 Abled in an Air, major sponsorship was given by Green Mountain Support Services, empowering neighbors with disabilities to be home in the community. Also sponsorship was given by Washington County Mental Health Services, where hope and support come together and Champlain Community Services of Vermont. A service intake coordinator here at Green Mountain Support Services. What exactly is an intake coordinator? An intake coordinator works on bringing new consumers into the agency. We also help with the annual reassessments for the adult family care program. And most of the intakes that I do are with the adult family care program. Okay, so can you explain to me, so adult family care, is that a specific age? No, actually, well let me back up. So you have to be at least 18. And most of our participants are older, although we have some who are younger and some really unique cases. I think the youngest is going to be like 19. And they did not meet the criteria for any of the other programs throughout the state, but Choices for Care, they did still have needs. Can you explain, so in other words, would you say that it was too high functioning for certain services, is that it? So they needed support, but they didn't meet the IQ criteria or the A BAS requirement for, say for example, developmental services. They didn't really meet the criteria for mental health services, or they just didn't fit, they didn't have a, But they still needed services. They still needed services. So Choices for Care, which is the umbrella where ASC funding comes from, it's a Choices for Care program, was able to provide services. And we are in the process of developing a home. Each home that's developed is a group home. No, no, not group homes. So it's an individual home. There might be up to two participants living in a home, but everything is tailored specifically to what that individual needs. Everybody's got their own unique service plan, their own unique person centered plan, their own unique shared support plan. And then we use a lot of the person centered thinking tools to create those plans. So everybody's- Stay more independent as possible. Yes, we want people to be as independent as possible, but we want to make sure that health and safety and wellness guidelines are being followed. So people have as much independence as they want or need, and as much support as they want and need. But there's no two programs that are exactly the same. So whether you're 19 or 91, you get to pick what you need. And that's one of the things that I really love about this program. I started working with a program probably five years ago, and we had just a very few clients within the agency who were ASC funded, and the growth is huge. I think we're up to 31 now, effective today. And the referrals pour in from all over. So you basically help them find a place. Yep, we help them to find a place. Sometimes they come to us and they've already got a place picked out, but we get that lined up so that they've got all the supports, the choices. So you help them through their income, like if they need help paying rent or they need help. So their rent is paid for by, it's actually room and board, and they pay that out of their social security or whatever their income is. We do have the ability to offer the same service for those who don't qualify financially for choices for care. We do have the ability to provide a private pay service of the same model. Is this similar to, because I know it's very, they have, we live with somebody or- Yes, it is a shared living situation. We have individuals who live right in the home. We have been able to have family members stay together. We have the ability to tailor it specifically to what each individual needs. Say for example, it's a couple and they don't want to go to two separate nursing homes. They don't have to. They can come into the same adult family care home, providing we're within the requirements of no more than two individuals receiving care. We have some unique situations where the referral is coming, where the individual needs to bring their animal. We have some situations where individuals are bringing a family member. So everything is tailored specifically to what they need. So how long does this process usually take? Yeah, there's a huge range. We've had some expedited cases where it was- A year or two years? No, the fastest record is three days. Really? Yeah, they don't happen very often because- Because they have to be, so they, okay, I'm going to ask a question, I don't know if it's far-fetched or not, but you don't have to answer it. Do you have to be like homeless or- The expedited cases, typically, it is somebody who's experiencing homelessness or about to experience homelessness. If this is the same Vermont, if you're experiencing homelessness, they get through housing quicker than- Yeah, and well, it's, so our agency, you know, we want to help people and living on the streets is not a safe way, especially if you've already got other health conditions. It's good saying how my wife and I get appropriate housing, so yeah, I understand. So those, we also get referrals sometimes where somebody's on hospice, you know, they don't have much time left. And so we can expedite those unique cases. Typically, people are already, they've already done the choices for care application, they've already been found eligible clinically, and they've already been found eligible financially, although there have been cases where the hospital is called and said, this guy is homeless and they're on hospice. We don't know how much time they have left. Now, what if someone, okay, can you help married couples? I'm just already asking. We certainly can, we certainly can. So an example, let's say if someone wants a bigger place to live, and they're not happy with places they're in, can you help them find a larger place? So we can't help them find just an apartment. We work specifically with the shared living provider model. But there are several instances where we put people in to say, for example, a mother-in-law apartment. So they've got the attendant, you know, the independence that they want, the privacy that they want, and the space that they want, but at the same time, they've got somebody right there who can help them with whatever their needs are. The clinical eligibility piece is determined by the local LTCCC, the long-term care clinical coordinators with Dale, and there's one in each basically, I think there's 12 of them, basically one for each county, although there is a little bit of overlap. Each of them has a region that they serve, and we work very closely with them. They are the ones that review the independent living assessments that we do. We work closely with the long-term care clinical