Unlock
the Doorway
to
Independence!
How to Use
Relocation Services to
Leave the Nursing Facility and
Return to Your
Home and Community
Do you live in a nursing home?
Are you tired of feeling like you have
lost control of your life?
Do you want to make your own choices?
Do you want to take back your life?
Would you like to live independently
in the community of your choice?
We can help you help yourself!
This information is available in other forms to persons with disabilities.
Call 320-529-9000 (voice or TTY).
© 2006
Metropolitan Center for Independent Living. General Editor
Eva
Hansen. Design and editing Jill Averil Keen. Research Maggie
Griffitt. MCIL is grateful to the Statewide Independent Living
Council (Grant #POB2200000000010208) for funding this project and
other efforts that successfully promote nursing home relocation and
independent living.
*Some changes have been to reflect the service area.
How Can We Help You?
Independent
Lifestyles a Center for Independent Living (ILICIL) provides a number
of services for people with disabilities, their families and
friends, service providers, and interested community members. These
services include nursing home relocation, advocacy and support
services, independent living skills training, information and
referral, peer programs, home modifications, and personal assistance
services.
We can show you how to work through the process of finding the programs you need to gain your independence. Our Relocation Coordinators will help you identify and understand available services and teach you how to become your own advocate.
In this booklet you will find a guide to some common resources, as well as a glossary of terms related to nursing home relocation, a question sheet to help you prepare for your first meeting with your relocation coordinator, and a short list of useful phone numbers.
You can learn how to obtain Medical Assistance and waivered services, find housing, and tap into community resources.
You are eligible for relocation services if you
$ live in a licensed nursing facility or other institutional setting,
$ are between the ages of 18 and 65 (or over 65 and eligible for an Elderly Waiver),
$ receive Medical Assistance, and
$ desire to move back into the community.
How do you get started? Just turn the page!
Your Keys to Independence
Call
your local Center for Independent Living (CIL) or your county human
services office to discuss your options.
Arrange
with your nursing home social worker to schedule a long term care
consultation (LTCC) with your county.
During
your Long Term Care Consultation, tell the county worker that you
desire relocation services.
Your
request will be referred to a Relocation Coordinator who will
schedule a meeting with you, your nursing home social worker, and
anyone else you wish to attend. Make sure you attend all meetings so
your wishes can be heard and understood by
everyone involved.
Talk
with your Coordinator about where and how you want to live.
Help
your Coordinator gather important information and complete the
necessary paperwork
You and your Coordinator will explore and identify, and visit housing options that meet your needs. Your Coordinator will help you fill out rental applications.
Ask
your coordinator for information about financial benefits, waivers
and services that will help ou live independently in the community.
Once
suitable housing has been found, you and your Coordinator will
arrange for your services, equipment, and supports.
When
everything is in place, your Coordinator will arrange the physical
move to your new home.
Remember
that plans may change as the situation develops. Stay in touch
with your Coordinator. Call regularly with up dates.
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Be patient!
This process takes time!
Why we do this? The law says that you have a choice!
The Americans with Disabilities Act (ADA) requires housing, employment, and public services to be accessible and inclusive. After the ADA was passed, two women with disabilities challenged Olmstead County, Georgia, to let them live outside of a nursing home. Their case went all the way to the Supreme Court.
In
1999, the Supreme Court ruled that the ADA forbids unnecessary
institutionalization of people with disabilities. Services to
persons with disabilities must be provided “in the most integrated
setting possible.” This makes Olmstead a critically important
civil
rights decision affecting people with disabilities.
What does Olmstead mean for you? It gives you a choice to live and participate in your community in the most inclusive setting possible. Olmstead challenges federal, state and local governments to develop more opportunities for individuals with disabilities, to expand home and community options, and make community living a reality for more people with disabilities.
Your relocation coordinator, county social worker, and other members of your care team will take your wishes seriously and will help you access the broad array of housing choices and community services that will enable you to live as independently as possible. Your formal support will come mainly through the Medical Assistance (MA) program. There are also a variety of informal supports, including family, friends, churches, and community-based organizations.
What if my family does not want me to leave the nursing facility?
It is possible that your family does not wish you to move. They may be afraid that they will have to take care of you, or they may feel that you will fail in the community.
