Money Follows the Person participant transition planning guide : for returning to the community

Money Follows the Person
Participant Transition Planning Guide
for returning to the community
2010

Money Follows the Person (MFP) Contact Information

If you are an older adult or a person with a physical disability or acquired brain injury and want more information about MFP, contact: B&B Care Services, Inc. P.O. Box 1040 Springfield, GA 31329 Toll Free: 800-657-7017 Telephone: 912-754-0817 Fax: 912-754-1534 E-mail: mccullough_trish@ yahoo.com Website: www.bandbcare.com
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If you are a person with a developmental disability and want more information about MFP, contact the Department of Behavioral Health and Developmental Disabilities (DBHDD), Regional Office nearest you: Region 1 DBHDD Office (Rome): 706-802-5272 Region 2 DBHDD Office (Augusta): 706-792-7733 Region 3 DBHDD Office (Tucker): 770-414-3052 Region 4 DBHDD Office (Thomasville): 229-225-5099 Region 5 DBHDD Office (Savannah): 912-303-1670 Region 6 DBHDD Office (Columbus): 706-565-7805
E-mail: gamfp@dch.ga.gov
Website: dch.georgia.gov/mfp

Transition Guide Icons
The following icons will help remind you to take action or call attention to important activities and information:

Information

Medical Equipment and Supplies

Assignment

Daily Support

Moving

Self-Direct

Affordable Housing

Community Activities

Transportation Options

Would you like to return to your home or community?
Money Follows the Person could be your answer!
If You:
Are Medicaid eligible and have lived for at least three months in a nursing facility or an Intermediate Care Facility (ICF); AND
Have a strong desire to go home
Read on:
This booklet will help you understand the services and supports that are available through Money Follows the Person (MFP) to help you successfully move back into your home or a qualified residence in the community. In addition, this booklet contains information that you will need in order to move into the community.
MFP offers you support so you are not alone in the transition process. You will get help to plan for the services and supports you need to make your move back into the community and to live successfully. A number of people will be available to assist you. The MFP Transition Coordinator (Transition Coordinator) will facilitate planning and help you coordinate your move. Once your waiver application has been accepted, you will either select a Waiver Case Manager or one will be assigned to you. Your Case Manager is the main person who will guide you through the long-term care system.
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What's Inside
Are You Interested in Moving?.................................................................... 6 The Choice is Yours .................................................................................... 6 Some Simple Ground Rules ......................................................................... 7
What are Medicaid Home and Community-Based Programs?....................... 8 Documents You Will Need............................................................................ 8
What MFP Services Will Help You? .............................................................. 9 Assignment: MFP Services......................................................................... 13
Identify Who Will Assist You .................................................................... 14 Your Transition Team ................................................................................ 14 Circle of Friends/Circle of Support .............................................................. 15 Peer Supporters ....................................................................................... 15 Advocacy Partners.................................................................................... 16 Providers ................................................................................................ 16 Court-Appointed Guardian ......................................................................... 16
Complete Your Individualized Transition Plan........................................... 17 Assignment: Complete Your Self-Assessment ............................................... 17 Personal Finances and Trial Budget ............................................................. 20
Apply for a Home and Community-Based Service Waiver .......................... 24 What Will My Waiver Case Manager Do? ...................................................... 28 Assignment: Apply for a Waiver ................................................................. 28
Locate Appropriate Housing...................................................................... 30 Assignment: Complete the Housing Needs Assessment ................................. 32 Conduct a Housing Search......................................................................... 37 Affordable (Non-Subsidized) Housing Resources ........................................... 38 Affordable (Subsidized) Housing Resources.................................................. 39 Housemate and Roommate Match Services .................................................. 40 Public Housing and Housing Choice Vouchers ............................................... 41
Identify Daily Health Services, Supplies and Equipment You Need..............43 Assignment: Complete Healthcare and Nutrition Worksheet ........................... 44
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Identify Daily Supports You Need ............................................................. 48 Assignment: Complete the Personal Support Services Log ............................. 49 24/7 Emergency Backup Service Plans ........................................................ 51 Independent Living Skills Training............................................................... 53
Do You Want To Self-Direct?..................................................................... 54 Assignment: Self-Direction ........................................................................ 56
Identify Transportation Options ............................................................... 57 Assignment: Complete Transportation Planning Worksheet............................. 57
Complete Community Activities ................................................................ 63 Assignment: Complete Social & Recreational Planning Worksheet..................... 64 Training, School and Employment ................................................................ 66
Moving Day (Discharge Day) and Beyond ................................................. 68 Your First Year in the Community ............................................................... 69 Your Waiver Services Continue After MFP..................................................... 70 Assignment: Complete Discharge Day Planning Worksheet.................................. 71 Short-Term Hospitalizations or Nursing Facility/Rehab Stays ...................................74
Quick Reference Guide to Resources......................................................... 76 Centers for Independent Living (CIL) .......................................................... 76 Area Agency on Aging (AAA)...................................................................... 79 Aging and Disability Resource Connections (ADRC) ....................................... 83 SOURCE Providers.................................................................................... 86 Startup Household Goods & Supplies Worksheet........................................... 93 Documents Needed for Housing Searches .................................................... 96 Benefits and Services for MFP Participants by Waiver ............................................... 98 Health and Emergency Resources ............................................................. 100 Emergency Food Resources ..................................................................... 103 Durable Medical Equipment and Assistive Technology Equipment and Services.......................................................................................... 104 Environmental Modification Services ......................................................... 106 Legal Services ....................................................................................... 109 Additional Transportation Resources.......................................................... 110 Training and Employment Resources ......................................................... 111
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Are You Interested in Moving?

In 1999, the United States Supreme Court issued a landmark decision in Olmstead v. L.C. recognizing that "unjustified institutional isolation of persons with disabilities is a form of discrimination" under the Americans with Disabilities Act (ADA). As a qualified Medicaid eligible person you should know that Olmstead v. L.C., gives you the choice to return to the community from a nursing facility, hospital or Intermediate Care Facility (ICF). You now have a choice of where you want to live - you can stay in the nursing facility, hospital or ICF or you can return to your community. Georgia is implementing the Olmstead agreement in part by using the MFP Demonstration, a $36 Million Grant awarded to Georgia by the Centers for Medicare & Medicaid Services (CMS).

The Choice is Yours
The first step is to express interest in Money Follows the Person (MFP) to one of the contacts listed on page 2, or by notifying the social worker at your nursing facility or Intermediate Care Facility (ICF). The social worker will coordinate a visit from a MFP Transition Coordinator. The Transition Coordinator will review MFP with you and tell you how it works. If you are interested, you will sign the MFP Consent for Participation and you will complete the Authorization for Use of Disclosure of Health Information. The Transition Coordinator will complete a MFP Transition Screening Form. The Transition Coordinator will also help you complete the MFP Quality of Life Survey. During the screening, the Transition Coordinator will ask you questions in order to get a better picture of your goals, needs and resources. If you decide not to participate, there will be no penalty or loss of any current benefits.

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Some Simple Ground Rules
MFP offers transition services to qualified, Medicaid-eligible older adults, adults and children with all types of disabilities. Your MFP Transition Coordinator will assist you with understanding the information and helping you choose the services and supports you need to live in the community.
There are many factors that determine how long it will take to make your move to the community. Some of these factors include identifying your goals and resources, locating housing, identifying and obtaining the health services and equipment you need, identifying the daily support services you need and identifying transportation options. The most important factor will be how actively involved you are in the transition process.
The transition process is based on trust. You must be honest with your Transition Coordinator and each member of your transition team at all times during the transition process. Dishonesty can cause difficulties which can slow down or stop the process. Your transition team members (see Identify Who Will Assist You, page 14) are there to help you leave the nursing facility or ICF, not to judge you.
For more information on your rights and responsibilities, ask your MFP Transition Coordinator for a copy of the booklet called, Home and Community Services; A Guide to Medicaid Waiver Programs in Georgia. The booklet covers information about MFP services, information about Home and Community-Based Service waivers and near the end of the booklet, a section that provides information on your rights and responsibilities.
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What are Medicaid Home and Community-Based Programs?

Documents You Will Need
You will need your Medicaid card. Usually, Medicaid pays for your stay in the nursing facility or ICF, unless you have private insurance or someone is paying for your stay. If you do not have your Medicaid card yet, you should apply. Ask your Transition Coordinator or the social worker at your nursing facility or ICF to help you get your Medicaid card. Medicaid will pay for participating doctors, pharmacists, hospitals and other providers of your care in the community.
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In addition to the MFP services listed on pages 9 - 12, you may be eligible for a variety of Home and CommunityBased Services, also known as waiver services. Waiver services help people with basic needs. Each waiver program (see Apply for a Home and Community-Based Service Waivers, page 24, for details) offers several core services including; service coordination, personal support services, home health services, emergency response systems and respite care for care givers.
MFP participants typically enter a Medicaid waiver program immediately upon discharge from the nursing facility or institution. To help smooth out your move to the community, waiver services and MFP transition services are combined. For example, waiver services do not include funds for making security and utility deposits. MFP funds can be used for this purpose.
In addition, MFP can provide basic household furnishings (e.g. bed, table) and basic household goods and supplies (e.g. cookware, toiletries) to participants who need these items to set up their qualified residence. These items are not usually provided by waiver services, but MFP provides these items to assist participants to move into the community.
After you leave the facility, you will receive 365 days of MFP transition services. After your MFP transition services end, you will continue receiving home and communitybased waiver services, Medicaid State Plan services, state funded programs and local community services that you are qualified to receive.

What MFP Services Will Help You?

The next step is to consider what services and support you need to relocate to the community. Review the following list of 14 MFP transition services and check the box beside the services you may need.

Service Name

Service Description/Allowable Cost

o Peer Support

Peer Supporters may have transitioned out of nursing facilities themselves or they may have experience helping others to resettle. They can assist you to connect to agencies, individuals and associations in your local community. This service is limited to $1,200.

o Trial Visit-

This service provides a brief period of personal support

Personal Support services or residential services (such as a personal care

Services

home) during a trial visit to the community before you

transition. The purpose of this service is to give you

an opportunity to manage and direct Personal Support

Services staff and/or interact with staff in a personal care

home. This service is limited to $1,044.

o Household Furnishing

You may be in need of basic household furnishings such as a bed, table, chair, dresser, appliance, etc. You can use this service to obtain basic household furnishings to set-up your qualified residence. This service is limited to $1,500.

o Household Goods You may need basic household goods (e.g., cookware,

and Supplies

toiletries). This service is limited to $750. You can use

this service to help you obtain basic goods and supplies

that are needed to set-up your qualified residence. You

can also use this service for a one-time, $200 purchase

of groceries.

o Moving Expenses When you leave the nursing facility or ICF, you may need assistance to move your belongings. This service is limited to $750 and can be used to cover the cost of a moving service or the rental of a moving van or trailer.

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What MFP Services Will Help You?

Service Name o Utility Deposit

Service Description/Allowable Cost
You may have to make a utility deposit. This service is limited to $500 and can be used to make utility deposits for phone, electric, water and gas.

o Security Deposit

You may need to make a security deposit on a qualified residence. This service is limited to $1,000 and can be used for housing application fees and deposits for rentals.

o Transition Support

As you begin the process of planning and making your move to the community, you may find that you have unique service needs such as obtaining documentation or accessing paid roommate match services, etc. This service is limited to $600 and can be used for unique expenses needed to transition. These expenses must be authorized on a case-by-case basis. Check with your MFP Transition Coordinator for details.

o Transportation

You may need assistance to get around the community in search of housing and other services required for transition. This service is limited to $500 and can be used to pay for transportation when public and/or para-transit are not available. This service does not replace Medicaid nonemergency transportation (for medical appointments) or ambulance services.

o Skilled Out-ofHome Respite

Once you are discharged from the nursing facility or ICF, your caregivers and/or family members may need a brief period of support or relief from providing your care. This service will pay for up to 14 days of skilled respite during the MFP 365 day period. The respite must be provided at a Georgia qualified nursing facility or community respite provider approved through a Georgia waiver program. This service is limited to $1,878.

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Service Name
o Long-Term Care Ombudsman (LTCO)

Service Description/Allowable Cost
Once you are discharged, a Long-Term Care (LTC) Ombudsman is available to contact you monthly during your 365 days of MFP to review your health, welfare and safety and to assist you with making any adjustments. This service is limited to participants in the Community Care Services Program (CCSP), the Service Options Using Resources in the Community (SOURCE) and the Independent Care Waiver Program (ICWP) who transition into a home or apartment. This service excludes residential settings, where LTC Ombudsman already visit, including Personal Care Homes. This service is limited to $1,800.

o Equipment and Supplies

If you need Assistive Technology and services, supplies or equipment that are not covered by your Medicaid Health Insurance plan, you can use this service to obtain these devices and services. This service is limited to $5,000 and might include bath chairs, communication systems, specialized or customized wheelchair accessories, environmental control systems, and/or computer access devices that will help you live more independently, enhance your quality of life and reduce your dependence on others. You will need to be evaluated for some of these devices before you leave your current facility. You need time to learn to use them before you move to your new community. This may be difficult because these items can't be ordered until you have a discharge date. Second, in most cases Medicaid must deny coverage for the item before you can use this service to obtain it. Ask for assistance.

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What MFP Services Will Help You?

Service Name o Vehicle
Adaptations

Service Description/Allowable Cost
You may need to have your existing vehicle modified for your use and safety. This service is limited to $6,240 and can be used to make adaptations to a vehicle that you or your family owns. You can add such thing as a hydraulic lift, van ramp, special seats and other interior modifications for access into and out of the vehicle as well as to improve safety while moving.

o Environmental Modifications

You may need to modify your qualified residence so that you can use it more independently. Your Transition Coordinator will help you determine the environmental modifications you need. These might include such things as the installation of ramps, widening doorways, obtaining and installing grab-bars and/or modifying a bathroom to ensure your health, welfare and safety and to assist with your activities of daily living.