coordinators. There's one in basically each county of the state. There is a little bit of overlap, but they do the clinical assessment. They determine whether or not somebody is politically eligible for the Choices for Care program. If they've met that criteria, then part of the intake process is that we're going to complete an independent living assessment. They'll review that clinical assessment, and they will approve the service plan authorization that we submit as well. So there is- But if it's a shared living provider, so the person is given privacy due to a shared living provider? Yep, yep. So there's also a live and care agreement, which is kind of a lease agreement. It states that it agrees what the room and board rate is going to be. It agrees on any household rules that are applicable to everybody living in that household. So the individual who's coming into the home knows they can make an educated decision. Is this a household that you want to live in? Because they've got full choice on whether or not this is the right match for them. Are fastest- So they're not forced? No, no, no, no. It's all about choice. Are the rest is an emergency? Well, the emergency, it's all about choice too. In the two cases that we've had where we rushed them, we were really lucky that we found matches right to begin with. But we go through a lot in the matching process, and most often it takes time. We go through lots of applications. Occasionally we just get lucky, and occasionally we just, we know people. I mean, I've been here at Green Mountain for almost 11 years, so I've had the opportunity to work with some really fabulous home providers, and, you know, other staff. Has there ever been a situation where it hasn't been a match? Oh yeah. Like, they had to move out or? Yeah. So they're in the living care agreement. It specifies that they're, unless there's an emergency, they're each going to give each other 30 days notice. Green Mountain Support Services has some resources. We have a transition house. We have a crisis house, which gives us, you know, when there's the, oh my goodness, crises. Wait a minute. I thought that Green Mountain Support Services doesn't help mental health issues. No, we do. We do help. In fact, we are going to be developing an adult family care shared living model for Department of Mental Health as well. So we've got something, yeah, because at first, because Worcester County Mental Health funds our show. So I didn't know that, that I didn't know that there was crisis situations. Yeah, so, so crises might be something where the home provider has a sudden death in the family. It might be that the individual experiences some, and lots of times people have more than one diagnosis. Maybe they're, you know, they have Parkinson's, or they have MS, or they have a seizure disorder, but on top of that, they also have a mental health disorder. So occasionally there are crises where somebody just can't stay in the home anymore. Either they, they just need a break from each other, or they need to, we need to look for another home. We have the crisis house and the transition house as an option. We also have other home providers who might be willing to take in a second person. We find ways to deal with crises, and they do happen. And sometimes we do need to look for another home. You know, we use a lot of the person-centered thinking tools to try to make the matches. So typically we like to take our time in making a good, solid match. When there's an emergency, then we do our best, but we triage between an immediate need and whether or not it's, it's, you know, somebody in a safe, stable place where they want to get out, you know, say they're in a nursing facility. We know their health and wellness are being met. Maybe they're desperately unhappy and we can take a little bit more time. I've got a guy in a nursing facility and I had to meet three different, three different homes. We do utilize some, when there's a big distance, you know, if you've got to travel to Springfield or Bennington, we try to do the first meet and greet by phone so that we can kind of guess, do you want to meet in person or do you want to, do you want to meet somebody else over the phone first too? And other times, I mean, I walked into a nursing home in Burlington one day. The nursing home social worker asked me if I could meet with somebody else just, just for a few minutes. He was, he was working with another agency, but there hadn't been a lot of movement yet. And so they, they wanted us to, to just chat. In 20 minutes, I had a feeling just from the way, just from the way his voice, the way he talked, I knew, I have to have you meet this person. And a week later they met and he's been there three years now. He loves it, loves it. I've seen the adult family care program make huge improvements in people's health in their, in their happiness, in stress reduction, because it's not about living in an institution. It's, it's, you've got, you've got a family. And it's not for everybody, but it works really well for a lot of people. And the fact that we can tailor it specifically to what, what are the needs? The choices for care eligibility process consists of two pieces. One of them is clinical eligibility. Do you have the care needs that, that will qualify you for choices for care? The other piece of it is, do you meet the financial eligibility? And one of the things that they do is they allow, so if somebody had some money saved up and you're over resource, they will allow you to take, I think it's up to $10,000 of that and put it aside for a burial fund. And they, Social Security can't touch it. Social Security can't touch it. And it won't leave you disqualified for the choices for care. Because choices for care can provide a lot of resources for your care needs. And, and also Social Security, from what I understand, if your family a long time ago sets up a trust fund, so security or SSI cannot trust that either. Yes, so there's, there's certain ways to protect some so that, that SSI is a lot more financially, it's less, it's less money and it's also much more income sensitive. There are things that you, you can't save up so much money and not be found uneligible. But they all have an ABLE account too. Right, the ABLE accounts can make a huge difference. Now one other thing that I want to mention, one thing that not everybody knows about regarding SSI and the Adult Family Care Program, is that you're actually eligible for a slightly higher SSI rate when you're living with a shared living provider. So what is the normal rate? I'm on SSI, what is the normal rate for 7, 800 dollars a month? It's, I think it's 825 dollars and 4 cents if you're living independently. And then you add like 50 dollars on to that if you're living with