These fears are understandable. Not everyone who moves from a nursing home to the community is successful. Still there are ways to reassure your family and improve your chances of success.
First, involve your family in your relocation planning from the onset. Participating in the planning process may help your family feel more at ease about your relocation. Family support is important and can help you make a successful transition to independent living.
Next,
your care team will address questions and concerns about care and
available services as they help you plan your discharge. Your
relocation coordinator will ensure that the supports you need to
succeed are in place when you leave the nursing home, but no one can
guarantee the future.
This is what Relocation Services is all about: You have the right to live where you want and to have control over what happens to you. You have a choice!
Remind your family that living independently does not mean that you will be all alone. There is a lot of help available from your county, your care team, and your community.
Your Care Team
During the relocation process, your care team is made up of people whom you wish to have involved with your transitional services, such as your nursing home social worker, doctor, occupational therapist, physical therapist, dietitian, and nurse. Other players on your team are your Relocation Services Coordinator (RSC), family members, pastor and friends in the community who will assist you after your move. The team works closely with you to decide what services you need and want. Remember you have the right to choose who is on your team.
After you move, if you receive waivered services in the community, a county case manager will be assigned to you. The case manager will make sure all your services are in place and that they meet your needs. Remember that your services can be changed at any time to meet your level of need. You may wish to have family or friends involved in your daily activities. Most likely you will have some personal care attendants (PCAs) involved in your preparation for the day. Nurses may also be a part of your team.
Some people leave a nursing home without a waiver and use only services they receive under Medical Assistance. If you choose this option, your relocation service coordinator will arrange the move and ensure that appropriate community supports are in place. Although you will not have a county case manager, your ILICIL advocate will stay in touch as long as necessary.
Waivers
A waiver provides funds through Medical Assistance that can pay for extra services that you need to live successfully in the community. In addition to services typically covered by Medical Assistance, these waivers can be used to pay for additional needs such as home modifications, delivered meals, adult day programs, and extra personal care attendant (PCA) hours.
Depending on your current needs, you may qualify for one of the following Waivers:
· Traumatic Brain Injury (TBI) Waiver
· Community Alternatives for Disabled Individuals (CADI) Waiver
· Elderly Waiver (EW)
· Mental Retardation & Related Conditions (MR/RC) Waiver
· Community Alternative Care (CAC) Waiver.
You may qualify if you are a person with a disability living either in a nursing facility or an institutional setting who receives Supplemental Security Income (SSI). You must be under age 65 to qualify for most waivers. The exception is the Elderly Waiver.
You may receive waivered services in your home or in a foster care home. If you are married you may receive waivered services while living at home with your spouse. The services must be necessary to your health, welfare, and safety, and they cannot be covered by any other funding sources
For additional information on any of the Waivers please contact your local Department of Human Services staff or call the Centers for Independent Living at 651-646-8342.
The Community Alternative Care Waiver (CAC) provides funding for home and community-based services for people with disabilities or chronic illness who would otherwise require the level of care provided in a hospital. Available services include case management, home health aide, therapy, nursing services, family counseling and training, foster care services, homemaker services, respite care, and modifications to your home or vehicle.
The
Community Alternatives for
Disabled Individuals (CADI) Waiver provides funding for
home and community based services for people who would otherwise
require the level of care provided in a nursing facility. These
services include adult day care, assisted living services, extended
home nursing services and therapies, extended personal care
assistant services, extended transportation services, family
counseling and training, foster care services, home delivered meals,
home-maker services, independent living skills, residential care
services, respite care, and supported employment services.
The CADI waiver may also provide for transitional services that pay for expenses related to your move. These items include essential furniture, household supplies, utility deposits and rental deposits. Transitional services are limited to $3,000 per move and may be used only once every three years.
Mental Retardation/Related Conditions (MR/RC) Waiver provides funding for home and community-based services for people with mental retardation or related conditions. Services include adult day care, assistive technology, care giver training and education, chore services, 24-hour emergency assistance, homemaker services, live-in personal caregiver expenses, modifications to the home or vehicle, respite care, specialist services, supported employment services, supported living services, and training and habilitation services.