This service is limited to $8,000 and provides assistance for making physical adaptations to a qualified residence where you will be living, or a qualified residence owned by you or by your family. If you have a Housing Choice Voucher, these funds can be used to modify a qualified residence you rent using the voucher. On a case-by-case basis, these funds can be used to make modification to almost any qualified residence with the approval of the landlord or owner. Check with your MFP Transition Coordinator for details. Most of these modifications need to be completed before you move into your qualified residence.

Assignment: MFP Services
1. Review boxes that you checked. For each service you checked, use the space below and indicate how you will use that service.
2. Write down questions you have for the MFP Transition Coordinator.

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Identify Who Will Assist You
Your Transition Team
You don't have to move all by yourself! As you plan your move, you will meet with your MFP Transition Coordinator and begin to build or gather a transition team. By this point, you probably know your Transition Coordinator. In the space below, write down the name of your Transition Coordinator and her/his telephone number:

Circle of Friends/Circle of Support
Your circle of friends includes you, family members, friends, your MFP Transition Coordinator, your Waiver Case Manager, neighbors and others you chose for support. In the space provided, list friends/family members that you would like to include in your transition process:

If you have not yet met your Transition Coordinator, call the appropriate number listed in the front of this booklet and ask for a referral. Building your transition team can seem challenging at first. But all it really means is drawing together a group of people who can help you get the resources, support and services you will need.
The Transition Coordinator will help you develop a transition team made up of friends, family members and anyone who contributes to your physical, mental and emotional well-being. The team will include your circle of family and friends. The team will also include a Waiver Case Manger. The team will most likely include a peer support person, nursing facility or ICF staff members and community service providers. You will continue to build your transition team during the transition process by asking other people in your life to participate. Everyone depends on others at times. Through MFP, you will learn who these important people are and you will build more relationships with new people who share qualities that are important to you.
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Peer Supporters
Peer supporters offer advice and support and help you get connected to your community. Peer Supporters may be people with disabilities or older adults who have transitioned out of nursing facilities or other state institutions themselves, or they may have experience helping others to resettle. They can assist you to connect to agencies, individuals and associations in your local community. If you want the assistance of a Peer Supporter, ask your MFP Transition Coordinator
to help you locate one. They are typically found by contacting Georgia Centers for Independent Living (see Quick Reference Guide to Resources pages 76-78). Peer Supporters will be part of your transition team and support system, if you want them to be.
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Identify Who Will Assist You

Advocacy Partners
The state of Georgia has several agencies that will be part of your support. The Office of the State Long-Term Care Ombudsman, Adult Protective Services and the Georgia Advocacy Office are agencies that work to protect the health, safety, welfare and rights of MFP participants. They, along with your Transition Coordinator and Waiver Case Manager, can investigate and resolve any problems or complaints that may arise.
Long-Term Care Ombudsman 888-454-5826
Adult Protective Services 888-774-0152
Georgia Advocacy Office 800-537-2329

Providers
Providers of your MFP transition services and your waiver services are expected to be an active part of your transition planning process and must adhere to strict policies and procedures when providing services and supports, including emergency back-up staff.
Court-Appointed Guardian
If you have a court-appointed guardian, he or she will have a level of authority in making decisions for you. Your MFP Transition Coordinator will work with both you and your guardian to decide the best community living options.
Notes:

Complete Your Individualized Transition Plan (ITP)
The MFP Transition Coordinator and your transition team will work with you to develop an Individualized Transition Plan (ITP). The ITP is different from the assessment you completed when you first entered your present facility. The ITP looks at your personal goals, your support and service needs and how these needs can be met in the community. In preparation for completing the ITP, you should complete the self-assessment below and on page 18-19.
The purpose of the self-assessment is to focus on your goals, what you want to do and the supports you need to live in the community. It does not focus on what you cannot do. The self-assessment will help you identify barriers that need to be removed and what needs to be done to assist you to leave the nursing facility or ICF and live in the community. After completing the selfassessment, you will be ready to lead your team in the development of your ITP.
Assignment: Complete Your Self-Assessment
The self-assessment will help you identify what you think and how you feel about where you now live and where you would like to live. You do not have to show your answers to anyone, but you can if you want to. It will help you (and anyone you want to share with) to plan for your future.
A good way to start your self-assessment is to review or think about what help or assistance you get now. What works for you and what doesn't work? Answer each question on the next two pages using the space provided.

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Complete Your Individualized Transition Plan (ITP)
Self-Assessment:
A. What is my disability, or what are the things that lead to my being here or that have kept me here?
B. How does my disability (or age-related changes in health) affect my ability to live independently?
C. What is my ideal situation (city, suburb or rural; by myself, with family or with a roommate)?
D. Are there people in my life such as family, friends, etc., that I can ask to assist me in my move to the community? Make a list and include contact information.
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E. What are my strong points or good qualities that I can use to help me make the move to the community?
F. What barriers do I see to making my move to the community and what can be done to remove them?
G. What strengths and resources are available from my family and friends and my new community to help me succeed?
H. What goals do I want to meet in my new community (health and nutrition, personal care, social, recreational, school/work, etc.)?
I. What do I need more information about?
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Complete Your Individualized Transition Plan (ITP)

Budget Worksheet

Personal Finances and Trial Budget
Check the areas below that you need help or assistance with in the community. In the box to the right, describe the type of assistance that would be most helpful, or describe concerns you have about your needs. Complete the trial budget on the next page to estimate the costs to live in the community.

I need help with... o Paying bills

Describe Assistance Needed; Comment or Concern

o Establishing a monthly budget
o Opening a bank account, establishing direct deposit of income
o Stopping my Social Security check from going to the nursing facility/ICF and setting it up to go to my bank
o Resolving past or present credit issues or problems
o Training in budgeting money
o Legal counsel

Budget Categories

Monthly Amounts/Costs

Monthly Resources/Income

Housing (rent, utilities) costs
Food costs

Debts (credit card and other)
Medical, health care service expenses, prescription drugs (not covered by Medicaid) Personal items, movies, entertainment costs, etc.,
Transportation costs

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Complete Your Individualized Transition Plan (ITP)
Your Transition Coordinator will need to know the following:
Your monthly income and any financial issues that might hinder your transition
Any problems that may have an impact on your ability to access some programs, such as housing. These could include your present credit, such as unpaid utility bills, a past criminal record, drug or alcohol abuse problems, or evictions
Access to your personal identification papers, including your Social Security card and birth certificate. If you need to get replacements, your MFP Transition Coordinator can assist you
It is important to be totally honest with your Transition Coordinator. The sooner you reveal any problems the sooner solutions can be identified.
Once you have completed your self-assessment and gathered the personal and financial documents needed, you will be prepared to lead your transition team in developing your ITP.
Your Transition Coordinator will facilitate a meeting (or several short meetings) with you and your transition team to fully develop the ITP. The ITP will link your goals,
needs and resources with available services and supports. The ITP will list the MFP services you are requesting and the reason for each requested service. You should be aware that there are budget limits for each MFP service (see Allowable Cost listed in What MFP Services Will Help You?, pages 9-12).
The ITP will include a To-Do list--a list of plan assignments/tasks and who on the team is responsible for completing each task. The Transition Coordinator will write up the plan. Everyone on the team will have input and will receive a copy of the ITP, if they request it.

Notes:

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Apply for a Home and Community-Based Service Waiver
Georgia has several home and community-based waivers. Waiver services exist because the CMS allows states to waive certain Medicaid requirements and pay for home and community-based services as an alternative to institutions, such as nursing facilities or hospitals for people with developmental disabilities (Intermediate Care Facility). Essentially, the law provides you a choice.
Each waiver program offers several core services: Service coordination or case management (help with managing services and supports) Personal support (assistance with daily living activities, i.e. bathing, dressing, meals and housekeeping) Home health services (nursing, home health aide, occupational, physical and speech therapy) Emergency response systems Respite care (caregiver relief)
Although waiver programs offer different services, they have some things in common: Each waiver program is designed to help you return to the community from a nursing home or ICF Each program requires that you are eligible for Medicaid. To qualify for a waiver program, you can have higher income and resources than permitted in the regular Medicaid program Under federal regulations, the total cost of providing waiver services may not be more than the cost of providing care in a hospital, nursing facility or ICF
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Note: You may meet the criteria to receive waiver services, but you may not receive services immediately. Funding for waiver slots is limited and only a certain number of MFP participants can receive services based on available funds. Your Transition Coordinator will assist you in applying to the most appropriate waiver for your needs. To accommodate qualified MFP participants, each waiver has submitted appropriation requests for additional waiver slots for MFP participants each year.
You will be notified within 90 days or less about your eligibility for waiver services. If you are eligible for waiver services, you will be advised about when services begin. You will either select a Waiver Case Manager or a Case Manager will be assigned to you. If you are told that you do not qualify for a waiver, your MFP Transition Coordinator will assist you to apply for one of the other waiver options or will help you understand why you are being denied waiver services. You have a right to appeal all of these decisions.
Below is a short description of the Home and Community-Based Service Waiver Programs and the contact information for applying for each. For a complete list of waiver services available to MFP participants, refer to Benefits and Services by Waiver at the end of this Participant Guide, pages 98-99.
Community Care Services Program (CCSP)
This waiver program provides Home and Community-Based Services to people who are elderly and/or functionally impaired or have disabilities. In addition to core services, CCSP offers adult day health care, alternative living services (personal care home) and home delivered meals.
To apply for CCSP, contact the Area Agency on Aging (AAA) serving your area. For a list of AAAs, see page 79-82 in the Quick Reference Guide to Resources at the end of this booklet.
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Apply for a Home and Community-Based Service Waiver
Service Options Using Resources in Community Environments (SOURCE)
Service Options Using Resources in Community Environments (SOURCE) is a statewide Primary Care Enhanced Case Management Service that links primary medical care with many long-term health services in a person's home or community setting to prevent unnecessary emergency room visits and hospital stays and avoid institutionalization. In addition to core services, SOURCE offers home delivered meals, adult day health care, personal care home and 24-hour medical access.
To apply for SOURCE, contact the SOURCE provider serving your county. For a list of SOURCE providers, see pages 86-92, in the Quick Reference Guide to Resources at the end of this Participant Guide.
The Independent Care Waiver Program (ICWP)
The Independent Care Waiver Program (ICWP) provides waiver services to MFP participants between the ages of 21 and 64 with physical disabilities or acquired brain injuries that will help them live in their own homes and communities as an alternative to a nursing facility.
In addition to core services, ICWP covers specialized medical equipment and supplies, counseling and environmental modifications.
To apply for ICWP, contact the Georgia Medical Care Foundation (GMCF) at 800-9820411 or 678-527-0319. You can also contact GMCF at www.gmcf.org. GMCF will ask you questions over the phone, have you submit an application and schedule an in-person assessment.
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The New Options Waiver (NOW) and the Comprehensive Waiver (COMP) Programs
The New Options Waiver (NOW) and the Comprehensive Waiver (COMP) programs provide home and community-based services to MFP participants with developmental disabilities. Services are provided to MFP participants who reside in an ICF or are at risk of institutional placement.
In addition to core services, NOW/COMP services include: Adult Therapy Services (occupational, physical, speech and language therapy); Behavioral Supports Consultation Services; Community Access Services; Community Guide; Community Living Support; Community Residential Alternative Services (only under COMP); Environmental Accessibility Adaptation; Financial Support Services; Individual Directed Goods and Services (only under NOW); Natural Support Training (only under NOW); Prevocational Services; Respite Services (only under NOW); Specialized Medical Supplies; Support Coordination; Supported Employment; Transportation Services and Vehicle Adaptation.
To apply for a NOW or COMP waiver, contact the Department of Behavioral Health and Developmental Disabilities (DBHDD) Regional Office nearest you:
Region 1 DBHDD Office (Rome): 706-802-5272
Region 2 DBHDD Office (Augusta): 706-792-7733
Region 3 DBHDD Office (Tucker): 770-414-3052
Region 4 DBHDD Office (Thomasville): 229-225-5099
Region 5 DBHDD Office (Savannah): 912-303-1670
Region 6 DBHDD Office (Columbus): 706-565-7805
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Apply for a Home and Community-Based Service Waiver
What Will My Waiver Case Manager Do?
Your Waiver Case Manager will help assess your need for different waiver services. Your Case Manager will know the availability of the services in your community. You will get help to set up services you need.
Assignment: Apply for a Waiver
Write down any questions you have about applying for waiver services. Discuss these questions with your MFP Transition Coordinator.

Notes:

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Locate Appropriate Housing

A residence in the community of your choosing is the foundation of living independently. Due to a lack of affordable, accessible and integrated housing in Georgia, it is important to begin to explore housing needs and living situations very early in the transition process.

