People with a disability who receive services through a Medicaid waiver, the public behavioral health system, or a Center for Independent Living will have a person-centered plan/treatment plan or independent living plan that describes what you need and want for your life in the community and includes goals and plans for services and supports to help you achieve those goals.
Person-Centered Planning for People Receiving DDA Services
Person-centered planning is a process that begins with the understanding that all people have the right to live, love, work, play and pursue their aspirations in their community. To that end, people have the right to figure out and pursue their good life. What defines a good life is as individual and unique as the person being supported. Many people also have family and others in their lives who play a meaningful role as the person explores potential interests and opportunities not considered before.
If you have waiver services through DDA, you will have a person-centered plan that addresses the services and supports you need and want to achieve your goals. If you want to move to your own place, you will have a housing goal in your plan that includes information on the kind of support you need and steps along the way to help you reach your goal. Information on DDA person-centered planning can be found here.
Creating a Housing Plan
People with DDA waiver services can get help from Housing Support Services (HSS) professionals to create their personal housing plan. The HSS specialist will talk with you about a number of topics including:
- Where you want to live.
- Who you want to live with.
- Your resources including any financial and personal assistance from family and friends.
- Any barriers to housing you that you may have.
- Your support services.
- Any additional services you can receive that may help you be successful in your own home.
- Any housing assistance programs you may qualify for.
For people with DDA waiver services, the housing plan becomes part of the overall person-centered plan. The HSS professional will coordinate with your Coordinator of Community Services (CCS) to ensure that your desires and needs are known and that supports and services are included to help you achieve your goals. The housing plan can be modified whenever needed to reflect changes in your wants, needs and status. It will also be changed when you get a housing opportunity. The HSS professional will work closely with you to be sure that you get the help you need when a housing opportunity is available. They will help with completing your housing application and with obtaining documentation that are needed by the landlord. In addition, they will make sure that a plan is made to help you transition to your new home.
If you don’t have DDA waiver services, you can get assistance from your case manager, Supports Planner or from your local Center for Independent Living.
Person-centered Planning for People Receiving Other Services
- Community Options Waiver – People using the Community Options Waiver can get assistance with creating a housing plan from their supports planner.
- Brain Injury Waiver – People using the Brain Injury Waiver can receive assistance from their case manager.
- Behavioral Health Treatment Services – People receiving public behavioral health services can get assistance from their case manager to create a treatment plan.
- Center for Independent Living (CIL) – People receiving assistance from their local CIL will develop a plan for independent living.
Planning Ahead for What You Will Need When You Move
It’s important to think about how your service needs may change when you are living in your own home. Your family or the staff at your group home may have helped you with many activities of daily living and now you will need to make a plan for how your needs will be addressed in your new place. Your case manager, Coordinator of Community Services (CCS) or Supports Planner can help you think this through. If you have a Housing Support Service (HSS) professional, they can help you think about your needs as well.
One way to think about it is to list everything that happens in your day from the time you wake up to the time you go to bed. How do you get all of the daily things done? Does someone help you? Do you sometimes get up in the middle of the night and need help? How will you get your groceries, get to medical appointments, get to recreational activities, visit family, pay your bills, read and understand your mail? The answers to these questions and more will become part of your new person-centered plan.
Listed below are some support need issues that can help you think about your needs in a new home:
- Bathing and hygiene
- Transferring to and from a wheelchair
- Toileting
- Home maintenance and cleaning the home
- Budgeting and paying bills
- Staying safe and emergency preparedness
- Communicating with staff, friends and family
- Preparing meals
- Laundry
- Transportation
- Taking medications
Here are some resources to help you plan for a few of the things you will need:
Preparing Meals at Home
You don’t need to know how to cook to live in your own home. There are options for meal delivery, cooking classes and in-home supports that can help with meals, including special diets.
Some options are listed below:
Meal Services
Accessible Chef
Accessible Chef is a Baltimore-based website with a collection of free visual recipes and other resources to help teach cooking skills to individuals with disabilities. Visual recipes make use of task analysis, which is an evidence-based approach for breaking down a complex task into manageable steps. Each task is separated into discrete skills and individuals can learn to complete skills in a specific order to learn new tasks. Students may require visual, physical or verbal prompts to complete each skill, and prompts may be gradually removed as the individual becomes more independent. Visual recipes share similarities with PECS (Picture Exchange Communication System) and curricula created with Boardmaker.