The
Traumatic Brain Injury (TBI)
Waiver provides funding for home and community-based
services for people who have an acquired or traumatic brain injury
and who experience significant behavioral and cognitive problems
related to the injury. Services include adult day care services,
assisted living services, behavior programming by professionals,
companion services, extended cognitive rehabilitation therapy,
extended nursing, health therapy and personal care services, family
counseling, foster care, independent living skills and independent
living therapies, mental health testing, night supervision services,
respite care, structured day program services, and supported
employment services.
The Elderly Waiver (EW) program funds home and community-based services for people age 65 and older who are eligible for Medical Assistance (MA) and require the level of medical care provided in a nursing home, but choose to reside in the community. Services include visits by a skilled nurse, home health aide, homemaker, companion, personal care assistant, as well as home-delivered meals, adult day care, supplies and equipment, home modifications, assisted living, foster care, and residential care.
Personal Assistant Services
Personal care assistants (PCAs) provide medically necessary services to persons who need help with day-to-day activities in order to be more independent in their home. You may use a PCA if you have a physical, emotional or mental disability, a chronic illness or an injury.
Personal care assistants provide care in four areas:
· Activities of daily living, including eating, toileting, grooming, dressing, bathing, transferring, mobility and positioning;
· Health-related functions, which, under state law, can be delegated or assigned by a licensed health care professional to be performed by a PCA;
· Instrumental activities of daily living, such as planning and preparing meals, managing finances, shopping for essential items, performing essential household chores, communicating with others, getting around the neighborhood, and participating in the community;
· Redirection and intervention for behavior, including observation and monitoring.
Waivered services and PCA services are administered by the Minnesota Department of Human Services. For more information, call your county service agency.
County Human Service Agencies
Benton County Social Services
P.O. Box 740
Foley, MN 56329
Voice Phone: (320) 968-5087
Web: http://www.co.benton.mn.us/
Isanti County Human Services
Isanti County Government Center
509-555 18th Avenue S.W.
Cambridge, MN 55008
Voice phone: 763-689-8226
Web: http://www.co.Isan.mn.us/
Kandiyohi County Family Services
2200 23rd Street NE, Suite 1020
Willmar, MN 56201
Voice phone: 320-231-6285
Web: http://www.co.kandiyohi.mn.us
Meeker County Social Services
114 N Holcombe Avenue, Suite 180
Litchfield, MN 55355
Voice phone: 320-693-5300
Web: http://www.co.meeker.mn.us/
Mille Lacs County Family Services
Courthouse Square Building
525 Second Street SE
Millaca, MN 56353
Voice phone: 320-983-8208
Web: http://www.co.mille-lacs.mn.us/
Morrison County Human/Social Services
213 SE 1st Ave.
Little Falls, MN 56345
Voice phone: 320-632-2941
Web: http://www.co.morrison.mn.us
Sherburne County Social Services
13880 Hwy 10
Elk River, MN 55330
Voice phone:763-241-2700
Web: http://www.co.sherburne.mn.us
Stearns County Social Services
705 Courthouse Square
St. Cloud, MN 56302
Voice phone: 320-656-6000
Web: http://www.co.stearns.mn.us
Wright County Human Services
1004 Commercial Dr.
Buffalo, MN 55313
Voice phone: 763-682-7400
Web: http://www.co.wright.mn.us
Housing
The most important decision you will make in the relocation process is where and how you want to live. ILICIL provides services to residents of nursing homes in Benton and Stearns counties, but we will help you move within our nine-county service area. Your relocation coordinator will ensure that your housing is both affordable and accessible.
Accessible housing provides wheelchair access, knee space, grab bars, easy-to-turn door handles, and other features that allow people with disabilities to function on their own.
Affordable
housing
means that your rent and utilities cost less than 30% of your
household income.
What kind of living arrangements are right for you? Here are some possibilities.
Independent Living is just what it sounds like. You live in your own home or apartment without supervision. You may arrange for some services such as home-delivered meals or housekeeping . Training in independent living skills is provided by a variety of agencies, including ILICIL.
Assisted Living allows you to live in a residential center such as an apartment building with staff on hand to provide 24-hour emergency response and individual support services, such as help with meals, medication, bathing, and housekeeping.
Congregate Housing is assisted living in which you have your own apartment, but share meals and social activities with other residents. Personal, housekeeping and medical services are provided as needed.