To participate in MFP, you must transition into a qualified residence. There are several categories of qualified residences:
A. A home owned or leased by you or by a family member. This living situation meets the requirement for a "qualified residence," if you or your family member owns or leases the home where you will live. In this situation, you retain independence and equal legal rights under the lease or as the owner.
B. An apartment with an individual lease, with lockable entrance/exit doors, that includes living, sleeping, bathing and cooking areas over which you or your family have domain and control.
To meet the requirement for qualified residence, you (or your family representative) must sign a lease for an apartment. Apartments can be fair-market (nonsubsidized), affordable and subsidized, senior living complexes and/or senior high-rise apartment buildings (just to name a few types). You must have control over the living, sleeping, bathing and cooking areas in the rental unit. If the apartment does not have these areas or you do not have control over their use, the apartment would not be considered a qualified residence under MFP. Your unit must have a lockable entrance and exit doors, not just locking doors into the building. The lease cannot require you to receive services from a specific company or require you to

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notify the landlord if you are absent for a period of time. To be a qualified residence, the landlord can not assign apartments or change apartment assignments.
Assisted Living Facilities or Settings are unlicensed providers of housing for older adults or people with disabilities that can live independently, but need some assistance with activities of daily living like bathing, grooming, eating, etc. You must sign a lease with the provider. Assisted living services may include meals, housekeeping, laundry service, transportation, emergency call service, planned activities, medication assistance and the services of licensed nursing staff.
Your rental unit must have lockable entrance and exit doors. You must participate in the care planning process and resolve care plan differences that may arise between you and the assisted living service provider. The lease cannot require you to receive Medicaid services from a specific company that is not included in the rental rate. The assisted living service provider cannot require notifications if you are absent from the facility for a period of time. The assisted living service provider can not assign apartments or change apartment assignments and must allow you to age in place. In other words, the assisted living service provider can not terminate your lease/contract due to declining health or increased service needs.
C. A residence in a community-based residential setting, in which no more than 4 unrelated individuals reside. There are a number of different living situations covered in this category that meet the criteria for a qualified residence.
Personal Care Homes (PCH) and Community Living Arrangements (CLA) are group living situations that provide staff supervised meals, housekeeping, laundry services, transportation and semi-private sleeping rooms. They do not
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Locate Appropriate Housing
provide medical or nursing care as a service. These facilities are licensed and must meet design and operating standards, including minimum staff requirements. To meet the requirement of a qualified residence, PCHs and CLAs must be smaller group homes that house no more than four unrelated residents. This means that in a PCH or CLA, you will typically live with three other people (not counting staff) that you are not related to. You sign an Admission Agreement with the PCH provider/operator.
Host Homes also known as Life Sharing Arrangements are similar to Personal Care Homes. The most important difference is that in a host home, you will live with a family with one other unrelated person.
Check with your Transition Coordinator for more information on available group living arrangements in the area where you expect to resettle or call the AAA/ Gateway office in that area (see pages 79-82 for the AAA serving your area). If you need housing, you will need to use every available resource to locate a qualified residence.
What does this mean to you? What types of residences and living situations should you look for as a MFP participant?
Assignment: Complete the Housing Needs Assessment
A realistic budget is essential. If you completed the budget worksheet (see Complete Your Transition Plan, pages 17-22), then you have some idea how much you can afford to spend on living expenses. Generally, one-third of your income will be used to pay rent and utilities. If you did not complete the budget worksheet, stop now and go back and do so.
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The following housing needs assessment will help you identify important information about where you would like to live. Complete the housing needs assessment to begin planning for your qualified residence. Check the box to indicate that you need assistance and use the space provided to describe the assistance that you may need.
I need assistance to: Describe Assistance Needed:
o Enter and leave residence, using a ramp or zero-step entrance
o Climb/descend interior stairs, using railings and grab bars, etc
o Move around inside the residence, wheelchair access, wider doorways, hallways, etc
o Use the bathroom facilities, elevated toilet, tub/shower transfer bench/chair or roll-in shower, knee space under sinks, access to storage
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Locate Appropriate Housing

I need assistance to:
o Use the bed/bedroom, transfers to/from the bed with lift, lowered shelves and clothing racks, dressing and grooming aids, etc.

Describe Assistance Needed:

o Use the kitchen, knee space under sinks, lower cabinets, access to appliances, adapted utensils, etc.

o Use the laundry facilities, access to the washer/dryer

o Clean and maintain my home, sweeping, dusting, moping, etc

o Control my home environment (open/close doors, windows, turn on/off lights, AC/Heat, fans, make phone calls, control TV, etc., using environmental control systems, large button phone, reachers, etc.
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I need assistance to:

Describe Assistance Needed:

o Obtain or locate basic household furniture for my home (bed/ hospital bed, table, chairs, lamp)

o Obtain household goods and services (see worksheet at end of this booklet)

o Pet care or service animal trained to assist me (pick up or retrieve objects, open doors, and or other tasks)

o Locate affordable housing

o Obtain rental assistance using a Section 8 voucher
o Locate a roommate or shared housing/group home
o Make security and/or utilities deposits

o Make environmental modifications to my living space

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Locate Appropriate Housing

I need assistance to:

Describe Assistance Needed:

o Pay old utility bills and/ or restore my credit, credit counseling; clear up old evictions, etc.

o Get around the neighborhood during the day and after dark, use sidewalks, lights and crosswalks

o Access neighborhood transportation options

o Find other type of housing because of a Section 8 violation, eviction, felony, or illegal drug conviction
Money Follows the Person can help you with some of these items. Review the Assignment: What MFP Services Will Help You? that you completed on pages 9-12. Based on your housing needs, are there other MFP services that you need in addition to the ones that you checked in the Assignment? List them below:

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Conduct a Housing Search
First, tell family, friends, neighbors, fellow church/synagogue or other organization members that you are looking for housing. Obtain the newspaper for the community to which you expect to resettle. Review the classified ads for housing/rental options. Most newspapers are available at a branch library near you.
Second, ask your MFP Transition Coordinator to assist you with the Georgia Housing Search tools at georgiahousingsearch.org. Georgia Housing Search is free and provides a toll-free number (877-428-8844) if you are blind and/or do not have internet access. The website and toll-free number are bilingual. You will find available housing information on affordable units, amenities and some information on accessibility. The service also provides links to housing resources and helpful tools such as an affordability calculator, rental checklist and information about renter rights and responsibilities.
In addition to Georgia Housing Search, you can locate and use housing resource lists form non-profit agencies including the United Way. Call 2-1-1 or follow the link to www.unitedwayatlanta.org/211FindHelp/ Pages/OrderHelpfulGuides.aspx, scroll down to "Affordable housing directory" and click on Download the directory.

You must be actively involved in your housing search. You will need to use every resource available to find housing. You will need certain documents to complete your housing search. The list of documents needed to complete your housing search can be found on page 96, in the
Quick Reference Guide to Resources.
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Locate Appropriate Housing
Third, contact a local housing specialist at your nearest Center for Independent Living (CIL), Aging and Disability Resource Connection and/or the AAA Gateway Network. The Atlanta Regional Commission (ARC) maintains a database of resources for older adults, including housing resources. The database can be accessed by calling ARC at 404-463-3333 or by following the link to www.agewiseconnection.com.
Fourth, conduct an internet search for housing. If you don't have a computer with internet access and need one, you will find one at your local county library. Friends and family members may also be able to assist with internet searches for affordable housing.
Affordable (Non-Subsidized) Housing Resources
Affordable (non-subsidized) rental properties charge rents that are below market rates for that area. Since affordable housing varies according to income, not all of these properties will be affordable to you. If you have not done the budget worksheet (see Complete Your Individualized Transition Plan: Trial Budget on page 21), you should stop your housing search and complete the trial budget so that you have some idea of rental rates you can afford.

Your online housing search should include: www.lowincomeapartmentfinder.com www.affordablehousingonline.com/apartments.asp?mnuState=GA www.forrent.com www.senioroutlook.com for apartments for older adult participants Apartment finder magazines and local newspaper classified ads online, such www.apartmentfinder.com or www.appartmentguide.com/ apartments/Georgia
Affordable (Subsidized) Housing Resources
You may be eligible for rental assistance which can substantially lower the amount of money you spend on housing. Your ability to qualify will depend on your income or the income of the household, if you live with one or more people.
Subsidized rental properties are properties (usually apartment complexes) that are not owned or managed by a local Housing Authority (see next section). As you search apartment listings and classified ads, you will notice "BOI" meaning, Based On Income. BOI means that the rental cost of the unit is based on the tenant's monthly income. These properties have rental rates based on 30% of the household's income. No pre-approval is needed to apply. Apply directly to the property manager at the complex.

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Locate Appropriate Housing
To search for affordable (subsidized) housing, try: Call The United Way at 2-1-1 or follow the link to www.unitedwayatlanta. org/211FindHelp/Pages/OrderHelpfulGuides.aspx, scroll down to "Affordable housing directory" and click on Download the directory Low-Rent Apartment Search at www.hud.gov/apps/section8/index.cfm, at the page, select "Georgia" from the drop-down menu, then click "Next" Search for rental properties in Georgia at www.georgiahousingsearch.org
Housemate and Roommate Match Services
Depending on your financial resources and your needs, you might consider renting a room from a home-owner (check with your Transition Coordinator about specific requirements). You might also consider renting with a roommate. Roommate services work when people share their home or apartment with you. This service is a safe way to find others seeking a housing solution.
If you need an affordable place to live, Housemate Match can match you with a homeowner who has extra room in their home in Fulton, DeKalb, Cobb or Gwinnett counties. For more information, contact:
Marcus Jewish Community Center of Atlanta Housemate Match 5342 Tilly Mill Rd. Dunwoody, GA 30338 Phone: 678-812-4408
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If you want to locate a potential roommate, try the following services, but beware of the cost of using them:
Roommates.com at www.roommates.com Roomiematch.com at www.roomiematch.com

Public Housing and Housing Choice Vouchers
Local Public Housing Authorities offer affordable housing for low-income individuals and families. Application processes and availability of units vary from one local housing authority to another. The best strategy is to identify the housing authority closest to where you want to resettle and then contact that housing authority for an application. Local housing authorities are now on the internet. Begin your search by following the link to www.hud.gov/offices/ pih/pha/contacts.

Waiting Lists. Most housing authorities will have waiting lists. Waiting lists may seem discouraging. Often you may be told that there is a 6 month to 2 year waiting list. If you are interested in living in the property, you should apply anyway! Waiting periods are only estimates. It could be longer or shorter. You might need to take something less desirable at first, but if you are on the waiting list, you will move up and be in line for something better.

Applications for Public Housing. If you apply for public housing, you must:

1.Follow up with the apartment/housing authority to make sure they received your application and that they have all the necessary information they need to process your application. You will need to make periodic phone calls to see that your application is still active and to find out where you are on the waiting list.

2. Find out how long the apartment/housing authority will hold your application.

You may need to renew the application on a regular basis.

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Locate Appropriate Housing
3. If your circumstances change, be sure to update your application by phone and follow up with a letter.
4. You must reply to all requests for additional information or to verify that you are still interested. You may find it helpful to request that a friend, family member, your MFP Transition Coordinator or an advocate receive a copy of any written correspondence. Your Transition Coordinator will assist you in following these steps.
Section 8 Housing Choice Vouchers. MFP participants can take advantage of the Section 8 Housing Choice Voucher programs that MFP has with the Georgia Department of Community Affairs (DCA) and the Housing Authorities in the following cities: Augusta (Richmond County), Macon (Bibb County), Columbus (Muscogee County), Savannah (Chatham County) and Decatur (DeKalb County). The Housing Choice Voucher programs are tenant-based rental assistance programs that provide subsidies for the rental of apartments or houses in the private rental market. Your Transition Coordinator can assist you with the application process for a Housing Choice Voucher.
Notes:
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Identify Health Services, Supplies and Equipment You Need
Health care in the community is different in important ways from the health care you have been receiving in the nursing facility or ICF.
First, you must understand your own aging process or your disability and medical conditions. Your MFP Transition Coordinator will assist you to plan for and obtain adequate medical support services and medical supplies before you leave the facility. This usually includes locating a Primary Care Physician in the community, specialists (as needed) and a pharmacy. On your discharge day, the nursing facility will provide you with your remaining medications and supplies. Take the remaining supply of your meds and any other supplies offered to you by the nursing facility when you leave. A few days before your discharge date or on that date, locate a pharmacy near your community residence, get your prescriptions filed and obtain any supplies you need.
In addition to your meds and supplies, you will need several weeks of food supplies to last until your Social Security check (or other resource) arrives. Ask your Transition Coordinator for assistance in obtaining these items.
It is important that your personal care attendants are trained to provide the services and supports that you may need. Discuss this with you Transition Coordinator and Waiver Case Manager.
Finally, durable medical equipment and assistive/adaptive technology devices such as shower transfer benches, Hoyer lifts, wheelchairs, bedside commodes, etc., will need to be ordered by the facility shortly before you are discharged or when you have a discharge date. Your Transition Coordinator will assist you with this process.
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Identify Health Services, Supplies and Equipment You Need

Assignment: Complete Health Care and Nutrition Worksheet
Use the following Worksheet to plan for the services, supplies and equipment you need. Check the box to indicate that you need assistance and use the space provided to describe plans or assistance needed to complete the task.

