Services in Your New Home

Planning Ahead for What You Will Need

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/CCS/Supports Planner can help you think this through.  One way to think about it is to talk about 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.

  1. Personal care
    • Bathing/hygiene
    • Transferring to/from a wheelchair
    • Toileting
  2. Home maintenance/cleaning the home
  3. Budgeting and paying bills
  4. Staying safe and emergency preparedness:  Staying safe in your home is one of the most important things to consider.  Important issues to think through include
    • Planning for getting into your home if you lose the keys
    • Making sure you feel safe on wet surfaces like the shower and bathroom floor
    • Planning for weather and other emergencies.  

It’s important to have emergency preparedness plans that help you be safe if you need to shelter in place, such as during a snowstorm, or if you need to evacuate such as during a hurricane.  The Maryland Department of Disabilities has helpful information to guide you through creating emergency plans:
Emergency Prep Home

Preparing meals

One thing is certain, 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

Meal kits for people with disabilities: What Meal Delivery Kits Mean for People with Disabilities 

Freshly is a meal delivery service that does not require assembly or cooking – each meal is already prepared in a limited-time window so the food doesn’t have any freezer taste. Every single meal is perfectly-portioned, certified gluten-free, contains extra vegetables (such as butternut squash or lentil pasta instead of wheat) and doesn’t use corn syrup or artificial sweeteners. Meals can be customized for extra protein, carb consciousness, low sodium, or lean calories.
About Freshly 

Tovala is a meal delivery service that has an intentional commitment to accessibility on their website, and their meals are also accessibility-friendly. Tovala is a meal delivery kit and system that handles the cooking for you and prepares meals in 20 minutes or less. Its key feature is its Smart Oven, which cooks everything the meal kit delivers (except salads). Meals arrive fresh, not frozen, and ready to cook. Tovala meals are entirely prepackaged and require no chopping, mixing, or meal prep. To cook them, simply place them in the Smart Oven, scan the meal’s bar code, and let the oven cook the meal exactly as Tovala’s chefs intended. If you live in the continental US, you can order anywhere between three and 16 meals a week, and have two choices for your preferred delivery day. Because Tovala’s meals are prepackaged and ready to cook, they don’t call for the dexterity that chopping, dicing, mincing, slicing, and stirring requires. And, Tovala’s Smart Oven app has VoiceOver support that allows users to easily browse menus, order, and prep Tovala meals at home.
Tovala | The truly effortless way to cook at home. 

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.
Accessible Chef – Accessible Cooking for Budding Chefs 

Medications

If you need help with preparing and taking medications, many people can get help through their waiver services.  If you don’t have this assistance, you can ask family or friends to help you put your medications in pill organizers.  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.

Shopping/medical appointments

Some people who have waiver services can get assistance from staff to go shopping and to get to doctor appointments.  If you have waiver services, you should include plans for this in your person-centered plan.  If you don’t have waiver services, you may be able to get help from family and friends.

Transportation

Some people who have waiver services can get transportation services as part of their person-centered plan.  In addition, people who have Medicaid can get medical transportation to doctor’s appointments.  Public transportation can be helpful if you live close to a fixed transit route.  People with disabilities are entitled to receive paratransit services if they live within ¼ mile of a fixed transit route. You can also use services like Uber and Lyft to get to the store and to appointments.  Some communities have special transportation services for people with disabilities.  

Creating a Housing Plan

People with DDA waiver services can get help from Housing Support Services (HSS) staff to create their personal housing plan.  The HSS staff will talk with you about 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 that you may have, your support services and any services you can receive that may help you be successful in your own home, and 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 staff will coordinate with your Coordinator of Community Services (CCS) to ensure that your desires and needs are known and that steps 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.  The plan will also be changed when you get a housing opportunity.  The HSS staff will work closely with you to be sure that your housing application and documentation are given to the landlord and 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 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 the goals you have.  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 at:
Person-Centered Planning 
Frequently Asked Questions: Person Centered Plans (PCPs)

Person-centered Planning for People Receiving Other Services

  1. Community Options Waiver – People in the Community Options waiver can get assistance with creating a housing plan from their Supports Planner.  
  2. Brain Injury Waiver – People in the Brain Injury Waiver can receive assistance from their case manager.
  3. Behavioral Health Treatment Planning – People receiving public behavioral health services can get assistance from their case manager.

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 case manager should draft a new 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 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.  


Live-in Aides

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 law provides “reasonable accommodations” for people with disabilities to have an additional bedroom at to accommodate a live-in aide.  The aide must be approved by the landlord who will usually do a criminal background check, and medical documentation will be needed from a healthcare professional substantiating your need for a live-in aide.  A live-in aide’s income is not counted as part of household income, and they do 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 them 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.  

If you receive DDA Community Pathways waiver services, you may be able to take advantage of the Live-in Caregiver Rent service.  

DDA Waiver – Live-in Caregiver Rent:
Community Pathways Waiver

  1. Live-in Caregiver Rent is part of the Community Pathways Waiver and includes rent for an unrelated personal caregiver who is residing in the same household with an individual who, but for the assistance of such caregiver, would require admission to an intermediate care facility.
  2. A caregiver is defined as someone unrelated by blood or marriage who is providing Personal Supports (formerly Community Supported Living Arrangements (CSLA)) services in the individual’s home.
  3. Live-in Caregiver Rent for live-in caregivers is not available in situations in which the recipient lives in their family’s home, the caregiver’s home or a residence owned or leased by a DDA-licensed provider.
  4. DDA and the State Medicaid agency will pay for this service for only those months that the arrangement is successfully executed, and will hold no liability for unfulfilled rental obligations. Upon entering in the agreement with the caregiver, the individual (or his/her legal representative) will assume this risk for this contingency.