Adult Foster Care provides structure and companionship for those who are not able to live alone. Adult foster homes offer food, lodging, supervision, and household services in a family-like setting. You may also receive assistance with living skills, medication, and safeguarding finances.
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For more information on housing call your local city or county housing authority.
Housing & Redevelopment Authority- St. Cloud
320-252-0880
Housing & Redevelopment Authority - Stearns County
320-685-7771
Housing & Redevelopment Authority - Morrison County
320-632-4506
Food
A number of resources can help you with groceries. Meals on Wheels, Store to Door, and commercial programs like Coborns Delivers will bring food and groceries to your home. If necessary, you can get Meals on Wheels through your MA waiver. If you have a limited income you can also go to a food shelf.
Food
shelves are usually run by community-based organizations like
churches or service clubs to serve people in their area who cannot
afford groceries. Most of them can also help with personal care
items and some clothing. In general, you can go to a food shelf once
every 30 days. Each time you will get enough food for three to seven
days. You should have a picture ID, proof of income, and proof of
residence, such as a piece of mail with your current address. You
will need proof of residence for each person in the household.
Here is a partial list of food shelves in our nine County Service area. Call for hours and area served before you go.
Benton County
CROSS Center for Benton County Food Shelf
150 4th Ave.
Foley, MN 56329
(320) 968-7012
Rice Area Food Shelf
Old Village Hall
Main Street
Rice, MN 56367
(320) 393-4441
Isanti County
Braham Area Food Shelf
105 West Central Drive
Braham, MN 55006
(320) 396-4609
Isanti County Food Pantry
P.O. Box 506
Cambridge, MN 55008
(763) 691-0121
New Pathways, Inc. Food Shelf
310 S Ashland Street
Cambridge, MN 55008
(763) 691-0121
Kandiyohi County
Willmar Area Food Shelf (will provide food only 3 times per year per family)
624 Southwest Pacific Avenue
Willmar, MN 56201
(320) 235-2641
Meeker County
Litchfield Food Shelf
127 North Sibley Avenue
Litchfield, MN 55355
(320) 693-7661
Mille Lacs County
Isle Area Food Shelf
Smokin Hills
Isle, MN 56342
(320) 676-3184
Milaca Area Food Shelf
145 South Central
Milaca, MN 56353
(320) 982-3773
Family Pathways - Onamia Food Pantry
502 Main Street
Onamia, MN 55056
(320) 532-7665
Pantry Food Shelf
104 6th Avenue S.