I need assistance to:

Describe Plans/Assistance Needed:

o Locate a Primary Care Physician in the community and schedule an office visit
o Locate a specialist doctor/clinic (urologist, cardiologist, pain management, mental health, etc.) in the community and schedule an office visit
o Locate a dentist, vision care specialist, foot doctor, etc. in the community and schedule an office visit
o Locate a therapist in the community (respiratory, physical, occupational, speech/ language, hearing/ audiologist) and schedule an evaluation

I need assistance to:

Describe Plans/Assistance Needed:

o Locate a pharmacy and/or get a list of my current medications/ dosages

o Take my medications, use/need personal medication system, obtain 30 day supply of current meds upon leaving facility

o Obtain supplies (urological, bowel program, bags, tubing, formula, pump, syringes, etc.) in the community

o Learn my current skin care and/or wound care routines and/ or schedule a clinic appointment

o Locate a dialysis or other specialty clinic

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45

Identify Health Services, Supplies and Equipment You Need

I need assistance to:

Describe Plans/Assistance Needed:

o Make transfers/lifting/ positioning in bed, pressure relief in wheelchair, etc.
o Identify equipment I have and equipment I need (wheelchair, walker, hospital bed, Hoyer lift, reacher or other devices for assisting, etc.), and/or schedule appointments for evaluations and/ or get the approvals needed to get the equipment
o Train myself and my personal care attendants/caregivers on my daily care routines and equipment I use/need

o Laundry and house keeping chores or other chores

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Identify Health Services, Supplies and Equipment You Need

I need assistance to:

Describe Plans/Assistance Needed:

Food and Nutrition
o Manage my diet; dietary restrictions, etc.

o Plan my meals and/or prepare my food, eat using adapted utensils, etc.
o Obtain food supplies -- grocery shopping, obtaining deliveries from sources such as Angel Food, etc.
o Obtain food donations -- application for food stamps from my local Division of Family and Children Services (DFCS) office, vouchers for and location of food banks, etc.
o Other

Check pages 100-103 of the Quick Reference Guide to Resources, for a list of Health, Food and Emergency Resources.
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Identify Daily Supports You Need
Living independently does not mean that you must be able to do everything by yourself. Most people rely on an informal network such as a circle of friends/family and a formal network of services for assistance.
It is important to identify both informal and formal support networks. You may not have control over your informal network of support, but you need to have control over the formal services you receive and how these services are delivered.
As an MFP participant, it is critical that you be able to work with a variety of different people - your formal network of service providers. These people will be providing you with the services you need.
For example, if you need assistance with your personal care (bathing, dressing, using the bathroom, etc.), a Personal Care Attendant or Personal Support Services staff person will assist you. You should consider how much help you need on a daily basis. You may want to consider "self-directing" these services - hiring, supervising/ training and firing (at times) people that provide these services (see Do You Want to Self Direct? on page 54 for more details).
In addition to your Personal Care Attendant or Personal Support Services staff, your MFP Transition Coordinator, Peer Supporter and your Waiver Case Manager are available to assist you to develop the skills for managing the complexities of daily life and following through on things you need to do.
In addition to this formal network of services, you need to develop and rely on your informal network of friends and/or family members. It is your life and even when you need help managing it, you must be the person in control.
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Assignment: Complete the Personal Support Services Log
When you need help with bathing, eating, going to the bathroom, managing your home or cooking, a Personal Care Attendant or Personal Support Services person may help you. To understand how much Personal Support Services you may need, complete the following two-day log. In the left column, indicate the service the nursing facility/ICF staff performed for you and in the right column, note the time it took to complete the care routine. Share the results with your MFP Transition Coordinator and with your Waiver Case Manager.

Day 1

Morning Assistance w/Routine:

How much staff time (in minutes) to complete the task?

Afternoon Assistance w/Routine:

Staff time to complete

Evening Assistance w/Routine: Night Assistance w/Routine:

Staff time to complete Staff time to complete

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Identify Daily Supports You Need

Day 2 Morning Assistance w/Routine: Afternoon Assistance w/Routine:
Evening Assistance w/Routine:
Night Assistance w/Routine:

How much staff time (in minutes) to complete the task? Staff time to complete
Staff time to complete
Staff time to complete

You, your Transition Coordinator, your Waiver Case Manager and transition team will use this information in the planning process to develop your Individualized Transition Plan (ITP) and to establish your waiver plan for services and supports. While the ITP provides you with a set of transition services to assist with your move to the community, your waiver plan for services (also called a care plan) assesses your need for other services. For more information on the services provided under each waiver, review the section, Apply for a Home and Community-Based Services Waiver, pages 24-29.

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Each waiver program offers several core services: Services coordination/case management (help with managing services and supports) Personal support (assistance with daily living activities, i.e. bathing, dressing, meals and housekeeping) Home health services (nursing, home health aide, occupational, physical and speech therapy) Emergency response systems Respite care (caregiver relief)
The waiver services plan includes a list of service providers and a projected budget for the services you need. The waiver services plan includes information about risks to your health and safety such as equipment failures, interruptions in daily routine care, and/or transportation failures. Each risk must include plans for emergency backup.

24/7 Emergency Backup Service Plans
Your Transition Coordinator, transition team and Waiver Case Manager will work with you to develop your 24/7 emergency backup services plan. To begin this process, complete the following list. Use the space in the left column to write down your emergency backup plan for each risk in the right column.

When this happens...

I will do this...

o My equipment fails (wheelchair breaks down, have a flat, my Hoyer lift stops working, etc., list DME vendor, etc. )

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Identify Daily Supports You Need

When this happens...

I will do this...

o My Personal Care Attendant/ Personal Support Services staff do not show up for work. List who you call first for help, 2nd (friends/family), etc., list 1st and 2nd contacts for my home health agency and/or for the agency providing my Personal Care Attendant/Personal Support Service staff, etc.
o My transportation fails (my van lift breaks down, paratransit does not come, my ride does not show)
o The power goes out in my home or apartment

o There is a natural disaster (fire, flood, tornado, emergency evacuation plans, etc.)
o I get sick (list contact for Primary Care doctor, 24 hour pharmacy phone, case manager, etc.)
o My Social Security check doesn't come (SSA contact info), or I need temporary assistance (TANF, food stamps, food banks, etc.) contact Division of Family and Children Services, food banks, etc.
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Independent Living Skills Training
Independent Living Skills Training can help you make the most of your abilities and increase your self-reliance and self-confidence. Through these classes you will receive training and information plus you will learn about resources to help you take control of your life in order to live independently.
The goals of Independent Living Skills Training are: To educate you on relevant issues To teach you self-advocacy, assertiveness and empowerment To increase your self-awareness and independence
Classes may include: Business Basics - money management, internet 101 and e-mail, basic computer skills, transportation skills, telephone skills, etc. Communication/Social Skills Basics - personal traits and building/ understanding relationships, anger management and conflict resolution, leisure skills, stress management, nutrition/physical fitness, basic hygiene and decision making skills
To attend Independent Living Skills Training classes near you, contact your nearest Center for Independent Living (CIL), see pages 76-78, or ask your Transition Coordinator for more information. Classes are usually free, but you will need to arrange transportation to the CIL to participate
Notes:
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Do You Want To Self-Direct?

"Choice" is the hallmark of self-direction and this includes the choice not to self-direct and to selfdirect to the extent of your ability and interest. Waiver programs permit you to elect the traditional service mode - agency delivered - if self-direction does not work for you, or to direct some of your services but receive others from agency providers.

What does it mean to self-direct your services? The basic concept behind self-directed services is the idea of giving you a budget for services and then asking you (and your transition team) to decide how the budget is spent for available services. Being given a budget to manage puts you in the driver's seat. You, as the budget-holder, are the person taking the lead in improving your own situation. As your authority increases over your formal network of services, so does your responsibility. In addition, your informal network of friends/family can be more involved both in giving advice and in delivery of services. Rather than beginning with a professional assessment of your needs, the starting point is your own self-assessment. If you have not completed your Self-Assessment on pages 17 - 19, stop here and complete it. Self-direction has two basic features, each with a number of variations. The more limited form of selfdirection referred to as employer authority - enables you to hire, dismiss, and supervise individual workers (e.g., personal care attendants, personal support service staff and homemakers). The comprehensive model - referred to as budget authority - provides you with a flexible budget to purchase a range of goods and services to meet your needs.

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Under Community Care Services Program (CCSP) and The Independent Care Waiver Program (ICWP) waivers, you must be enrolled in the waiver for a minimum of six (6) months prior to choosing self-direction as an option. If you want to self-direct after the 6 month enrollment period, your Transition Coordinator, transition team and Waiver Case Manger will:
Train you to develop and manage a budget based on level of care and other assessment tools and criteria Help you select a Financial Management Service or Fiscal Intermediary who disburses the funds for payment of your Personal Support Services staff Train you to recruit, interview, hire, train, supervise and discharge Personal Support Services staff Assist you to develop and implement a service plan that includes an assessment of risks to you and a back-up plan in case an issue arises with your Personal Support Services employee If you experience a reduction in Personal Support Services services or the termination of self-directed services within the first 6 months, your Transition Coordinator will explain and assist you with the appeals process. Your Transition Coordinator may also assist you to prepare for a Fair Hearing or can assist you with a referral for additional legal assistance
Your transition team's involvement and assistance decrease as your skills increase.
If you're enrolled in the CCSP waiver or will be soon, refer to Benefits and Services for MFP Participants by Waiver (see pages 9899). Ask your Transition Coordinator and Waiver Case Manager about the following CCSP waiver services: Consumer Directed Personal Support Services Financial Management Services
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Do You Want To Self-Direct?
If you are enrolled in the ICWP waiver or will be soon, refer to Benefits and Services for MFP Participants by Waiver (see pages 98-99). Ask your Transition Coordinator and Waiver Case Manager about the following ICSP waiver services:
Consumer Directed Personal Support Services Fiscal Intermediary Under NOW/COMP waivers, you are afforded the opportunity to self-direct many of your waiver services under two options: 1. Consumer/Self-Directed 2. Co-employer/Self Direct. All services are not Self-Directed. If you choose to self-direct services under NOW/COMP, you can not receive the same service through traditional services delivery. If you're enrolled in the NOW or COMP waivers or will be soon, refer to Benefits and Services for MFP Participants by Waiver (see pages 98-99). Ask your Transition Coordinator and Waiver Case Manager about the following NOW/COMP waiver services: Individual Directed Goods and Services Financial Support Services The goal of MFP is to expand your understanding of and use of self-directed services.
Assignment: Self-Direction
Write down any questions you have about self-direction. Discuss these questions with your MFP Transition Coordinator, peer supporter and Waiver Case Manager.
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Identify Transportation Options

Generally there are three transportation options: 1. Obtain your own vehicle and drive yourself or hire someone to
drive you 2. Hire someone to drive you in their vehicle or rely on family
and friends 3. Use the available public transportation system (both fixed route and paratransit)
or medical transportation system
Each option has its own benefits and problems. If transportation options are limited in the area you have selected for resettlement, you might want to consider how this will affect your quality of life. You should become familiar with all transportation options available to you.
Assignment: Complete Transportation Planning Worksheet
Use the Transportation Planning Worksheet to plan for the transportation services and equipment you need. Check the box to indicate that you need assistance and use the space provided to describe plans or assistance you need to complete each task.

I need assistance to:
o Arrange personal transportation from the nursing facility/ICF to complete tasks in the community (look for housing, make utility deposits, obtain home furnishings, etc.)

Describe Plans/Assistance Needed:

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Identify Transportation Options

I need assistance to:

Describe Plans/Assistance Needed:

o Arrange moving service to move my belongings to my qualified residence (moving services, U-Haul trailer and help from family/friends, etc.)

o Arrange for and use paratransit and specialized transportation (obtain needed documents, complete applications, travel training, etc.)

o Arrange for and use public transportation (apply for reduced fare cards, travel training, etc.)

o Arrange to have my vehicle modified so that I or my family/friends can drive me (van lift or ramp, driving controls, etc.)
o Arrange other types of transportation (dial-a-ride, voucher travel assistance program, etc.)

o Other

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Your MFP Transition Coordinator will help you explore transportation resources and options for the community in which you choose to live. The following is a list of transportation resources to get you started.
MFP Transportation Services. MFP transportation services are designed to assist with gaining access to community services and resources required during the pre-transition period and are provided when transportation is not otherwise available. This service does not replace Medicaid Non-Emergency Transportation or ambulance services. Transportation funds can be used for making trial visits to the community, viewing apartments and personal care homes to find a suitable, qualified residence, obtaining needed documents such as personal identification and for going home on the day of discharge. The service limit is $500 per participant.
Public Transportation. Public transportation services vary by county. For example, Fulton and DeKalb counties have accessible public transportation (MARTA) with daily schedules that run early morning to late night, while Gwinnett County has limited accessible transportation with limited service routes and no services on Sunday. Clayton County has no accessible public transportation. Most non-metro countries have no accessible public transportation. To complicate matters, there are very few links between county transportation systems, so getting from Town A to Town B using accessible public transportation will be a problem. For more information on Public Transportation in Georgia, log onto www.grta.org/commuter_options/home.htm.
Paratransit services may or may not be available in your current or chosen country of residence. There are 14 urban transit systems in the State. Check the transit system nearest you for more information about paratransit services. www.dot.ga.gov/travelingingeorgia/transit/Pages/default.aspx.
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Identify Transportation Options
Non-emergency transportation providers. You can use Non-Emergency Transportation (NET) for doctor appointments, therapy and clinic appointments, trips to your medical equipment vendor for wheelchair repair, etc., and trips to the pharmacy to get your medications. NET providers by region include North-Southeastrans (866-388-9844), Atlanta-Southeastrans (404-209-4000), Central-Southeastrans (866-991-6701), East-LogistiCare (888-224-7988) and Southwest-Southwest GA Regional Development Center (866-443-0761).
Specially designed transportation aids are available to meet transportation needs. These include van lifts and ramps for wheelchairs and scooters, and/or driving controls that can be installed in SUVs, vans, pickups and cars. If you or your family owns a vehicle, MFP funds can be used to adapt the vehicle for your use. MFP vehicle adaptation funds are not available for the purchase of a vehicle. You must obtain three quotes for the needed adaptations. Vehicle adaptations include the installation of driving controls (when applicable), a lift or ramp for wheelchair or scooter access, wheelchair tie-downs and occupant restraint system (WTORS), special seats or other modifications that are needed to provide for the safe access into and out of and operation of the vehicle. This service does not cover repairs to the vehicle or to the adaptations once they are installed and operational. There is a maximum of $6,240 available during the 365 day MFP period.
Dial-a-ride. This program varies by county. Check for it in the county where you expect to live.

