1. Session 1-A  June 17, 2015

2. Debra Brockman, Director of Marketing & Outreach Elaine Bleiler, Resident Masonic Village at Elizabethtown Scott Badesch, President/CEO Autism Society of America John Snader, President & CEO Brethren Village Joe Wagman, Chairman Wagman Construction, Inc. Presenters

3.  Masonic Village Group Home Experience  Population Trends & Implications  Critical Questions/Issues for CCRCs  Business Plan for Launching a Pilot Project  Discussion

4.  Masonic Villages’ Mission of Love ◦ How can our mission help include more people in our community? ◦ How can a more inclusive community strengthen the value of our mission? What is a Community?

5.  Vision of generosity of Ken & Elaine Bleiler  Over the last 115 years our community has continued to grow  We have found that the more inclusive we’ve become, the stronger our community has become  We view our campus as a microcosm of the larger community around us Why Bleiler Cottage

6.  Program is located in a safe and supportive environment with access to staff, amenities and services on campus as well as interaction with the surrounding community  Could not provide same level and convenience of services in off-campus setting Why Bleiler Cottage

7.  We had the staff with necessary skill sets  1:8 staff-resident ratio  Current budget for eight individuals = $276,479  Estimated budget for four individuals = $255,993 Staffing and Costs

8.  The Bleiler Caring Cottage and similar residential programs for Autism are licensed by the 6400 regulations through the Office of Development Programs under the DHS  Residents may receive Base dollars, which are county/state funded  Consolidated waiver funding (federally matched) is the primary funding source for residential programs but not if on a CCRC campus Funding & Licensing

9.  National ◦ 1 in 10 families affected by ID ◦ > 700,000 people with autism over 65 by 2030 ◦ 1/110 2006; 1/68 2014 and rising  PA ◦ By 2030 > 74,000 adults will need services and support ◦ Over 1.2 million persons in PA with a disability Population Trends

10.  Fewer young people caring for aging parents or siblings  More seniors with ID, or adult sons or daughters with ID  80% of long term care for individuals with ID is provided in the home by family  Parents looking “for back-up plan”  Now is the time to begin to focus on the issue: “Community” impact Population Implications

11.  Community Integration  State-by-State Funding  Medicaid  Self-determination  Conclusion: Limited funding available Government Funding Trends

12.  CCRCs – Benefits to Prospective Residents ◦ Perpetual existence ◦ Mission driven – not-for-profit ◦ Programmatic offerings ◦ Campus setting ◦ Vocational opportunities Implications for Senior Housing ◦ Dietary ◦ Skilled staff ◦ Security ◦ Continuum of care

13.  CCRCs – Potential Benefits to CCRCs ◦ Utilize existing infrastructure ◦ Adapt capabilities of staff ◦ Serve community Implications for Senior Housing

14.  Mission ◦ “Community” ◦ Values – how inclusive?  CCRCs good at retirement and geriatric care ◦ This would be a new service offering ◦ Similarities of senior and aging ID populations Critical Questions for CCRCs

15.  No public funding available  “First cost” of facility  Operational costs ($100,000 +/- per res, per year)  Private pay ◦ Actuarial/financial calculation ◦ Sources: Trust, Life Insurance, etc. ◦ Niche? Critical Questions - Financial

16.  Fair Housing Act 62/55  Group home Licensure ◦ DPW 6400 – Chapter 51, 52  501 (c)(3) implications  Zoning  ADA issues ◦ EEOC/Civil Rights  Defined admission and discharge criteria  Contractual arrangement Critical Questions - Legal

17.  Staff ◦ New ◦ Training ◦ Competencies ◦ Ratio  Marketing/PR ◦ Resident acceptance ◦ Market demand ◦ PMA ◦ Niche? Critical Questions - Operational

18.  Residential Accommodation ◦ Group home (vs. living w/ parents - “independence”) ◦ Define “bandwidth” for potential residents ◦ Number of residents ◦ Staffing level ◦ Programming – non-clinical ◦ Evacuation Critical Questions - Facilities

19.  Lifetime Coordinated Care Model – third party?  Social, emotional, behavioral  Multi-disciplinary team  Medication management  Dietary Critical Questions – Clinical Overlay

20.  “Walk before run” ◦ High functioning – need support ◦ Minimum age limit ◦ Private pay ◦ Group home ◦ High consumer/parental expectations Pilot Project

21.  Business Plan ◦ Location on or off campus ◦ Building design ◦ Financial requirements for residents ◦ Market research Pilot Project

22.  Business Plan ◦ Build the budget/proforma  Facility first cost  Facility operating costs ◦ Regulatory requirements ◦ Pre-sales / reservations ◦ Funding and contracts in place ◦ Construction Pilot Project

23.  Learning outcomes ◦ Care model ◦ Funding (for non-high net worth prospects)  Endowments  Pitch to government (savings)  Foundations  Grants  Gifts  Regulatory changes ◦ See: “Who Decides Where Autistic Adults Live?” www.theatlantic.com/health/archive/2015/05/who-decides-where-autistic-adults- live/393455/?utm_source=SFFB www.theatlantic.com/health/archive/2015/05/who-decides-where-autistic-adults- live/393455/?utm_source=SFFB Pilot Project

24. Discussion John Snader Brethren Village jsnader@bv.org Joe Wagman Wagman Construction joewagman@wagman.com jsnader@bv.org joewagman@wagman.com Scott Badesch Autism Society of America sbadesch@autism-society.org Debra Brockman Masonic Village at Elizabethtown dbrockman@masonicvillage.org sbadesch@autism-society.org dbrockman@masonicvillage.org