Princeton, MN 55371
(763) 631-3578
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Morrison County
Morrison County Food Shelf
1912 1st Avenue SW
Little Falls, MN 56345
(320) 632-8304
Motley Area Food Shelf
697 3rd Avenue South
Motley, MN 56466
(218) 352-6344
Area Food Shelf
Behind Fire Hall
Pierz, MN 56364
(320) 468-6952
Sherburne County
Becker Area Food Shelf
12060 Sherburne Avenue
Becker, MN 55308
(763) 261-4612
Big Lake Food Shelf
160 Lake Street
Big Lake, MN 55309
(763) 263-2432
CAER Food Shelf
19279 Watson Street
Elk Riverl, MN 55330
(763) 441-1020
Stearns County
Albany Food Shelf
741 Lake Avenue
Albany, MN 56307
(320) 845-2343
St. Benedict's Food Shelf
16895 County Road 9
Avon, MN 56310
(320) 356-7224
Belgrade/Brooten/Elrosa Area Food Shelf
Medical Building
Brooten, MN 56316
(320) 346-4193
Cold Spring Area Food Shelf
P.O. Box 307
Cold Spring, MN 56320
(320) 685-8785
Eden Valley Area Food Shelf
Box 298
Eden Valley, MN 55329
(320) 453-2000
Holdingford Area Food Shelf
P.O. Box 13
Holdingford, MN 56340
(320) 746-2401
Kimball Area Food Shelf
Church of St. Ann
441 Hazel Avenue E.
Kimball, MN 55353
(320) 398-2211
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Melrose Area Food Shelf
211 S fifth Ave. W
Melrose, MN 56352
(320) 256-2555
Paynesville Community Services Food Shelf
107 River Street
Paynesville, MN 56362
(320) 243-4953
Sauk Centre Western Stearns Food Shelf
523 Sinclair Lewis Avenue
Sauk Centre, MN 56378
(320) 351-2287
St. Cloud Good News Assembly Food Shelf
712 17th Avenue South
St. Cloud, MN 56301
(320) 255-0620
Caritas Food Shelf
157 Roosevelt Road, Suite 100
St. Cloud, MN 56301
(320) 229-4560
Place of Hope Ministries
811 St. Germain W.
St. Cloud, MN 56301
(320) 203-7881
Salvation Army Food Shelf
223 East St. Germain
St. Cloud, MN 56304
(320) 252-4552
St. Joseph Area Food Shelf
12 West Minnesota Street
St. Joseph, MN 56374
(320) 363-7505
Waite Park Area Food Shelf
St. Joseph's Rectory
106 7th Avenue North
Waite Park, MN 56387
(320) 251-5231
Wright County
Annandale Area Food Shelf
P.O. Box 94
Midtown Plaza
Annandale, MN 55302
(320) 274-5745
Buffalo Food Shelf
Lakeview Mall
15 1st Avenue South
Buffalo, MN 55313
(763) 684-1699
Clearwater/Clear Lake Area Food Shelf
Clearwater Lion's/Lioness Community Building
East Highway 75, PO Box 324
Clearwater, MN 55320
(320) 558-2954 (leave Msg)
Monticello Christian Social Services
P.O. Box 1220
Monticello, MN 55341
(763) 295-4031
Delano Helping Hands Food Shelf
140 Elm Avenue
Mail: 216 South 5th Street
Delano, MN 55328
(763) 972-2077
Some Common Terms Related to Nursing Home Relocation
Activities of Daily Living are tasks essential to your routine self-care such as dressing, bathing and eating.
Adult Foster Care is licensed, supervised living arrangements in a family-like setting.
An Advocate is an individual you designate to speak on your behalf and to help you identify your needs and make informed choices of services.
The
American with Disabilities Act
(ADA) is federal civil rights legislation passed in 1990
that guarantees equal opportunity for persons with disabilities in
public accommodations, employment, services, and telecommunications.
Assessment identifies your strengths, skills, preferences, and needs; determines how well community-based supports meet your needs; and decides what help you need from human services agencies and other providers.
Assisted Living arrangements allow you to live in your own apartment while receiving a customized package of supportive services from the residential center.
Your Community Support Plan identifies your needs and preferences in order to arrange an individualized mix of supports that will help you achieve your goals in the most inclusive setting.
General Assistance Medical Care (GAMC) is a state health care program for low income Minnesotans who do not qualify for Medical Assistance (MA) or other state and federal health care programs.
Group Residential Housing (GRH) is a state-funded, income supplement program that pays for room and board costs for people with low-income who have been placed in a licensed or registered setting.
Home and Community Based Services (HCBS) is a federally funded waiver program that provides long-term care services beyond those covered by MA for persons with disabilities who live independently in home and community settings.
A Home Health Aid has been approved by your supervising registered nurse to perform medically oriented tasks that are part of your care plan. A Health Aid is not licensed to perform nursing services.
Inclusion happens when people with disabilities and people without disabilities participate in the same activities at the same time.
Independent Living Services include assistive technology, independent living skills training, and other community-based support services which help you live in the community.
Informed Choice is the voluntary decision you or your legal representative makes when you know and understand the possibilities that are available for you.
Instrumental Activities of Daily Living include planning and preparing meals, managing finances, shopping for food, using the phone or other communication technology, and similar activities which are part of daily life and allow participation in your community.
The
Least Restrictive Environment
is the one that gives you a maximum level of independence
and inclusion in the community, with minimum limitation or
disruption of typical patterns of living, with no unnecessary risks
to health or safety.
Long-Term Care Consultation (LTCC) identifies the long-term services and care you will need in order to prevent or delay your placement in a nursing home, or to assist your return from the nursing facility to the community.
Medicaid (Medical Assistance or MA) is a program that combines state and federal money to help states meet the costs of necessary medical and health related services to low-income persons who are aged, blind or disabled. In Minnesota Medicaid is called Medical Assistance.
Medical Assistance for Employed Persons with Disabilities (MA-EPD) is a work incentive which allows working people with disabilities to qualify for MA under higher income and asset limits than regular MA.
