group residential housing (grh) sophat jecsi & john petroskas minnesota department of human...
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GROUP RESIDENTIAL
HOUSING(GRH)
SOPHAT JECSI & JOHN PETROSKAS
MINNESOTA DEPARTMENT OF HUMAN SERVICES
October 14, 2013
GROUP RESIDENTIAL HOUSING (GRH)
Started in 1993
Individual income supplement to purchase “room and board”
GRH can pay for services in some cases
Goal is to prevent or reduce institutional residence or homelessness
FINANCES
GRH is entirely state-funded
GRH is administered by counties or tribal nations
The total cost of GRH in FY2012 was $122,000,000
Average GRH payment is approximately $545/month
DEMOGRAPHICS
Nearly 21,000 people receive GRH each month
Around 17% are seniors
Average age: 48 years
58% male (72% eligible as Over 65 were women)
15% report earned income, averaging $221/month
Nearly 70% had mental health diagnosis in last three years
One third had chemical dependency diagnosis in last three years
TYPES OF GRH HOUSING STATEWIDEAdult Foster Care (4104)
Board and Lodge (235)
Board and Lodge w/ Special Services (282)
Supervised Living Facility (56)
Non-Certified Boarding Care (16)
Housing w/ Services Establishment (520)
Housing w/ Services Establishment: Homeless (372)
Metro Demo (15)
Tribe Certified (0)
CHARACTERISTICS
Nearly half of all people receiving GRH live in Adult Foster Care
17% live in Board & Lodge with Special Services
12% live in Housing with Services Establishments
20% live in other settings
GROUP RESIDENTIAL HOUSING (GRH)
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
INDIVIDUAL ELIGIBILITY
Eligibility for GRH Housing Rate
•Meet a Basis of Eligibility for SSI
or•Meet a Basis of Eligibility for GA
SSI BASIS OF ELIGIBILITY
Individuals who are:
•Over 65
•Blind
•Have a disability as determined by Social Security Administration
•Do NOT need to actually receive SSI
GA BASIS OF ELIGIBILITYPermanent or Temporary Illness (medical opinion)
Requires Services in Residence (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)
RSDI/SSI Application or Appeal Pending
INDIVIDUAL INCOME ELIGIBILITY
Eligibility for GRH Housing Rate
•Countable Income: Less than maximum benefit (see 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)
GRH HOUSING REQUIREMENTS
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 RATE
GRH Housing Rate (Room and Board, Rate 1, Base Rate, MSA Equivalent Rate)
•$877, effective 7/1/13•Rent, Utilities, Food, Household Supplies
•Anything left: Other things necessary to provide room and board
•NOT services, clothing, medical costs
SERVICES
Examples of service funding include:•Waivers (57%)
• DD (28%)
• CADI (16%)
• EW (11%)
• BI (2%)
•GRH Supplemental Service Rate (27%)
•Difficulty of Care (DOC) (4%)
GRH SUPPLEMENTAL SERVICE RATE
Also known as: (Service Rate, Rate 2)
•$482.84, effective 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
•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
INDIVIDUAL ELIGIBILITY
Eligibility for GRH Service Rate• Only if waiver or PCA services not available
• 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 andreceive GRH Housing Rate
GRH SUPPLEMENTAL SERVICE RATE
Board and Lodge only and Adult Foster Care settings are not eligible
Moratorium on new service rate beds, unless…
• Banked Beds
• Legislative exception
• Individuals relocating out of certain shelters to Housing with Services (Homeless) setting
GRH APPLICATION
Combined Application Form (CAF) or applies online at www.applymn.org with required verifications (income, assets, shelter verification form, etc.)
Phone interview is okay, an in-person interview is not required
APPLICATION/RECERTIFICATION
Required to apply for other programs for which they appear eligible (SSI, MA, etc.)• Interim Assistance Agreement
•Counties recertify eligibility at least once every 12 months.
• Individuals report changes during the year (10 days to report changes that affect eligibility)
GRH PAYMENTS
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
Absent Days•GRH payment continues 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
CLIENT OBLIGATION
GRH Client Obligation (Countable Income)GROSS INCOME GA
example
SSI example
RSDI example
SSI Standard (FBR)/RSDI
+ $ 710.00 815.00
Other Unearned Inc. + $
Earned Income + $
DEDUCTIONS
Personal Needs - $ 94.00 94.00 94.00
Other - $
CLIENT OBLIGATION = $ 0.00 616.00 721.00
GRH PAYMENT
GRH PaymentEligibility GA
Example
SSI Example
RSDI Example
Total Days 31 31 31
VND2 Rate Limit 877.00 877.00 877.00
PAYMENT
GRH (State) AMT + 877.00 877.00 877.00
Client Obligation - 0.00 616.00 721.00
TOTAL PAYMENT = 877.00 261.00 156.00
Client Pays
State Pays
GRH PAYMENTS
In Congregate Settings:
Vendor
Client
$616
State (DHS)
$261
$200
Facility Operations and
Household Needs
$677
= $877
= $877
Food
Client
Personal Needs
Allowance
$94
GRH PAYMENTS
In Community-Based Settings:
Vendor
Client Client
$616
State (DHS)
$261
$141
Rent$736
= $877
= $877
Personal Needs
Allowance
$94
Up to $200 SNAP
Utilities, Household Needs,
or Gift Cards
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 or 1-800-657-3591
MN Ombudsman for Mental Health and DD 651-757-1800 or 1-800-657-3506
QUESTIONS?
MN Department of Human Services
John Petroskas 651-431-5644
Sophat Jecsi 651-431-4983