation for seniors and individuals with
  disabilities
• Recognize the importance of the link between
  housing and transportation
• Focus on education, awareness, and partnership
  building among housing and human service agencies
  and the individuals they serve

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MFP Annual Housing and Transportation Action Plan

• Each strategy has
• A lead agency
• A timeline
• Strategies recommended by Task Force have
  detailed work plans
• Office of Community Integration to track results

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Increase Affordability and Availability of Housing

• Develop a state-funded community living
  supplement
• Increase availability of sponsored residential
  and adult foster care providers through marketing
  and provider fairs
• Make the auxiliary grant portable for all
  populations
• Produce new housing units through QAP LIHTC and
  non-LIHTC initiatives, and low-interest loan
  programs
• VHDA Housing Solutions Work Group
• Assess local housing capacity and assure that
  needs are included in local planning
• Direct federal housing trust fund monies, when
  they become available, to these populations

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Increase availability of accessible
transportation

• Disseminate information about transportation
  providers that offer accessible vehicles, and
  about new services available under the New
  Freedom initiative
• Incentivize specialized transportation providers
  to coordinate their services beyond geographic
  boundaries
• Incentivize specialized transportation providers
  to provide door through door transportation
• Develop a transportation voucher system

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Recognize importance of the link between housing
and transportation

• Develop interactive housing and transportation
  website
• Use the existing Transportation and Housing
  Alliance Toolkit as a resource
• Create incentives to develop housing on public
  transportation routes

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Educate the housing community awareness, and
partnership building

• Offer assistance in follow up to HUD and
  Governors letters to PHAs
• Provide technical assistance to local housing
  offices, planning authorities and HUD offices on
  understanding the needs of persons transitioning,
  on www.accessva.org, and on laws that govern
  housing services, options and choice Encourage
  use of Virginia Easy Access.
• Distribute Rutgers Medicaid Services Primer at
  Governors Housing Conference
• Encourage PHAs to list accessible housing units
  on www.accessva.org
• Through speaking engagements, e-distribution
  list, HUD Lines and tele-tutorials, educate
  housing-related groups, including
• VAHCDO, PHAS, Housing Counselors
• COSCDA
• Housing Commission
• Local planners and contract administrators

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Educate disability/aging communities

• Orient individuals, advocates, local agencies to
  housing/transportation planning
• Disseminate Annual Action Plan
• Ensure input of disability/aging communities is
  considered in housing planning activities create
  a mechanism to track local changes in policy and
  relate ongoing needs/solutions to statewide and
  national housing funding agents and authorities
• Develop HOME, CDBG, and HCV contact lists
  disseminate to organizations to encourage
  participation in needs statements and priorities
  for resource allocation
• Document changes in housing policy work with the
  SILC to interface with multiple policy
  makers/funding agents to foster and sustain
  increased housing options
• Assure that service agencies and advocates have
  information about housing agencies and a
  description of the services they offer through
• Virginia Easy Access
• A housing resource bank on www.olmsteadva.com/mfp
  /
• Dissemination of information on HUD-Assisted
  Apartments
• Training of Transition Coordinators
• Developing a Housing Primer for services agencies
  and advocates

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For Further Information

• Visit the Money Follows the Person Website
  http//www.olmsteadva.com/mfp/
• E-mail MFP_at_dmas.virginia.gov