Increasing the Quality of Lives and Saving Money: Nebraska’s Comprehensive Service Delivery Model for Assistive Technology and Home Modifications September 11, 2003

System Overview Employment –Solutions On Site –One Stop Centers/Workforce Development Independent Living –HHS Aged and Disabled Medicaid Waiver Home & Community Based Waiver Medically Handicapped Children’s Program Disabled Children’s Program Disabled Persons and Family Support Program Public Assistance Subsidized Adoption Adult Protective Services Child Protective Services –Voc Rehab Part B Housing –Making Homes Accessible –Home Of Your Own

On Site Technical Assistance Offices in Omaha Lincoln Kearney North Platte Scottsbluff 4 Vans 12 Technology Specialists

Funding Coordination Developed and used cooperatively by over 18 agencies across Nebraska Simple and effective Includes release/agreement page

Equipment Re-use Average cost of an exterior lift installation has gone from $4,384 in Year 1 to $4,043 average cost in Year 4)

Why?

State Data Statewide study in –25,000 households with a member with a disability in Nebraska –Less than half (46%) of households with a member with a disability had home mods –Of those most critical, 70% needed financial assistance –Substandard housing often coincided with need for accessibility

Issues Lack of awareness and information Lack of providers statewide Fragmented services and funding Unclear funding policies Lack of consumer support (getting through the system)

Experience 66.2% Home modifications 15.4% Vehicle modifications 18.4% Assistive Technology Includes HHS, VR Title I, VR Part B, MHA, NVA Over 5 year period –$7.7 million on home modifications Doesn’t include VR Title I dollars

Home and Community Based Waiver- Aged and Disabled Assistive Technology and Supports Home Modifications Increase abilities to perform activities of daily living Control the environment in which s/he lives $5,000 cap Function with greater independence in the home and is Necessary to keep the individual in their home $5,000 cap

Process - The Checklist Referral is made Identify a Solution Diagnosis/Progression, Functional Abilities/Limitations, Roles, Assistance Available Assessment write-up

Process - The Checklist Verify ownership of property Draw blueprints & write specifications Consumer/Landlord approval Quote packets Award the project Update database

Process - The Checklist Send approval paperwork to Lincoln Monitor construction process Final inspection Project completion paperwork

Home Modifications-5 years Bath mods$3,531,000 Exterior Lifts$1,143,000 Ramps$1,295,000 Entrance mods $436,000 Interior Lifts $430,000 Other Home mods $556,000 2,173 Waiver projects

Half of the individuals are under the age of 55 and half of the individuals are over the age of 55.

Home Modification Funding Resources Aged and Disabled Medicaid Waiver $7,190,000 Vocational Rehabilitation Part B $354,000 Aid to Aged, Blind, and Disabled $291,500 Nebraska Veteran’s Aid Fund $141,000

Home Modification Funding Resources Disabled Childrens Program $108,000 Disabled Persons and Family Support $137,000 Barrier Removal (CDBG) $125,500 Making Homes Accessible (HOME) $788,500

System Outcomes More contractors More appropriate and cost effective solutions Consumer satisfaction More funding / cost savings Increased collaboration Starting point and a defined process Geographic access