Voucher Travel Assistance Program. Some Centers for Independent Living (CIL) have a Voucher Travel Assistance Program. Check with your nearest CIL (see pages 76-78 for a list of CILs). The voucher travel assistance program provides eligible participants vouchers worth $150 per quarter (every three months) to pay $.30 per mile transportation costs. The program is designed for people with all types of disabilities who are transitioning to the community from nursing homes, institutions, those seeking employment or those who are facing challenging transportation options in their communities. Eligibility requirements are:
Have a disability;
Be low-income, provide proof of household income; and
Live in the following counties: Fulton, DeKalb, Gwinnett, Clayton, Paulding, Bartow, Cherokee and Douglas.

For more information on the Voucher Travel Assistance Program, contact:
Margo Waters, IL Transportation Coordinator disABILITY Link
Decatur, GA
Phone: 404-678-8890 x 10
Email: mwaters@disabilitylink.org
www.disabilitylink.org

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Identify Transportation Options
Rural 5311 transportation providers. Rural communities with 50,000 residents may have access to DOT 5311 transit providers. Some 5311 transit providers have vans with lifts. Contact the Georgia Department of Transportation G-DOT at 404-6311237 or the local County Commissioner's offices for information. Transportation from family, friends, volunteers, church members, etc., are important options and worth considering. Using your MFP Transportation services budget, you could reimburse these individuals for transportation assistance. Georgia Department of Vocational Rehabilitation may be able to assist you with transportation as you begin your job search, once you have settled into your community. Follow the link to www.vocrehabga.org. For community based agencies with low-cost transportation options, try Friends of Disabled Adults and Children (FODAC) for used equipment such as liftor ramp-equipped vans, driving controls and other used transportation-related equipment, mobility devices and durable medical equipment. Follow the link to www.fodac.org.
Check page 110 of the Quick Reference Guide to Resources, for a list of Additional Transportation Resources.
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Complete Community Activities

Like transportation options, the types of recreation and social activities available to you will vary based on the community you chose.
Before you decide where to live, you should explore available community activities such as recreational, cultural, sporting events, school programs and events at your local house of worship. Some communities may not offer social, recreational or employment opportunities you would consider important.
Most communities have a brochure or pamphlet that contains information about services and activities available to people in that community. You can usually pick up the brochure at the town hall. Check for information about services for older adults and/or persons with disabilities.
Assignment: Complete Social & Recreational Planning Worksheet
Use the Social and Recreational Planning Worksheet to plan your social and recreational activities. The Worksheet begins on the next page.

Participating in community activities will help you overcome loneliness, isolation and boredom. You must plan to make contact with and communicate with people in your community that are not paid to provide your care or services. If you do not make an effort to reach out to others, your life in the community will seem empty and you may experience depression. Engaging in social and recreational activities and communicating with others is just as important as getting your basic personal needs met.

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Complete Community Activities

These tasks should be completed in the community where you expect to resettle, before you leave the nursing facility or ICF. Tasks are listed in column 1 (far left). Use column 2 to describe what you will do, the date of the activity and where you will go. Use column 3 to indicate the assistance you need to complete the activity.

Community task
Arrange to look at housing options with your Transition Coordinator

What? When? Where?

Meet your peer supporter for a social outing - attend a movie or other arts or cultural event

Visit with friends and/ or family members in their home (can use Trial Visit Personal Support Services funds)
Arrange a visit to the local Center for Independent Living (CIL), Senior Center or similar
Attend a service or other activity at a house of worship (church, temple, synagogue) or other ethnic or cultural activity

Who will assist?
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______ o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______

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Community task

What? When? Where?

Attend a birthday party, or attend a holiday gathering of some type

Volunteer or assist at a community event or for a community agency

Plan your `house warming' party for just after you move, invite your transition team
Other (describe)

Who will assist?
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______

In addition, you should create or obtain your own appointment book and begin using it to write down your daily schedule and appointments. Your appointment book should contain an address book. You must include the phone numbers of your transition team (MFP Transition Coordinator, peer supporters or case manager, friends, family members, etc.). Your Transition Coordinator will be checking with you to be sure your appointment book and contacts are complete.

65

Complete Community Activities
Training, School and Employment
Under current Social Security rules, you are able to earn some income from working, without losing your Social Security benefits (SSI, SSDI or retirement) or your Medicaid coverage. After leaving the nursing facility or ICF and getting settled in the community, you may decide to work occasionally or part-time to supplement your benefit check. Taking training classes may also be an option that you want to consider.
Volunteering, part-time/occasional employment or taking classes at your local community college or recreation center will help you:
Overcome the isolation you may experience after leaving the nursing facility or ICF. These activities offer a number of benefits, including connecting with people in your community, building new skills and increasing your independence Develop your skills and abilities. With the growth of technology, working is possible, even with a significant disability. Working from home or telecommuting may be an option. MFP Equipment and Supplies funds can be used up to $5,000 for things that you need that are work-related Qualify for employment opportunities. Improving your skills and abilities opens the door to a variety of supports and services offered through a number of different employment services. Information about the Georgia Division of Rehabilitation
Services, the Workforce Investment Act, employment services through the Georgia Department of Labor, and/or training available through the Georgia Department of Technical and Adult Education, see Training and Employment Resources page 111, in the Quick Reference Guide to Resources Earn income to spend on things you want. When considering income as part of your eligibility for MFP and waiver services through Georgia Medicaid, income you earn is treated differently, generally in ways that benefit you.
66

Training, school and employment can enrich your wallet or purse, your budget/ spending plan and your life. If you decide to work or go to school, don't forget to let your MFP Transition Coordinator and your Waiver Case Manager know about your plans. You are responsible for reporting changes in your circumstances. You must also report changes in your circumstances to the Social Security Administration within 10 days. In the space below, write down your vocational goals. What kind of work do you want to do? What are you good at? What do you enjoy doing that could make you some part-time income? What are some of the barriers to achieving your employment goals? Discuss these questions with your transition team, MFP Transition Coordinator, peer supporter and Waiver Case Manager.
Notes:
67

Moving Day (Discharge Day) and Beyond
My Discharge Date is set for: _____________________
Once you receive notification that your qualified residence is ready for you to occupy within 30 days, your MFP Transition Coordinator will review with you the documents and information needed to change your status from a nursing facility (or ICF) resident to a waiver participant/community resident.
Your Transition Coordinator will assist you to notify the Social Security Administration office and provide them with a discharge date. If you are moving into an apartment or house and will be paying rent, you will need to open a bank account. Your Transition Coordinator will help you set up a bank account and set up direct deposit of your Social Security check (or other resources).
On your discharge date, the nursing facility/ICF will provide you with the following: Case information from the nursing home/ICF record, discharge documents The remaining supply of your current medications and remaining supplies in the medication unit Personal clothing A current financial statement Contact information for the nursing facility/ICF discharge planner/social worker and contact information for the doctor who provided your medical care in the nursing facility/ICF
When possible, your circle of friends/family, your Transition Coordinator, your peer supporter and your Waiver Case Manager will all be available to assist you on moving day. Your Transition Coordinator will assist you to arrange for a moving service or help from your circle of friends/family to move your belongings and any furniture you have to your qualified residence. If your qualified residence needed to be modified, your Transition Coordinator will coordinate these services with contractors and will let you know when these will be completed. 68

If you need the assistance, you should ask either your peer supporter or your Transition Coordinator to accompany you to your local pharmacy to get your prescriptions filled.
Your First Year in the Community
During your first year in the community, your MFP Transition Coordinator will arrange monthly checkins (phone calls, visits, etc.) with you to see how you are doing. Your Transition Coordinator will work with you to resolve any problems or remove any barriers that you may have encountered. If you find that you need additional MFP services, such as additional modifications to your qualified residence, you should ask your Transition Coordinator and/or waiver case manager for help.
They can work with you to obtain additional equipment and/or services that are needed so you can use your qualified residence as safely and independently as possible.
During your first year in the community, your Waiver Case Manager and your Transition Coordinator work together with you to refine your waiver service plan and your 24/7 emergency backup plan.

On discharge day, your Waiver Case Manger will discuss your waiver service plan and waiver services with you and help you test your 24/7 emergency backup system. Your Transition Coordinator will make sure you have her/ his contact information and your Waiver Case Manager will provide you with her/ his contact information. Your Transition Coordinator will establish telephone communication with you once you have moved to your new place.

69

Moving Day (Discharge Day) and Beyond
Your Transition Coordinator will arrange for a surveyor to complete the follow-up Quality of Life (QOL) survey with you at about the same time your 365 days of MFP are ending. The surveyor will call you to complete the follow-up QOL survey sometime during your 12th month and sometime during the 24th month of living in the community. Your Transition Coordinator is responsible for informing you 30 days before your MFP services are set to end. You will receive a letter from your Transition Coordinator as a reminder that your MFP services are ending.
Your Waiver Services Continue After MFP
Your waiver services, state-plan and other community services will continue, unless you do not need these services any longer. Your Waiver Case Manager will continue to contact you periodically to see how you are doing and ask you if your situation has changed.
Once each year, your Waiver Case Manager will meet with you to update your waiver service plan. This can be done more often if changes in your circumstances require it. Be sure to contact your Waiver Case Manager if your income, resources, living arrangements, family size or other circumstances change. These changes could affect your eligibility for waiver services.
Assignment: Complete Discharge Day Planning Worksheet
Use the Discharge Day Planning Worksheet to plan for your discharge and moving day activities.
These tasks should be completed in the 30 days before you are scheduled to be discharged.
70

Tasks are listed in the 1st column. Use the 2nd column to describe what you will do, the date of the activity and where you will go. Use the 3rd column to indicate the assistance you need to complete the activity. Depending on the type of qualified residence you choose, some of these tasks may not apply.

Discharge task

What? When? Where?

You have arranged transportation to review housing options and/or your qualified residence is leased; the security deposit has been made; utilities tuned on and deposits made.

Who will assist?
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______

You have set up a bank account; you have notified Social Security of discharge date and change of address.

o Family member o Friend(s) o Transition Coordinator o Peer Supporter
o Other: ______

The Department of Family and Children Services (DFCS) in your new county of residence has been notified of your new address; status change to waiver status.

o Family member o Friend(s) o Transition Coordinator o Peer Supporter
o Other: ______

71

Moving Day (Discharge Day) and Beyond

Discharge task
Modifications to your qualified residence are complete or complete enough to allow you to move in safely.

What? When? Where?

Household items and furniture for kitchen, bath and bedroom have been obtained.

You have enough food for at least 10 days to 2 weeks and/or you have home delivered meals set up.
Friends/family members have agreed to help you on moving day or the services of a mover have been scheduled.
You have the remaining supply of your medications and the remaining supplies from the medication unit; you know where/how to get additional supplies.

Who will assist?
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______

72

Discharge task

What? When? Where?

Your prescriptions have been called into the pharmacy in your new community for refill; you know the location.

Who will assist?
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______

The durable medical equipment and/or assistive technology devices you need have been delivered or ordered and will be delivered; you have the contact information for the equipment vendors. Transportation you need in your new community has been tested and you know how to use it.
You know what waiver you are entering, the waiver services you will be receiving, and you have tested your 24/7 emergency backup system (ask Transition Coordinator for assistance).

o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______
o Family member o Friend(s) o Transition Coordinator o Peer Supporter o Other: ______

73

Moving Day (Discharge Day) and Beyond
Short-Term Hospitalizations or Nursing Facility/Rehab Stays
During your MFP period (for 365 days after your discharge date), if you need to be hospitalized for any reason for less than 30 days, you would not be considered an institutional resident. As soon as your condition is stable and you are able to return to your qualified residence, you will resume MFP and waiver services.
If your hospital stay was 30 days or longer, you would be discharged from MFP and would then be considered an institutional resident. If this happens and you are readmitted to a nursing facility or hospital and had to stay over 30 days, you would NOT need to meet another MFP three month institutional residency requirement, but you would be re-evaluated for discharge to the community and re-enrolled in MFP. Your Transition Coordinator and Waiver Case Manger would work with you to determine if any changes in your service plan were needed to prevent a readmission to the hospital. If you need to return to the nursing facility or hospital for a stay of longer than six months, institutional residency requirements would apply and you would need to be re-evaluated like a "new" MFP participant.
MFP staff, your Transition Coordinator, peer supporter, Waiver Case Manager and your transition team are all dedicated to helping you live successfully in the community.
My MFP Transition Coordinator's Contact Information:
My MFP Peer Supporter's Contact Information:

My Waiver Case Manager's Contact Information: My 24/7 Emergency Backup Contact Information:
My Long-Term Care Ombudsman's Contact Info:
Notes:

74

75

Quick Reference Guide to Resources

Centers for Independent Living
Center
Southwest Georgia:
BAIN (Bainbridge Advocacy Individual Network) 316 West Shotwell Street PO Box 1674 Bainbridge, GA 39818
Phone: 229-246-0150 TTY: call GA Relay 711 Toll Free: 800-255-0135 (V/TTY) FAX: 229-246-1715
Central Georgia:
Disability Connections 170 College Street Macon, GA 31201
Phone: 478-741-1425 Toll Free TTY/Voice: 800-743-2117 FAX: 478-755-1571
North Georgia:
Disability Resource Center 470-A Woods Mill Road Gainesville, GA 30501
Phone: 770-534-6656 TTY: call GA Relay 711 Toll Free: TTY/Voice: 800-255-0135 FAX: 770-534-6626 www.disabilityresourcecenter.org