Medicare is a federal health insurance program administered by the U.S. Department of Health and Human Services under the Centers for Medicare and Medicaid Services (CMS) for people who are 65 or older, or are under 65 and disabled for more than 2 years, or have permanent kidney failure.
An Ombudsman is an independent government official who receives complaints against government and government-regulated agencies or their staff, investigates, and recommends any necessary remedies.
The Options Initiative is Minnesota’s commitment to help people with disabilities who are under age 65 live where they choose with appropriate services to assure their health and safety.
Person Centered Planning (PCP) means that the planning process focuses on you and on what you want for your future.
Protection and Advocacy Agencies are federally funded organizations located in every state that protect the rights of persons with developmental disabilities. In Minnesota, the Disability Law Center is the designated Protection and Advocacy agency.
Relocation
Service Coordination (RSC)
provides coordinated activities
that are designed to help you receive necessary medical, social,
educational, and housing support in order to move from an
institution into the community.
Retirement, Survivors, and Disability Insurance (RSDI) is a program operated by the Social Security Administration that provides a monthly income to retired people, to survivors or dependents of insured people, and to people with disabilities.
Semi-Independent Living Services (SILS) include training and assistance in managing money, preparing meals, shopping, maintaining personal appearance and hygiene, and other activities needed so an adult with mental disabilities is able to live in the community.
Skilled Nurse Visits (SNV) are intermittent visits to you in your home by a registered nurse (RN) or a licensed practical nurse (LPN) under the supervision of an RN.
Social Security or Supplemental Security Income (SSI) is a federal program that pays monthly cash benefits to persons who are age 65 years or older, are blind or have a disability, and have limited resources and income.
Support Coordination provides information to assure that you and your family understand the responsibilities involved with self-direction and to help you develop an effective plan which meets your needs and provides emergency back-up.
Targeted Case Management (TCM) coordinates services and helps eligible people access needed medical, social, educational and other services.
Transition Services assist you in moving from one phase of your life to another, such as from high school to employment or post-secondary education.
Traumatic Brain Injury (TBI) is an injury to the brain caused by an external physical force, which results in impaired abilities, possibly including changes in behavior and/or emotional functioning.
Vocational Rehabilitation Services include a wide range of service and job training which help people with disabilities get and keep a job.
A Vulnerable Adult is a person 18 years of age or older who is unable or unlikely to report abuse or neglect without assistance because of a disability or impaired mental, physical or emotional capability.
A Waiver is a program that has federal approval to expand coverage for services not usually covered under MA. See pp. 10-11 for the waiver programs that are offered in Minnesota.
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The Next Step is Yours
The information we have provided you in this book will help you move forward with the process of relocating from a nursing facility to your home in the community.
Our sincere wish is to assist you in your relocation process, and to make your transition from the nursing facility to the community as smooth and enjoyable as possible.
If you have any questions, or if you are ready to begin the process, please call ILICIL at 320-529-9000 (voice or TTY).
When You Are Ready
Here are some questions that will help you prepare for a meeting with your relocation coordinator.
Where do you want to live? Who do you want to be involved in your care?
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What kind of transportation do you use? What are your sources of income?
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Have you lived in the community before?
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Use this space to write down any questions you want to ask your relocation coordinator about.
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Resources
Department of Human Services
Voice 320-656-6000
Mnnesota Disability Law Center
Voice 612-332-1441
TTY 612-332-4668
Disability Linkage Line
1-866-333-2466
Governor’s Council on Developmental Disabilities
Voice 651-296-4018
MN Relay Service 800-627-3529
Toll-free 1-877-348-0505
Metropolitan Transit Center (MTC) St. Cloud
Voice 320-251-1499 or 320-251-7433
Metro Bus Dial-A-Ride - St. Cloud
Voice 320-252-1010
MetroPlus Specialized Service
Voice 320-252-1010
Minnesota State Council on Disabilities
Voice and TTY 651-296-6785
MN Relay System
1-800-627-3529
Senior LinkAge Line
1-800-333-2433.
Legal Services - St. Cloud Area - Central MN Legal Services
320-253-0121
Independent Lifestyles, Inc. a Center for Independent Living
519 2nd Street North
St. Cloud, MN 55303
Voice: 320-529-9000
Fax: 320-529-0747