Veteran Directed Home and Community Based Services: Getting Started AoA & VA Grantee Conference Sandra Barrett National Resource Center for Participant- Directed Services (NRCPDS) February 14, 2011

Initial Planning Communication State Unit on Aging AoA & Lewin NRCPDS VAMC Identify VAMC VAMC serving your catchment area Geriatric and Extended Care NRCPDS Contact can help identify VAMC contact Identify NRCPDS Contact VDHCBS State Contact Chart at : /schools/gssw/nrcp ds/news.html /schools/gssw/nrcp ds/news.html 2

Agency Self Assessment Experience with Participant Direction Adapt P&P and Participant Manuals Adapt Assessment & Forms Staff Training in Participant Direction Training within your state Online Training at tdirection.org Availability of Support Services Existing counselors and FMS Develop a process for securing counseling and FMS 3

Support System in Consumer DirectionCounselor Embraces paradigm shift Explains the program Completes enrollment Collaborates with participant to complete the assessment, service plan, spending plan, and reassessments Offers skills training Partners with participant Fiscal/Employer Agent (F/EA) Assures that spending plan is followed Pays invoices including timesheets Figures tax liability and pays taxes Maintains savings Provides accounting reports Veteran Makes decision based on individual budget Hires, manages, and dismisses workers Sets tasks Trains (or arranges for training) of workers Evaluates worker performance Determines goods and services to be purchased 4

Processes to Plan VDHCBS Program Intake & Assessment Service Planning Directly Hired Workers Risk Mitigation Quality Assurance Monitoring the Spending Plan FMS Adm. Functions 5

Referral VAMC refers veteran to AAA. Includes XXXX (veteran information?) Referral VAMC refers veteran to AAA. Includes XXXX (veteran information?) Intake AAA contacts veteran & schedules home visit. Compiles materials (which Forms, manuals?) Intake AAA contacts veteran & schedules home visit. Compiles materials (which Forms, manuals?) Assessment AAA assesses veteran & discusses VD-HCBS roles & responsibilities. Reviews materials (Which Forms, manuals?) Assessment AAA assesses veteran & discusses VD-HCBS roles & responsibilities. Reviews materials (Which Forms, manuals?) Develop Plan AAA works with veteran to develop a spending plan. Helps identify goals & then potential workers and other goods & services. Sends to VAMC. Develop Plan AAA works with veteran to develop a spending plan. Helps identify goals & then potential workers and other goods & services. Sends to VAMC. Authorization of Budget Amount VAMC authorizes the budget amount or tier & sends to AAA Authorization of Budget Amount VAMC authorizes the budget amount or tier & sends to AAA Authorization of Plan VAMC reviews plan to assure no duplications exist & that items relate to a need because of disability. Sends approval to AAA. AAA bills 1 time full admin fee* Authorization of Plan VAMC reviews plan to assure no duplications exist & that items relate to a need because of disability. Sends approval to AAA. AAA bills 1 time full admin fee* Establish Employment XXXX (FMS) establishes Veteran as an employer, and processes worker information. Establish Employment XXXX (FMS) establishes Veteran as an employer, and processes worker information. Employee Paperwork XXXX collects required employee information and conducts background checks. Employee Paperwork XXXX collects required employee information and conducts background checks. Hiring Assistance AAA assists the veteran in the hiring process: job descriptions, recruitment, interview and reference checks. Hiring Assistance AAA assists the veteran in the hiring process: job descriptions, recruitment, interview and reference checks. Employer Paperwork XXXX assists veteran to complete the paperwork to be an employer Employer Paperwork XXXX assists veteran to complete the paperwork to be an employer Plan Distribution AAA transmits the authorized plan to the veteran and to XXXXXX (FMS). Plan Distribution AAA transmits the authorized plan to the veteran and to XXXXXX (FMS). Poor Candidate Veteran doesn’t want program or needs representative & none available. Referred back to VAMC. Bill 1 time half admin fee* Poor Candidate Veteran doesn’t want program or needs representative & none available. Referred back to VAMC. Bill 1 time half admin fee* Good Candidate AAA documents need and preliminary budget/budget tier & sends to VAMC. Good Candidate AAA documents need and preliminary budget/budget tier & sends to VAMC.

Savings/Rainy Day Fund XXXX assists veteran to complete the paperwork to be an employer Savings/Rainy Day Fund XXXX assists veteran to complete the paperwork to be an employer Payments XXXX (FMS) pays workers & invoices as in Spending Plan Payments XXXX (FMS) pays workers & invoices as in Spending Plan Timesheets and Invoices Veteran submits timesheets and invoices to XXXX (FMS) Timesheets and Invoices Veteran submits timesheets and invoices to XXXX (FMS) Initiate Services Veteran trains workers and begins services as authorized in the Spending Plan Initiate Services Veteran trains workers and begins services as authorized in the Spending Plan Reports XXXX (FMS) sends detailed spending and Savings/Rainy Day Fund reports to veteran & AAA Reports XXXX (FMS) sends detailed spending and Savings/Rainy Day Fund reports to veteran & AAA Monitoring AAA monitors veteran health, safety and outcomes, at least monthly phone contact and quarterly visits Monitoring AAA monitors veteran health, safety and outcomes, at least monthly phone contact and quarterly visits Reimburse AAA submits invoice to the VAMC. VAMS remits payment Reimburse AAA submits invoice to the VAMC. VAMS remits payment Reassessment Veteran reassessments and spending plans are done annually or sooner when changes occur Reassessment Veteran reassessments and spending plans are done annually or sooner when changes occur

Advancing choice and control for people living with disabilities Sandra Barrett Senior Program Consultant