a shared living provider. That's not a lot. No, it's not a lot. So how much does the shared living provider take from that for rent? So the rent, no actually what it is is it's a room and board rate and the maximum is 725.69 And that includes your lights, rent, heat, basic telephone service, and all your food. They cook for you? They do the cooking for you unless cooking is something that you want and still can do. What if someone would say I'm the NASA's Mieski kosher? Oh absolutely, we put that into the matching process and we let them know right from the start. No pork? No, no. Yep, so these are the things and that's, we talk a lot, I mean it sounds silly but we do talk a lot about food. When we're talking to people getting to know them, we find out you know what drives you nuts? What can you not tolerate? And then the home provider has to be on board with that. Or because the family in the same room, like because my wife and I keep kosher, so we can't be in the same room with someone that's cooking fatback or something. We would be, we would be, that would be one of the screening questions when we're interviewing home providers. We're going to talk about you know what does food look like? You know if you've got somebody who is strictly vegetarian and they can't even stand the smell of meat cooking and you move them into a home with somebody who all they cook is meat, you're looking at a cow's trouble every single day. You're in Vermont and this farmer's market's everywhere, so. But that's important, you know if you've got, if you can't stand the smell of garlic but all the home provider cooks is garlic, it's not necessarily going to be an easy match. If you can't, if you can't stand, let's just say you can't stand the smell of horse manure, you're in Vermont. Don't, don't live on a farm. But everybody's got things, yeah, everybody's got pet peeves and we take those into account because we know that as much as, as much as I might like, might like somebody, if our, if our interests and our personalities don't match, it's not going to be a successful placement. So you know earlier you asked me how long does it take to get somebody in and, and the record is. Hope that wasn't a bad question. No, that was, that was a great question. The, the, the fastest that we've ever done has been three days. I've, I've had intake processes take nine months because I needed to find the right home. And it's really hard to get to know somebody for real with meeting them for two hours. So you don't want to, I mean, unless there's an emergency situation, you don't want to rush a match because. And you don't want to, let's say you don't want to place someone in the home like if there's bad pipes or. No, and we, we, so the state of Vermont. Basement apartment, you're not allowed to really have a basement apartment because of mold. Well, basement apartments, if they're set up correctly are fine. They have to be set up correctly. So one thing that we do also is the state of Vermont requires that homes, a home safety inspection and accessibility inspection, if it's required is done prior to placement. Now they will make, you know, when we get those emergency cases where somebody's, it's going to be on the street or living in a home that we haven't inspected yet, the state will grant a variance based on extenuating circumstance. Explain what a variance is? A variance is, is like an exception to the rule. So if the rule says all homes must be inspected and any, any deficits corrected before an individual can move in. If we haven't had a chance to, to get the state contractor out to do the home inspection, but somebody is going to be homeless, the state can issue a variance in really unique situations. It requires the individual or their guardian to sign off that they're, they're okay with that application for a variance. But it's, it's, we've got health and wellness guidelines and we've got state home safety inspection guidelines that have to be maintained. If they're not, we can't move them in unless we ask for variance and be granted a variance. And, and those are very, very, very infrequent. Because the goal is going to be that we're going to be looking from a pool of home providers that already have home inspections done. Part of the, part of the application process is now going to be including, you know, a pre-inspection. So people know what they need to do before the home inspector even comes out. And with the home inspection takes one day or two days? The home inspection, I think it takes about an hour and a half. They're going to check window sizes in the bedrooms. They're going to check smoke detectors. They have to have a photo electric smoke detector, a regular photo electric. It detects a different type of smoke. So there's a requirement for a couple of different smoke detectors in the home. One smoke detector has to be in the individual's bedroom. The window size in the bedroom has to be a certain dimension. The home has to have a... If the person has a wheelchair, the door has to be a certain... Yep. So they have to do an accessibility review as well. Many homes won't pass an accessibility review without... And it doesn't mean that it wouldn't be accessible to that individual. So what needs to happen is we do the accessibility review, and then we have that individual, a physical therapist or occupational therapist who works with that individual, who knows that individual, come in and reassess and say, okay, they don't need to have... They fit just fine through the 32 inch doorway. It doesn't have to be made 36. They are able to do... They're able to turn a regular doorknob, or the toilet seat is a certain height, but that works for them. So it can still be personalized. It's the home safety inspections that there's very, very little wiggle room. There have to be railings. There have to be... And the exceptions, the few unique cases where there's a variance where, say, there's a home inspection that... What if there's a historic... Let's say somebody lives in a historic building. They don't necessarily need accessibility. So if the individual needs accessibility, then the home has to be accessible to that individual. There's no budging on that. But if somebody doesn't say... So say, for example, somebody can walk just fine, then we don't have to do an accessibility review. It's if somebody uses a walker or a wheelchair. Those are the things that will trigger the need for an accessibility review as well. All right. Abledon Air, major sponsorship was given by three mountain support services, empowering neighbors with disability to be home in the community. Also sponsorship was given by Washington County Mental Health Services, where hope and support come together, and Champlain Community Services of Vermont.