Granite State Independent Living & NH Disability Resources

The October CRC Information Session featured guest speaker Leslie Alcorn, RN and Outreach Coordinator from Granite State Independent Living Center (New Hampshire). Ms. Alcorn focused her presentation on the initiatives of ILCs, programs specific to GSIL, as well as an overview of how to access public benefits in New Hampshire.

Consumer-Directed Personal Care Services
For over 26 years, Granite State Independent Living has provided consumer-directed personal care services to New Hampshire residents. Consumer-direction is rooted in the premise that consumers should have the power to decide the types of services that they need, who will deliver the services, and when and how the services are delivered. Independent living centers are available in all 50 states.

At the heart of the consumer-direction movement in long-term care are personal care services. Personal care is assistance with activities of daily living, such as bathing, dressing, transferring from bed to chair, toileting, mobility, and nutrition assistance. It also includes housekeeping, cooking, shopping, and laundry. Personal care services are non-medical in nature.

Personal Care Service Options
Granite State Independent Living offers three options for personal care services. The options include the Personal Care Attendant Program (PCA), the Personal Care Services Program (PCSP), and Independent Care Options (ICO). Consumers select and hire their own personal care workers, and decide who delivers their care, when and where. Personal Care Service Coordinators teach consumers or their designated representative how to select, hire and manage personal care workers to meet their lifestyle needs.

Each program is similar in the scope of services that are offered. The primary differences are in eligibility requirements.

The Personal Care Attendant Program was GSIL’s first personal care program. Individuals who are eligible include those who:

• Are Medicaid eligible
• Have a severe physical disability
• Require a wheelchair for mobility
• Require at least two hours of personal care services daily
• Are 18 years of age or older
• Are their own legal guardian
• Are able to self-direct their care
• Are medically stable
• Do not require 24-hour care

The PCA program assists consumers with tasks of daily living, such as bathing and dressing, toileting and grooming, housekeeping and cooking, nutrition assistance, mobility assistance, and errands and shopping. Payment is through regular Medicaid.

The Personal Care Services program (PSCP) offers assistance with the same tasks-of-daily living as the PCA program. It differs from the PCA program in the following ways:

• Applicants must qualify for the Home and Community-Based Elderly and Chronically Ill (HCBC-ECI) Waiver program*;
• PCSPs can help consumers access their communities by driving them to and from appointments, visits, activities and more.
• family members or friends who are not legally responsible for the individual may provide PCSP services. “Legally responsible” excludes spouses and a person’s PCA or case manager.
• In addition to serving those who are able to direct their own care, they can serve those who have an authorized personal care services representative who acts on his or her behalf to direct care.

Independent Care Options
Independent Care Options the private-pay personal care option. Individuals who are eligible include those who:

• Are 18 years of age or older
• Are a New Hampshire Resident
• Can serve those who can direct his or her own care, or those who have a personal care representative who acts on his or her behalf to direct care.

The Independent Care Options program provides services that are individually-tailored to meet consumers’ lifestyles. Services include but are not limited to:

• Basic personal care services
• Assistance with accessing the community
• Companionship
• Respite Care
• Chore services
• Household Management Services

Granite State Independent Living currently serves over 400 consumers and acts as the “employer of record” for over 700 personal care workers in New Hampshire.

For more information about personal care services please call 603-228-9680 or visit the Long Term Supports section of Granite State Independent Living’s website at www.gsil.org.

Access to Public Benefits in New Hampshire: Medicaid

New Hampshire Medicaid.
To be eligible an individual must qualify both financially and medically, including proving a total and permanent disability. The Bureau of Elderly and Adult Services (BEAS), a branch of the New Hampshire Department of Health and Human Services, manages the Medicaid program. BEAS staff are located at twelve DHHS District Offices throughout NH. BEAS also has a main office, located in Concord, responsible for administrative support and general program and financial planning. http://www.dhhs.nh.gov/dcbcs/beas/

ServiceLink Resource Center:
ServiceLink, an Information & Referral center that assists seniors and adults with disabilities, facilitates a partnership between BEAS and local communities. ServiceLink provides information regarding long-term care, caregiver resources, and information about Medicaid and Medicare.

Although this service is available to all individuals seeking information about New Hampshire disability resources, Leslie Alcorn from GSIL suggested that Social Workers call to begin the application and information gathering process for clients, as it can be very frustrating for families. ServiceLink: 1-866-634-9412 or www.ServiceLink.org

Medicaid Waiver Programs- Home and Community Based Care (HCBC):
ServiceLink also assist clients with accessing Medicaid Waiver programs, which provide home care options to disabled or chronically ill individuals.

1. *Home and Community Based Care for the Elderly or Chronically Ill (HCBC-ECI) provides Medicaid funding for eligible individuals wishing to remain living independently in lieu of a nursing home facility. Individuals must be over 18 and in need of a nursing facility level of care.
2. Home and Community Based Care for Developmentally Disabled (HCBC-DD) managed by the NH Bureau of Developmental Services (BDS) the HCBC-DD program provides options for in home care and daily support versus institutionalization for individuals with developmental disorders.
3. Home and Community Based Care for Acquired Brain Disorders (HCBC-ABD) provides community-based daily-support services for individuals with traumatic brain injuries or neurological disorders.

Other NH Resources:

Housing:
The New Hampshire Housing Financial Authority manages public and affordable housing including federal and state rental assistance programs. The NHHFA organization not only manages state housing and affordable housing listings, but is also the primary source for all NH housing data. NHHFA: (603)-472-8623 or (800)-640-7239 or www.nhhfa.org

Nursing Services:
The VNA of New Hampshire is the primary source of nursing services VNA locator: http://www.vnaa.org/find-a-provider. Home health agencies are also a good resource. HHA can be located through ServiceLink at 1-866-634-9412 or by contacting the Home Care Association of New Hampshire, which offers a directory of licensed home health agencies in NH. www.homecarenh.org

Adult Foster Care Program:
The Moore Center in Nashua, NH, an Area Agency for people with Developmental Disabilities, is currently piloting the Adult Foster Care Program. The AFCP provides a combination of supervision, personal care, homemaking, and other services provided in the certified home of another individual. The AFCP is offered through the Home and Community Based Care for the Elderly and Chronically Ill (HCBC-ECI), which offer services to individuals who are eligible for nursing facility care and meet Medicaid financial guidelines. For more information about this program, please contact the Bureau of Adult and Elderly Services (BEAS) at ttarr@dhhs.state.nh.us

-Portions of this article are reprinted with permission of the author, Jill Burke, Vice President of Long-Term Supports, Granite State Independent Living.

11/07