1. GROUP RESIDENTIAL HOUSING (GRH) & MN SUPPLEMENTAL AID (MSA) HOUSING ASSISTANCE MN Age & Disabilities Odyssey June 18, 2013

2.  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 GROUP RESIDENTIAL HOUSING (GRH)

3.  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 GROUP RESIDENTIAL HOUSING (GRH)

4.  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 INDIVIDUAL ELIGIBILITY

5.  Aged  Blind  18 and Disabled SSI BASIS OF ELIGIBILITY

6.  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 GA BASIS OF ELIGIBILITY

7.  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) INDIVIDUAL ELIGIBILITY

8.  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 GRH HOUSING RATE

9.  GRH Housing Rate: How the Maximum Rate is Determined GRH HOUSING RATE Housing Rate – Individual7/1/117/1/127/1/13 SSI Federal Benefit Rate674698710 MSA Income Disregard-20 MSA supplement81 Food Support (SNAP) equivalent200 MN Community Living Standard935959971 Personal Needs Allowance-89-92-94 $846$867$877

10.  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) TYPES OF GRH HOUSING STATEWIDE

11.  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 GRH HOUSING REQUIREMENTS

12.  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 GRH AGREEMENT

13.  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) SERVICE REQUIREMENTS

14.  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 GRH SUPPLEMENTAL SERVICE RATE

15.  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 GRH SUPPLEMENTAL SERVICE RATE

16.  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 and receive GRH Housing Rate INDIVIDUAL ELIGIBILITY

17.  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 GRH SUPPLEMENTAL SERVICE RATE

18.  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 DIFFICULTY OF CARE (DOC)

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

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

21.  GRH Client Obligation (Countable Income) GROUP RESIDENTIAL HOUSING (GRH) GROSS INCOMEGA example SSI example RSDI example SSI Standard (FBR)/RSDI + $ 710.00815.00 Other Unearned Inc.+ $ Earned Income+ $ DEDUCTIONS Personal Needs- $94.00 Other- $ CLIENT OBLIGATION= $0.00616.00721.00

22.  GRH Payment GRH PAYMENT EligibilityGA Example SSI Example RSDI Example Total Days31 VND2 Rate Limit867.00 PAYMENT GRH (State) AMT+867.00 Client Obligation-0.00616.00721.00 TOTAL PAYMENT=867.00251.00146.00 Client Pays State Pays

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

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

25.  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) GRH PAYMENTS

26.  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 GRH PAYMENTS

27.  GRH Recertification  Counties recertify eligibility at least once every 12 months.  Individual reports changes during the year. GROUP RESIDENTIAL HOUSING (GRH)

28.  Other FAQ  GRH and Couples  GRH and MFIP  Quality Assurance  Private Pay vs. GRH  Tenant/Landlord Law  County Transfers/Servicing GROUP RESIDENTIAL HOUSING (GRH)

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

30. 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 GROUP RESIDENTIAL HOUSING (GRH)

31. 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… MINNESOTA SUPPLEMENTAL AID (MSA)

32.  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 MINNESOTA SUPPLEMENTAL AID (MSA)

33. 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 MSA ELIGIBILITY CRITERIA

34. $81 (individual) (MSA=$111 for couples) (additional $ for special needs ) TYPICAL MSA MONTHLY BENEFIT

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

36.  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 MSA HOUSING ASSISTANCE ELIGIBILITY

37. $710 (SSI FBR) + 81 (MSA) +200 (MSA Housing Assistance) $ 991 Total Income  + Supplemental Nutrition Assistance Program (SNAP) TYPICAL MSA HOUSING ASSISTANCE BENEFIT

38.  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.) MSA HOUSING ASSISTANCE THE BENEFIT

39.  Combined Application (CAF)or online at www.applymn.org 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 MSA APPLICATION & RENEWAL

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

41. 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 OTHER RESOURCES