Counties served
Calhoun Clay Baker Decatur Early Grady

Miller Mitchell Thomas Randolph Seminole Thomas

Baldwin Bibb Crawford Houston Jasper Jones
Banks Dawson Forsyth Franklin Habersham Hall Hart

Monroe Peach Pulaski Putnam Twiggs Wilkinson
Lumpkin Rabun Stephens Towns Union White

76

Centers for Independent Living, continued

Center
Metro Atlanta:
disABILITY LINK 755 Commerce Drive, Suite 105 Decatur, GA 30030
Phone: 404-687-8890 TTY: 404-687-9175 Toll Free Voice/TTY: 800-239-2507 FAX: 404-687-8298 Web site: www.disabilitylink.org

Counties served

Cherokee

Fayette

Clayton Cobb

Fulton Gwinnett

Coweta

Henry

DeKalb

Newton

Douglas

Rockdale

Northwest Georgia:
disABILITY LINK Northwest 410 Tribune St. Rome, GA 30161
Phone: 706-314-0008 Toll Free: 866-888-7845 TTY: 706-314-0017 Fax: 706-314-0011 Web site: www.disabilitylink.org

Bartow Catoosa Chattooga Dade Fannin Floyd Gilmer Gordon

Haralson Murray Paulding Pickens Polk Walker Whitfield

Southeast Georgia:
LIFE (Living Independence for Everyone) 12020 Abercorn Street Savannah, GA 31419
Phone: 912-920-2414 TTY: 912-920-2419 FAX: 912-920-0007 Web site: www.lifecil.com

Bryan Bulloch Camden Chatham Effingham Evans

Glynn Liberty McIntosh Tattnall Toombs

77

Quick Reference Guide to Resources

Centers for Independent Living, continued

Center
Northeast Georgia:
Multiple Choices 850 Gaines School Rd Athens, GA 30605
Phone: 706-549-1020 Toll Free: 877-549-1020 FAX/TTY: 706-549-1060 Web site: www.multiplechoices.us

Counties served

Barrow

Madison

Clarke Elbert

Morgan Oconee

Greene

Oglethorpe

Jackson

Walton

East Georgia: Walton Options for Independent Living PO Box 519 Augusta, GA 30903-5019 Voice: 706-724-6262 TTY: 706-261-0199 Toll Free: 877-821-8400 FAX: 706- 724-6729 Web site: www.waltonoptions.org
East Georgia: Warrenton Satellite Office
Phone: 706-465-1148 FAX: 706-465-1168

Burke Columbia Emanuel Jefferson Jenkins
Glascock Hancock McDuffie

Johnson Lincoln Richmond Screven Washington
Taliaferro Warren Wilkes

78

Area Agency on Aging (AAA)
To apply for Community Care Services Program (CCSP), call the number for the program serving your area:

AAA Contact Information
Atlanta Region
Atlanta Regional AAA 40 Courtland Street, N.E. Atlanta, GA 30303-2538
Phone: 404-463-3100 Aging Connection: 800-676-2433 Or 404-463-3333 Fax: 404-463-3264 Web site: www.atlantaregional.com/ aging-resources Central Savannah River
Central Savannah River AAA 3023 Riverwatch Parkway Suite A, Bldg 200 Augusta, GA 30907-2016
Director Direct Line: 706-210-2013 Aging Program: 706-210-2000 Aging Connection: 888-922-4464 Fax: 706-210-2006 Web site: www.csrarc.ga.gov

Counties served

Cherokee Fayette

Clayton Cobb

Fulton Gwinnett

DeKalb

Henry

Douglas

Rockdale

Burke Richmond Columbia Screven Glascock Taliaferro Hancock

Warren Jefferson Washington Jenkins Wilkes Lincoln McDuffie

Coastal Georgia
Coastal Georgia AAA 127 F Street Brunswick, GA 31520
Phone: 912-262-2822 Information Link: 800-580-6860 Fax: 912-262-2313 Web site: www.crc.ga.gov

Bryan Bulloch Camden Chatham Effingham

Glynn Liberty Long McIntosh

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Quick Reference Guide to Resources

Area Agency on Aging (AAA), continued

Center
Georgia Mountains
Legacy Link AAA Physical Address: 508 Oak St., Ste 1 Gainesville, GA 30501
Mailing Address: PO Box 2534 Gainesville, GA 30503-2534
Phone: 770-538-2650 Fax: 770-538-2660 Intake Screening: 800-845-5465 Web site: www.legacylink.org

Counties served

Banks

White

Stephens Dawson

Habersham Hall

Towns

Hart

Forsyth

Lumpkin

Union

Rabun

Franklin

Heart of Georgia Altamaha: Heart of Georgia Altamaha AAA 331 West Parker Street Baxley, GA 31513-0674 Phone: 912-367-3648 Toll Free: 888-367-9913 Fax: 912-367-3640 or 912-367-3707 Web site: www.hogarc.org
Middle Georgia: Middle Georgia AAA 175 Emery Highway, Suite C Macon, GA 31217-3679
Phone: 478-751-6466 Toll free: 888-548-1456 Fax: 478-752-3243 Web site: www.middlegeorgiarc.org

Appling

Treutlen

Montgomery Evans

Bleckley

Wayne

Tattnall

Jeff Davis

Candler

Wheeler

Telfair

Johnson

Dodge

Wilcox

Toombs

Laurens

Emanuel

Baldwin Peach Bibb Pulaski Crawford Putnam

Houston Twiggs Jones Wilkinson Monroe

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Area Agency on Aging (AAA), continued

Center
Northeast Georgia:
Northeast Georgia AAA 305 Research Drive Athens, GA 30610
Phone: 706-369-5650 Toll free: 800-474-7540 Fax: 706-425-3370

Counties served

Barrow

Greene

Newton Clarke

Walton Jackson

Oconee

Jasper

Elbert

Madison

Oglethorpe

Morgan

Northwest Georgia:
Northwest Georgia AAA Physical Address: 1 Jackson Hill Dr. Rome, GA 30161
Mailing Address: PO Box 1798 Rome, GA 30162-1798
Phone: 706-295-6485 Fax: 706-295-6126 Screening Fax: 706-802-5506 Web site: www.nwgrc.org

Bartow Murray Catoosa Paulding Chattooga Pickens Dade Polk

Fannin Walker Floyd Whitfield Gilmer Gordon Haralson

River Valley:
River Valley AAA 1428 Second Avenue PO Box 1908 Columbus, GA 31902-1908
Phone: 706-256-2910 Toll Free: 800-615-4379 Fax: 706-256-2908 Web site: www.rivervalleyrc.org

Chattahoochee Quitman Clay Randolph Crisp Schley Dooley Stewart

Harris Sumter Macon Talbot Marion Taylor Muscogee Webster

81

Quick Reference Guide to Resources

Area Agency on Aging (AAA), continued

Center
Southern Georgia: Southern Georgia AAA 1725 South Georgia Parkway, West Waycross, GA 31503-8958 Phone: 912-285-6097 Toll Free: 888-732-4464 Fax: 912-285-6126 Web site: www.sgrc.us
Southwest Georgia: SOWEGA AAA 1105 Palmyra Road Albany, GA 31701-1933 Phone: 229-432-1124 Toll free: 800-282-6612 Fax: 229-483-0995 Web site: www.sowegacoa.org

Counties served
Atkinson Cook Bacon Echols Ben Hill Irwin Berrien Lanier Brantley
Baker Lee Calhoun Miller Colquitt Mitchell Decatur

Three Rivers:
Southern Crescent AAA Physical Address: 13273 Hwy. 34 East Franklin, GA 30217
Mailing Address: PO Box 1600 Franklin, GA 30217-1600
Phone: 706-407-0016 or 678-552-2853 Toll Free: 866-854-5652 Fax: 706-675-9210 or 770-854-5402 Web site: www.scaaa.net

Butts Pike Carroll Spalding Coweta

Lowndes Brooks Pierce Charlton Tift Clinch Turner Coffee Ware
Seminole Dougherty Terrell Early Thomas Grady Worth
Troup Heard Upson Lamar Meriwether

82

Aging and Disability Resource Connections

Georgia's Aging and Disability Resource Connection is not a place or a program. It is a coordinated system of partnering organizations that are dedicated to:
Providing accurate information about publicly and privately financed long-term supports and services Offering a consumer-oriented approach to learning about the availability of services in the home and community Alleviating the need for multiple calls and/or visits to receive services. Supporting individuals and family members who are aging or living with a disability

For assistance, contact the Aging and Disability Resource Connection that serves your area:

ADRC Contact Information
Atlanta Region:
Atlanta Regional Commission 40 Courtland Street, N.E. Atlanta, GA 30303-2538
Phone: 404-463-3333 Toll Free: 800-676-2433 Web site: www.agewiseconnection.com

Counties Served

Cherokee

Fayette

Clayton Cobb

Fulton Gwinnett

DeKalb

Henry

Douglas

Rockdale

Central Savannah River Area:
Central Savannah ADRC 3023 Riverwatch Parkway Suite A, Bldg 200 Augusta, GA 30907-2016
Phone: 706-210-2018 Toll Free: 888-922-4464 Web site: www.csrardc.org

Burke Richmond Columbia Screven Glascock Taliaferro Hancock Warren

Jefferson Washington Jenkins Wilkes Lincoln McDuffie

83

Aging and Disability Resource Connections

Aging and Disability Resource Connections (ADRC)

ADRC Contact Information
Coastal Area:
Coastal ADRC 127 F Street Brunswick, GA 31520
Phone: 912-262-2862 Toll Free: 800-580-6860 Web site: www.georgiaadrc.com

Counties Served Bryan Bulloch Camden Chatham

Effingham Glynn Liberty Long

River Valley:
River Valley ADRC 1428 Second Avenue PO Box 1908 Columbus, GA 31902-1908
Phone: 706-256-2900 Toll Free: 800-615-4379 Web site: www.lcrdcaaa.org
Northeast Georgia:
Northeast Georgia ADRC 305 Research Drive Athens, GA 30610
Phone: 706-583-2546 Toll free: 800-474-7540

Chattahoochee Quitman Clay Randolph Crisp Schley Dooley Stewart Barrow Newton Clarke Oconee Elbert Oglethorpe

Harris Sumter Macon Talbot Marion Taylor Muscogee Webster Greene Walton Jackson Jasper Madison Morgan

Northwest Georgia: Northwest Georgia ADRC 1 Jackson Hill Dr. Rome, GA 30161 Phone: 706-802-5506 Toll Free: 888-759-2963 Web site: www.northwestga-aaa.org
84

Bartow Murray Catoosa Paulding Chattooga Pickens Dade Polk

Fannin Walker Floyd Whitfield Gilmer Gordon Haralson

Aging and Disability Resource Connections

ADRC Contact Information
Southern Georgia:
Southern Georgia ADRC 1725 South Georgia Parkway, West Waycross, GA 31503-8958
Phone: 912-287-5888 Toll Free: 888-732-4464 Web site: www.sgrc.us/AAA/default.html

Counties Served

Atkinson Cook Bacon Echols Ben Hill Irwin Berrien Lanier Brantley

Lowndes Brooks Pierce Charlton Tift Clinch Turner Coffee Ware

Southwest Georgia:
SOWEGA ADRC 1105 Palmyra Road Albany, GA 31701-1933
Phone: 229-432-0994 Toll free: 800-282-1026 Web site: www.sowegacoa.org

Baker Lee Calhoun Miller Colquitt Mitchell Decatur

Seminole Dougherty Terrell Early Thomas Grady Worth

Southern Crescent:
Southern Crescent ADRC Physical Address: 13273 Hwy. 34 East Franklin, GA 30217 Mailing Address: PO Box 1600 Franklin, GA 30217-1600
Phone: 706-407-0033 Toll Free: 866-854-5252 Web site: www.scaaa.net

Butts Pike Carroll Spalding Coweta

Troup Heard Upson Lamar Meriwether

85

SOURCE Providers
Call the number for the program serving your county to apply for SOURCE:
Albany ARC Phone: 229-883-2334 Fax: 229-431-8534 Counties: Baker, Calhoun, Clay, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell Thomas, Worth
Columbus Regional Healthcare System Phone: 706-660-6356 Fax: 706-660-6279 Counties: Chattahoochee, Harris, Marion, Muscogee, Talbot
Crisp Regional Health Services, Inc. d/b/a Crisp Care Management Phone: 229-273-6282 Fax: 229-273-5990 Counties: Crisp, Dooley, Macon, Pulaski, Sumter, Wilcox
Diversified Resources Inc. Phone: 912-285-3089 or 800-283-0041 Fax: 912-285-0367 Counties: Atkinson, Clinch, Coffee, Pierce and Ware
Nahunta Office Phone: 912-462-8449 or 866-903-7473 Counties: Brantley, Camden, Charlton, Glynn Tifton Office Phone: 229-386-9296 or 800-575-7004 Counties: Ben Hill, Irwin, Tift, Turner, Wilcox Valdosta Office Phone: 229-253-9995 or 800-706-9674 Counties: Berrien, Brooks, Cook, Echols, Lanier and Lowndes
86