Other Meal Services
Home delivered meal kits can help make living in your own home easier. With a home delivered meal kit, you will receive the foods you need to cook the meal as well as instructions for how to cook the foods. There are many different home delivered meal kit companies.
You can learn about them by going to this link: https://www.cbsnews.com/essentials/best-meal-kits/?ftag=MSF0951a18
Note that most home delivered meal companies do not accept EBT SNAP benefits.
Medications
If you need help with preparing and taking medications, many people can get help through Medicaid waiver services. If you don’t have this assistance, there are several possible ways to get help with taking your medications:
- You can ask family or friends to help you put your medications in daily or weekly pill organizers. Family, friends or staff can also remind you to take your medications.
- Some people find it very helpful to use a pill box with a built-in alarm. The box can be filled with your medications once a week by your family or friends and locked. When it’s time for you to take your medication, the box will sound an alarm and open the compartment with your next dose of medication. The alarm will continue to sound until you take your medication and close the compartment. The box will then sound an alarm when your next dose of medication is due. Alarmed pill boxes are easy to find on the internet and there are many varieties that can meet your needs. Below are a few examples:
Transportation
If you have Medicaid, transportation to medical appointments can be provided at no cost. Be sure to make arrangements well in advance to ensure transportation is available. More information about this service can be found here: https://www.wellpoint.com/md/medicaid/benefits/extras/transportation
Some people who have waiver services can get assistance from staff to go shopping to get to doctor appointments. If you have waiver services, you should include plans for this in your person-centered plan. The Developmental Disabilities Administration includes Transportation Services in all three of its waiver plans, including Community Pathways, Community Supports and Family Supports. Transportation Services can include training to use public transportation and informal/generic transportation services, assistance with accessing Mobility and volunteer transportation services, mileage reimbursement when another person provides transportation with their car, and purchase of pre-paid transportation vouchers and cards including Charm Cards and Taxi Cards. The cost for transportation services through one of these waivers is limited to $7,500 per year per person.
Timing of Services and Signing the Lease
Sometimes, when you find just the right place to live, the landlord may say that you need to sign the lease as soon as possible and if you can’t they will rent the unit to someone else. This can be stressful if your service and supports plan is not approved. You know you can’t move into your new place without the supports you need.
What can you do? It is always best to make sure that your person-centered plan includes information about the services you will need when you have your own home. It’s also best to keep everyone informed about the progress you are making toward your housing goal. Your CCS or case manager should draft a revised plan with most of the services and supports you know you will need and have it ready to submit for approval as soon as you start to look for a place to live. Your plan can still be updated if your needs change. Your CCS or case manager can also let those who approve the plan know that it needs to be expedited to ensure that you don’t lose the housing opportunity.
If you will pay part of your rent with a rent subsidy, it is important that you DO NOT sign a lease until the apartment you have chosen passes a required inspection. If you sign the lease before the apartment passes the inspection and the apartment doesn’t pass, you may not be able to use the rent subsidy and will be required to pay rent for a year without financial assistance.
Live-in Caregivers
Sometimes a person with a disability needs to have someone live with them to help with activities of daily living and to assist with safety. Fair housing laws require most landlords and housing offices to provide “reasonable accommodations” for people with disabilities. There are many possible reasonable accommodations a person with a disability may need. One of these reasonable accommodations can be to have an additional bedroom for a live-in aide. In addition, the person with a disability will need to provide medical documentation from a healthcare professional detailing the need for reasonable accommodation. A live-in aide’s income is not counted as part of household income, and the live-in aide does not have rights of tenancy. This means that the aide cannot continue to live in your home if you are no longer living there. It also means that the aide must leave if you tell him/her you no longer want their services. It is important to discuss this with potential live-in aides. They need to understand that they are living with you to assist you at your request and that their housing depends on you being there and being satisfied with their services. This can be especially difficult when family members agree to be a live-in aide.
It is also important to have a written agreement with the aide that spells out the services they will provide, the hours they will work and any other conditions that may be important to you.
DDA Waiver – Live-in Caregiver Rent: Community Pathways Waiver
If you receive DDA Community Pathways waiver services, you may be able to take advantage of the Live-in Caregiver Service. The service provides funds for the additional rent for a larger apartment with a bedroom for the caregiver. It also pays for the additional food costs for a live-in caregiver. A written caregiver agreement must be approved by the DDA to receive this service.
Live-in Caregiver Services for live-in caregivers are not available in situations in which the individual lives in their family’s home, the caregiver’s home or a residence owned or leased by a DDA-licensed provider.