1. Presented by Tishaun Harris-Ugworji, DARS Adult Services Program Consultant Kathryn O’Connell-Raymond, VDSS Medicaid Consultant May 5, 2016 Catch the Wave of Auxiliary Grant

2.  SSI was established in 1972  Before then, there was the Old Age Assistance (OAA), Aid to Permanently and Totally Disabled (APTD) and Aid to the Blind (AB)  SSI replaced these programs but paid benefits at a lower rate.  To prevent a reduction in benefits, the Mandatory State SSI Supplementation Program was established; Virginia calls it Auxiliary Grant.

3.  Age 65 or over, be blind, or be disabled  voluntarily resides in Virginia for 90 days  A citizen of the United States or an alien who meets specified criteria  assessed and determined to need assisted living facility care or adult foster care placement  reside in a licensed assisted living facility or approved adult foster care home  non-exempted resources less than $2,000 for one person or $3,000 for a couple  non-exempted (countable) income less than the total of the auxiliary grant rate approved for the assisted living facility plus the Personal Needs Allowance

4.  Application for Benefits  Retroactive period  Level of Care  Assistance unit and community spouse  Entitlement  Child support  Guardian Fee Exclusion  Conditional Benefits  Third Party payments http://spark.dss.virginia.gov/divisions/dfs/as/ manual.cgi

6.  Must review the court order to determine fee.  Fee based on Percentage ◦ Managed Funds Do not Include the AG payment ◦ Managed Funds Include AG payment

7. Conditional Benefit policy is unique to AG. It applies to: non-SSI applicants who fail to meet resource requirements solely because of excess non-liquid resources. Conditional Policy offers the opportunity to:  evaluate liquid resources at 3 times the SSI payment rate  sell non-liquid resources to come under the resource limit  determine if the individual is resource ineligible solely due to excess non-liquid resources.

8.  the individual signs an agreement to sell excess non- liquid resource.  conditional period is 9 months for real property  conditional period is 3 months for personal property  verify reasonable efforts to sell  reasonable effort to sell exclusion  disposal period

9. Nonfinancial requirements  Relationship to SSI  Residency Clause  Residing in an ALF and AFCH  Citizenship and Alienage for Non-SSI

10. The individual applying for AG must have resided in Virginia voluntarily for a minimum of 90 days to meet the Virginia residency requirement. An individual's residence is the city or county within the state where the individual last resided outside of an institution. Institutions for purposes of this requirement are the following:  Both public and private pay ALFs  Nursing Homes  Intermediate Care Facilities  Correctional Facilities  Rehabilitation Centers  Psychiatric Facilities  Hospitals or other Medical Facilities

11.  Verification of an alien’s immigration status must be completed before eligibility can be established. Failure to provide the needed verifications will result in ineligibility for AG.  Verification is a multi step process. The individual must provide information sufficient to establish his alien status and the eligibility worker must confirm that status through the DHS Systematic Alien Verification for Entitlements (SAVE) process.  An alien’s identity and alien status cannot both be verified by one document. Two documents are required, one for identity and one for alien status.

12. Resources  Transfer of Resources  Resource Evaluation

13. SPARK Divisions→ Partnerships→DARS Guidance, Procedures & FAQ→ALF & AG→Auxiliary Grants-Facilities &Rates or http://spark.dss.virginia.gov/divisions/dfs/as/procedures.cgi

14. Effective July 1, 2012  A third-party payment is a voluntary payment for goods and services beyond those required by the Auxiliary Grant (AG) program for maintenance and care on behalf of an AG recipient in an assisted living facility (ALF) or adult foster care home (AFCH).  These payments shall be strictly voluntary on the part of the third party and shall not be a condition of admission, length of stay or care and services.

15. Discharge Assistance Program  DAP provides individualized community services and supports that enable individuals to transition from state hospitals to communities where they can recover in the least restrictive and most integrated settings possible.  DAP funds are state funds given to DBHDS to be administered at the local Community Service Board.

16. Individuals 65 or older who meet these eligibility criteria:  Have a diagnosis of serious mental illness or dementia with behavior problems  Residents of Arlington, Fairfax, Prince William, Loudoun Counties or the City of Alexandria  Need assisted living or nursing home level care  Have a history of psychiatric hospitalization or are at risk of hospitalizations

17.  No longer in the facility  Jail or incarceration  Over income or resource limits  No longer meets residential/ assisted living criteria

18. HB675 Delegate Chris Peace  60 persons Capp  Providers are approved by Behavioral Health and Developmental Services  Must have resided in an ALF or AFC prior to transitioning to supportive housing  Contingent on Social Security Administration’s approval of third setting

19. DARS APS DIVISION TISHAUN HARRIS-UGWORJI, Adult Services Program Consultant 804-662-7531 TISHAUN.HARRISUGWORJI@DARS.VIRGINIA.GOV