Faith Health Services Phone: 678-624-1646 Fax: 770-442-3320 Counties: Fulton, Cobb, Clayton, Dekalb, Forsyth, Gwinnett, Rockdale
Wesley Woods (Atlanta SOURCE) Phone: 404-728- 6555 Fax: 404-728-4973 Counties: Dekalb, Fulton
Source Care Management LLC Phone: 478-621-2070 ext. 2871 or ext. 2872 Alt Number: 888-762-2420 Fax: 478-862-9111 E-mail: info@source-ga.org
Source Care Management Offices: Americus Phone: 478-621-2070 ext 2981 Fax: 229-928-4485 Counties: Crisp, Dodge, Dooly, Lee, Pulaski, Sumter, Terrell, Turner, Wilcox, Worth
Augusta Phone: 478-621-2070 ext 2731 Fax: 706-737-0205 Counties: Burke, Columbia, Lincoln, McDuffie, Richmond, Taliaferro, Warren
Athens Phone: 478-621-2070 ext 2882 Fax: 706-543-8293 Counties: Banks, Barrow, Clark, Elbert, Franklin, Greene, Hart, Jackson, Madison, Morgan, Oconee, Oglethorpe, Stephens, Wilkes Butler Phone: 478-621-2070 ext 2832 Fax: 478-862-4844 Counties: Macon, Marion, Schley, Talbot, Taylor, Upson
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SOURCE Providers
Source Care Management Offices, continued: Columbus Phone: 478-621-2070 ext 2861 Fax: 706-562-2342 Counties: Chattahoochee, Clay, Harris, Muscogee, Quitman, Randolph, Stewart, Webster Douglas Phone: 478-621-2070 ext 2627 Fax: 912-592-4630 Counties: Atkinson, Bacon, Ben Hill, Berrien, Charlton, Clinch, Coffee, Cook, Echols, Irwin, Lanier, Lowndes, Tift, Ware Duluth Phone: 478-621-2070 ext 2651 Fax: 770-717-2692 Counties: Dawson, Dekalb, Fannin, Forsyth, Gwinnett, Habersham, Hall, Lumpkin, Newton, Rabun, Rockdale, Towns, Union, Walton, White Eatonton Phone: 706-485-4128 Counties: Baldwin, Greene, Hancock, Jasper, Lincoln, McDuffie, Morgan, Putnam, Taliaferro, Warren, Wilkes Jesup Phone: 478-621-2070 Fax: 912-427-2672 Counties: Appling, Brantley, Bryan, Camden, Chatham, Effingham, Glynn, Liberty, Long, McIntosh, Pierce, Wayne Macon Phone: 478-621-2070 ext 2777 Fax: 478-471-0751 Counties: Bibb, Bleckley, Butts, Crawford, Houston, Jasper, Jones, Lamar, Monroe, Peach, Putnam, Twiggs
88

Metter Phone: 478-621-2070 ext 2601 Fax: 912-685-7640 Counties: Bulloch, Candler, Emanuel, Evans, Jeff Davis, Jenkins, Montgomery, Screven, Tattnall, Telfair, Toombs, Treutlen, Wheeler Newnan Phone: 478-621-2070 ext 2812 Fax: 770-304-9521 Counties: Carroll, Clayton, Coweta, Douglas, Fayette, Fulton, Heard, Henry, Meriwether, Pike, Spalding, Troup Rome Phone: 478-621-2070 ext 2757 Fax: 706-378-1330 Counties: Bartow, Catoosa, Chattooga, Cherokee, Cobb, Dade, Floyd, Gilmer, Gordon, Haralson, Murray, Paulding, Pickens, Polk, Walker, Whitfield Thomasville Phone: 478-621-2070 ext 2902 Fax: 229-227-6157 Counties: Baker, Brooks, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Miller, Mitchell, Seminole, Thomas, Wrightsville Phone: 478-621-2070 ext 2926 Fax: 478-864-9423 Counties: Baldwin, Glascock, Hancock, Jefferson, Johnson, Laurens, Washington, Wilkinson
Legacy Link, Inc. Phone: 770-538-2650 Fax: 770-538-2660 Counties: Banks, Barrow, Cherokee, Clark, Dawson, Elbert, Forsyth, Franklin, Gwinnett, Habersham, Hall, Hart, Jackson, Lumpkin, Madison, Rabun, , Stephens, Towns, Union, White
89

SOURCE Providers
St. Joseph's/Candler Health System Phone: 912-819-1520 or 866-218-2259 Fax 912-819-1548 Counties: Bryan, Bulloch, Candler, Chatham, Effingham, Evans Baxley Office Phone: 866-835-0709 or 912-367-6108 Fax 912-367-0392 Counties: Appling, Bacon, Jeff Davis, Liberty, Long, McIntosh, Montgomery, Tattnall, Toombs, Wayne
UniHealth Solutions SOURCE-Corporate Office Phone: 770-925-4788
UniHealth Solutions Athens Phone: 706-549-3315 Fax: 706-543-3841 Counties: Banks, Barrow, Clark, Elbert, Franklin, Greene, Habersham, Hart, Jackson, Madison, Oconee, Oglethorpe, Stephens, Walton
UniHealth Solutions Atlanta Phone: 678-533-6200 Fax: 678-533-6488 Counties: Clayton, Dekalb, Fulton, Forsyth, Gwinnett, Hall, Henry, Newton, Rockdale, Spalding
UniHealth Solutions Augusta Counties: Burke, Columbia, Glascock, Hancock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren, Washington, Wilkes
UniHealth Solutions North GA Mountain/Blueridge Phone: 706-258-5300 Fax 706-632-0028 Counties: Cherokee, Dawson, Fannin, Gilmer, Lumpkin, Pickens, Rabun, Towns, White
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UniHealth Solutions Cobb Phone: 770-916-4502 Fax: 770-916-4505 Counties: Carroll, Cobb, Douglas, Paulding
UniHealth Solutions Columbus Phone: 706-322-7713 Fax: 706-322-7716 Counties: Chattahoochee, Marion, Muscogee, Quitman, Stewart, Webster
UniHealth Solutions Cordele Phone: 229-273-2570 Fax: 229-273-4750 Counties: Ben Hill, Bleckley, Clay, Crisp, Dodge, Dooly, Dougherty, Irwin, Lee, Macon, Marion, Pulaski, Randolph, Schley, Sumter, Telfair, Tift, Turner, Wilcox, Worth
UniHealth Solutions Jesup Phone: 912-530 7359 Fax: 912-530-7362 Counties: Appling, Bacon, Brantley, Camden, Charleston, Glynn, Pierce, Wayne
UniHealth Solutions Macon Phone: 478-474-0979 or 800-913-0134 Fax: 478-474-2068 Counties: Baldwin, Bibb, Butts, Crawford, Houston, Jasper, Jones, Lamar, Laurens, Monroe, Peach, Pike, Putnam, Taylor, Twiggs, Upson, Wilkinson
UniHealth Solutions Newnan Phone: 770-254-1545 Fax: 770-254-8605 Counties: Coweta, Fayette, Fulton (Zip Code 30291), Harris, Heard, Meriwether, Pike, Spaulding, Talbot, Troup
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SOURCE Providers
UniHealth Solutions, continued: UniHealth Solutions Savannah Phone: 912-925-9181 Fax: 912-925-9340 Counties: Bryan, Chatham, Effingham, Liberty, Long, McIntosh
UniHealth Solutions Rome Phone: 706-236-4705 Fax: 706-232-5912 Counties: Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson Murray, Polk, Walker, Whitfield
UniHealth Solutions of Swainsboro Phone: 478-237-7270 Fax 770-237-7290 Counties: Bulloch, Chandler, Emmanuel, Evans, Johnson, Montgomery, Tattnall, Tombs, Treutlen, and Wheeler
UniHealth Solutions Valdosta Phone: 229-241-8750 Fax: 229-241-8940 Counties: Atkinson, Berrien, Brooks, Clinch, Coffee, Colquitt, Cook, Echols, Jeff Davis, Lanier, Lowndes, Thomas, Ware
Georgia Corner of Care Phone: 706-496-3901 Fax: 706-496-3890 County: Richmond
SOURCE Partners Atlanta Phone: 404-463-3248 Fax: 404-463-3264 Counties: Cherokee, Clayton, Cobb, Dekalb, Douglas, Fayette, Fulton, Gwinnett, Henry, Rockdale
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Startup Household Goods and Supplies Worksheet

ITEMS
Kitchen Dishes Silverware Kitchen Knives Glasses Cups Tea Pitcher Tupperware Pots/Pans Cookie Sheet Cooking Utensils Can Opener Measuring Cups Salt/Pepper Shakers Pot Holders/Mitt Kitchen Trash Can Kitchen Towels Dish Cloths Dish Drainer Ice Trays Cleaning Paper Towels Laundry Detergent Laundry Basket

I Own/ Family Owns

Cost at Discount Store

Cost at Other Store

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Startup Household Goods and Supplies Worksheet

ITEMS
Cleaning, continued Bleach All Purpose Cleaner Pine Cleaner Glass Cleaner Dish Liquid Room Deodorizer Disinfectant Broom Mop Mop Bucket Dust Pan Dust Cloths Toilet Brush Trash Bags Light Bulbs Bedroom Blanket Sheet Set Pillow Alarm Clock Toilet Tissue Tissues 94

I Own/ Family Owns

Cost at Discount Cost at Other

Store

Store

ITEMS
Bathroom Bath Towels Hand Towels Wash Cloths
Shower Curtain
Shower Hooks Small Trash Can Toiletries Shampoo Soap Lotion Toothpaste Mouthwash Razors Hand Soap (Pump) Other Speaker Phone or Phone with large numbers Coasters

I Own/ Family Owns

Cost at Discount Cost at Other

Store

Store

Total Cost for Items

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Documents Needed for Housing Searches
You will need to gather and organize documentation needed to complete rental applications, including:
State-issued ID (must be current) Contact: Department of Driver Services Phone: 678-413-8400 Website: www.dds.ga.gov/drivers
Birth Certificate Contact: Vital Records Phone: 404-679-4702 Website: health.state.ga.us/programs/vitalrecords
Social Security card Contact: Social Security Administration Phone: 800-772-1213 Website: www.ssa.gov
Proof of Income (e.g. bank statements, SSI/SSD award letter)
When searching for subsidized housing and/or submitting applications for rental assistance programs, you will most likely have to do the following with assistance from your Transition Coordinator:
Obtain and review your credit reports, correcting incomplete and inaccurate information Find assistance to pay past unpaid utility bills Obtain and review criminal history/background reports Obtain and organize documents needed to complete rent-controlled and subsidized housing applications Obtain utility information and connect utilities
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As you do your housing search, you will see the following terms used:
Area Median Income (AMI) - refers to the middle or midpoint income for a particular area. The term is used to estimate the "average" income for a particular area
Affordable Housing - is a vague term generally defined as housing where the occupant pays no more than 30% of gross income for total housing costs, including utilities
Public Housing - is housing that a Public Housing Authority operates. A criminal background check is required for all Public Housing rental applications
Public Housing Authority (PHA) - is a public agency created by state or local government to finance or operate low-income housing
Housing Choice Vouchers (formerly Section 8) - is a federally funded rent subsidy program for low income persons. Local public housing authorities (PHA) receive funds from the U.S. Department of Housing and Urban Development (HUD) to administer the Housing Choice Voucher program. PHAs determine eligibility for the program and the amount of the rental assistance. The renter is required to pay 30% of her/his adjusted income for rent. If the PHA determines that the renter/family is eligible, it will issue a rental voucher or certificate. The renter is responsible for finding a suitable rental unit. The rental unit must meet minimum standards for health and safety, as determined by the PHA
Based On Income (BOI) - means that rent will be (in most cases) 30% of adjusted gross monthly income
Single Room Occupancy (SRO) - is a building in which tenants occupy single private spaces, but share cooking facilities and/or bathrooms. Generally known as a boarding house, this type of housing does not meet MFP qualified residence requirement
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Benefits and Services for MFP Participants by Waiver

Community Care Services Program (CCSP) Independent Care Waiver Program
and Service Options Using Resources in (ICWP)
Community Environments (SOURCE)

Adult Day Health

Adult Day Care

Alternative Living Services

Behavior Management

Emergency Response Services

Case Management

Enhanced Case Management

Consumer-Directed PSS

Financial Management Services

Counseling

Home Delivered Meals

Enhanced Case Management

Home Delivered Services

Environment Modification

Out-of-Home Respite

Fiscal Intermediary

Personal Support Services (PSS)/ (PSSX)/ Consumer Directed

Personal Emergency Monitoring

Skilled Nursing Services

Personal Emergency Response

Personal Emergency Response Installation

Personal Support Services

Respite Services

Skilled Nursing

Specialized Medical Equipment and Supplies

Vehicle Adaptation

Other Non-Medicaid Services

Adult Protective Services

Adult Protective Services

Caregiver Supports

Social Services Block Grant Svs

Older Americans Act Services

State Funded Services

Social Services Block Grant Svs State Funded Services

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New Options Waiver

Comprehensive Waiver (COMP)

Adult Occupational Therapy Svs

Adult Occupational Therapy Svs

Adult Physical Therapy Services

Adult Physical Therapy Services

Adult Speech and Language Therapy Services
Behavioral Supports Consultation
Community Access

Adult Speech and Language Therapy Services
Behavioral Supports Consultation
Community Access

Community Guide

Community Guide

Community Living Support Environmental Access Adaptation Financial Support Services

Community Living Support Community Residential Alternative Environmental Access Adaptation

Individual Directed Goods and Svs Natural Support Training Prevocational Services

Financial Support Services Prevocational Services Specialized Medical Equipment

Respite Services Specialized Medical Equipment Specialized Medical Supplies Support Coordination Supported Employment Transportation Vehicle Adaptation

Specialized Medical Supplies Support Coordination Supported Employment Transportation Vehicle Adaptation

Other Non-Medicaid Services

Adult Protective Services

Adult Protective Services

State Funded Services

State Funded Services

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Health and Emergency Resources

2 1 1

Call 2-1-1 from anywhere in the 404, 770 or 678 area codes to speak with a trained

referral specialist who can help you locate programs or services in your community:

Child and elder care

Counseling

Donate goods

Emergency shelter

Food and more

Internships

Job training

Substance abuse counseling Volunteer

Phone: 2-1-1

Web site: 211online.unitedwayatlanta.org

Adult Protective Services (APS) APS handles reports of abuse, neglect, and or/exploitation of disabled adults (18 to 64 years of age) and older adults (65+) who reside in the community. Contact: Division of Aging Services Phone: 888-774-0152 Web site: aging.dhr.georgia.gov

Community Action Agencies There are 20 Community Action Agencies in the State of Georgia, serving 159 counties. Agencies manage a variety of Federal, State and local resources including Head Start, employability services, emergency assistance, transportation, weatherization, Low Income Home Energy Assistance Program (LIHEAP), and case management. Web site: www.fullcirclegrp1.com/GCAA/services.htm

Division of Aging Services (DAS) DAS administers a statewide system of services for older adults, their families and caregivers. These services include Adult Protective Services and waiver services through the Community Care Services Program (CCSP). Contact: Division of Aging Services Phone: 866-552-4464 Web site: aging.dhr.georgia.gov

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Domestic Violence Services A statewide, toll-free 24-hour crisis line 800-33-HAVEN (334-2836) will connect you to the nearest family violence agency. Georgia certifies 45 non-profits throughout the state that provide 24-hour crisis lines: legal advocacy; parenting and children's programs; and emergency safe shelter. All services are free and confidential. Contact: Division of Family and Children Services Phone: 800-33-HAVEN (800-334-2836) Web site: dfcs.dhr.georgia.gov/portal/site/DHS-DFCS
Energy Assistance Program The Energy Crisis Program is provided to low income households with disconnection notices or already disconnected utility service. Regular home energy assistance is available to households meeting certain income and other requirements. Weatherization programs provide low-cost home energy conservation improvements. Contact: Division of Family and Children Services Phone: 800-869-1150 Web site: dfcs.dhr.gerogia.gov/portal/site/DHS-DFCS
Federally Qualified Health Centers FQHCs provide primary care services for all age groups. FQHCs use a sliding fee scale with discounts based on patient family size and income in accordance with federal poverty guidelines. FQHCs must be open to all, regardless of their ability to pay. Contact: US Department of Health and Human Services Web site: findahealthcenter.hrsa.gov
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Health and Emergency Resources
Georgia Relay Dail 7-1-1 to reach Georgia Relay, a Telecommunications Relay Service for customers with hearing and speech disabilities. Georgia Relay helps those who are deaf, hard of hearing or those with speech disabilities communicate with family, friends or business contacts by telephone. Phone: 7-1-1 Web site: www.GeorgiaRelay.org
General Assistance Fulton and DeKalb Counties offer cash assistance programs for individuals who have an SSI application pending with Social Security. Applications are processed at the Fulton and DeKalb DFCS offices. Eligibility and disability determinations are made in approximately 45 days. General Assistance benefits must be repaid when your Social Security benefit check arrives. Contact: Division of Family and Children Services DeKalb County Phone: 404-370-5251 Fulton County Phone: 404-206-5600 Web site: dfcs.dhr.georgia.gov/portal/site/DHS-DFCS
Georgia Crisis and Access Line Help is available 24/7 for problems with mental health, drugs or alcohol. Behavioral health link staff will help schedule appointments statewide for mental health and addictive disease services or dispatch crisis response teams when necessary. Contact: Department of Behavioral Health and Developmental Disabilities Phone: 800-715-4225 Web site: www.behavioralhealthlink.com
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Emergency Food Resources
Temporary Assistance for Needy Families (TANF) TANF provides cash help for eligible people who have limited income with dependent children. Contact: Division of Family and Children Services Phone: 800-869-1150 Web site: dfcs.dhr.georgia.gov/portal/site/DHS-DFCS Emergency Food Assistance Program (TEFAP) A federal program that supplements the diets of older adults, persons with disabilities and low-income families by providing emergency food assistance at no cost. Contact: Division of Family and Children Services Phone: 800-869-1150 Web site: dfcs.dhr.georgia.gov/portal/site/DHS-DFCS Food Stamps Program Provides a debit card that can be used to purchase food at most grocery stores. Contact: Division of Family and Children Services Phone: 800-869-1150 Web site: dfcs.dhr.gerogia.gov/portal/site/DHS-DFCS Food Banks A list of food banks in Georgia can be found at: dfcs.dhr.georgia.gov/DHRDFCS/DHR-DFCS_CommonFiles/5060625Food_Banks_in_Georgia.pdf
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Durable Medical Equipment and Assistive Technology Equipment and Services
Friends of Disabled Adults and Children (FODAC) FODAC is a statewide and national provider of home health care equipment -- mobility aids and daily living devices for people with disabilities and the newly injured. Programs and services include home health care for children, adults; repair service for durable medical equipment, Ramps for Champs; Re-mount Vehicle Adaptations services and disposable medical supplies. Phone: 770-491-9014 or 866-977-1204 Web site: www.fodac.org
Georgia Telecommunications Equipment Distribution Program (GATEDP) The Georgia Telecommunications Equipment Distribution Program (GATEDP) is a Georgia Public Service Commission program that provides, subject to eligibility requirements, specialized telecommunications equipment to state residents with physical impairments, such as hearing and speech, that prevent them from using ordinary telephones. Phone: 888.297.9461 Web site: www.psc.state.ga.us
Tools for Life Provides access to appropriate assistive technology devices and services for all Georgians with disabilities so they can live, learn, work, and play independently in communities of their choice. Phone: 800-497-8665 Web site: www.gatfl.org
Touch the Future, Inc. Touch the Future is dedicated to providing affordable computer and AT access to individuals with disabilities, disadvantaged communities, and healthy seniors. Touch the Future's expertise and services are as affordable as they are vital to successful independence within the community. Services include:
Equipment Demonstration and Loan Library (try-before-you-buy) with over 1,000 AT devices Expert AT needs assessments and AT device training 104

Skilled computer training with AT applications Complete AT products store and resource expertise STAR Network extends reuse services to underserved southeastern communities LINK: Opportunities Appraisal for Autonomy at Home RebootTM device and computer refurbishment
Phone: 770-934-8432 Web site: www.touchthefuture.us

RebootTM Services ReBootTM is a regional, nonprofit, collaborative organization committed to computer access for people with disabilities. Through donations, ReBootTM acquires computer equipment and other Assistive Technology equipment.
ReBootTM evaluates the equipment, makes needed repairs, loads licensed software, and distributes the equipment, thus providing availability to people with disabilities as well as healthy seniors and disadvantaged communities. Phone: 770-934-8432 Web site: www.touchthefuture.us/reboot.htm

The Center for the Visually Impaired (CVI) The Center for the Visually Impaired is Georgia's largest comprehensive, fully accredited, private facility providing rehabilitation services for individuals of all ages who are blind or visually impaired. Phone: 404-875-9011 Web site: www.cviatlanta.org

Georgia Assistive Technology Equipment Exchange Program (gTRADE)

gTRADE is designed to make assistive technology (AT) devices and services

more available and accessible to ALL Georgians with disabilities.

Phone: 800-497-8665

Web site: www.gtradeonline.org

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Environmental Modification Services

Adapted Living Spaces Specialty: General Contractor Coverage Area: North GA Phone: 404-734-7343
All in One Accessibility Specialty: General Contractor Coverage Area: North GA Phone: 678-766-1066
Amramp Specialty: Ramps Coverage Area: Athens and North GA Athens Phone: 706-255-5374; North GA Phone: 404-401-7339
B&G Construction Specialty: General Contractor Coverage Area: North GA Phone: 678-925-5301
Barrow's Masonry Specialty: Concrete Coverage Area: North Georgia Phone: 770-631-8929

BOSS Construction Specialty: Concrete Coverage Area: North Georgia Phone: 770-599-3800
D.V. Enterprises Specialty: General Contractor Coverage Area: Augusta Area Phone: 706-394-1618
Denison Construction Specialty: General Contractor Coverage Area: Southeast Georgia Phone: 912-221-1449
Deveale Construction Specialty: General Contractor Coverage Area: North Georgia Phone: 678-365-7890

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Friends of Disabled Adults and Children (FODAC) Specialty: Ramps Coverage Area: North Georgia Phone: 770-491-9014
Georgia Crete Specialty: Concrete Coverage Area: North Georgia Phone: 404-569-7866
Handicap Solutions Specialty: General Contactor Coverage: Statewide Phone: 678-858-0540
Home Remedies Specialty: General Contractor Coverage Area: North Georgia Phone: 678-344-5136
Johnny's Grandson Specialty: General Contractor Coverage Area: North Georgia Phone: 404-354-0669

Kerby Enterprises Specialty: General Contractor Coverage Area: Southeast Georgia Phone: 912-655-4593
Mobility Center Specialty: Stair Lifts Coverage Area: North Georgia Phone: 770-833-1411
Mt. Paran Homes Specialty: General Contractor Coverage Area: Augusta Area Phone: 706-860-3050
PJC Home Improvement Specialty: General Contractor Coverage Area: North Georgia Phone: 404-626-8367
Rover's Home Improvement Specialty: General Contractor Coverage Area: Augusta Area Phone: 706-364-8493

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Environmental Modification Services

Stetson Builders Specialty: General Contractor Coverage Area: Southeast Georgia Phone: 912-285-8635
Thornton Brothers Specialty: General Contractor Coverage Area: Southeast Georgia Phone: 912-285-4739
ThyssenKrupp Specialty: Stair Lifts Coverage Area: North Georgia Phone: 404-909-5558
Tri/Septem Developers Specialty: General Contractor Coverage Area: North Georgia Phone: 678-887-2448
Trivest Construction Specialty: General Contractor Coverage Area: North Georgia Phone: 678-772-7732

The Center for Financial Independence & Innovation Credit-Able provides low-interest loans through participating credit unions to enable Georgians with disabilities access to affordable financing for Assistive Technology and Home & Vehicle Modifications. Phone: 404-541-9005 Web site: www.thecfii.org www.thecfii.org/creditable

Legal Services
Atlanta Legal Aid Society, Inc. (ALAS), Mental Health and Disability Rights Unit The Atlanta Legal Aid Society has represented Atlanta's poor and disabled in civil legal cases since 1924. Our work helps our clients deal with some of life's most basic needs - a safe home, enough food to eat, a decent education, protection against fraud and personal safety. Our clients come from Clayton, Cobb, DeKalb, Fulton and Gwinnett Counties in Georgia. Contact: Atlanta Legal Aid Society, Inc. (ALAS) Phone: 404-377-0705 ext. 278 Web site: www.legalaid-ga.org/GA/index.cfm Web site: www.atlantalegalaid.org
Georgia Legal Services GLS provides access to legal assistance for the most critical legal needs experienced by persons with low-incomes. Contact: Georgia Legal Services Phone: 404-206-5175 Web site: www.legalaid-ga.org/GA/index.cfm Web site: www.glsp.org

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109

Additional Transportation Resources
Transportation may be available from different sources, public and private, groups and individuals. Some suggested resources to contact are listed below:
Local transit provider, see www.publictransportation.org for information on local systems. National 211 (United Way): www.211.org Eldercare Locator: www.eldercare.gov, or call 800-677-1116. Retired & Senior Volunteer Program (RSVP) for possible volunteer drivers: www.seniorcorps.gov/about/programs/rsvp.asp Area Agency on Aging, see list pages 79 82 Aging and Disability Resource Center, see list pages 83 85S For Medicaid trips, the local Medicaid dispatcher or provider. The trip qualification and booking procedure varies by state. Contact your state Medicaid program for more information. A Center for Independent Living, see list pages 76 78 for a directory of centers. Service clubs such as Kiwanis, Rotary, local business and charity associations. Hospitals Faith-based charities or churches
Online resources
Search engines and Google Transit Local transit trip planners or regional transportation planning organizations.
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Training and Employment Resources
Division of Rehabilitation Services (DRS) DRS operates five integrated and interdependent programs that share a common goal--to help people with disabilities become fully productive members of society by achieving independence and employment. Contact: Department of Labor Phone: 404-232-3910 Web site: www.vocrehabga.org
Workforce Investment Act (WIA) WIA provides career assessment and training services at no cost to you. It prepares you for the workforce, for jobs that are in demand. Services are provided through 20 local workforce areas, called `One-Stops' around the state. Each One-Stop career development center is physically accessible and is equipped with computers, faxes and phones that you can use in your job search. Contact: Career Development Services Phone: 404-232-3775 Web site: www.dol.state.ga.us/wp/wia_services.htm
Employment Services Employment services and resources are available at no charge to help you develop your resume, learn how to interview and find a job. Listings of part-time and full-time jobs are available. Contact: Department of Labor, Field Services Phone: 404-232-340 Web site: www.dol.state.ga.us/find_career_centers.htm
Department of Technical and Adult Education (DTAE) DTAE provides workforce development programs including technical and adult education, adult literacy classes, GED classes and more. Contact: Technical College System of Georgia Phone: 404-679-1660
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R. L. Grubbs, M.A., M.Ed. Specialist, Money Follows the Person
Georgia Department of Community Health Medicaid Division, Office of Long Term Care 2 Peachtree Street, NW, 37th Floor Atlanta, GA 30303
Phone: 404-657-9323 Fax: 770-357-8857 rlgrubbs@dch.ga.gov
This document was developed under grant CFDA 93.779 from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS). Money Follows the Person is a five-year, $36 million demonstration grant (Award #1LICMS030163/01) funded by CMS in partnership with the state of Georgia Department of Community Health. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal Government.