Increasing the Quality of Lives and Saving Money:

Nebraska’s Comprehensive Service Delivery Model for

Assistive Technology and Home Modifications

September 11, 2003

System Overview• Employment

– Solutions On Site– One Stop Centers/Workforce Development

• Independent Living– HHS Aged and Disabled Medicaid Waiver

Home & Community Based WaiverMedically Handicapped Children’s ProgramDisabled Children’s ProgramDisabled Persons and Family Support ProgramPublic AssistanceSubsidized AdoptionAdult Protective ServicesChild Protective Services

– Voc Rehab Part B

• Housing– Making Homes Accessible– Home Of Your Own

On Site Technical Assistance

Offices in •Omaha•Lincoln•Kearney•North Platte•Scottsbluff

4 Vans12 Technology Specialists

Funding Coordination

Developed and used Developed and used cooperatively by over 18 cooperatively by over 18 agencies across Nebraskaagencies across Nebraska

Simple and effectiveSimple and effective

Includes release/agreement pageIncludes release/agreement page

Equipment Re-use• Average cost of an exterior lift installation has gone

from $4,384 in Year 1 to $4,043 average cost in Year 4)

Why?

State Data

• Statewide study in 1994-95– 25,000 households with a member with

a disability in Nebraska – Less than half (46%) of households

with a member with a disability had home mods

– Of those most critical, 70% needed financial assistance

– Substandard housing often coincided with need for accessibility

Issues

• Lack of awareness and information

• Lack of providers statewide

• Fragmented services and funding

• Unclear funding policies

• Lack of consumer support (getting through

the system)

Experience

• 66.2% Home modifications• 15.4% Vehicle modifications• 18.4% Assistive Technology

• Includes HHS, VR Title I, VR Part B, MHA, NVA

• Over 5 year period– $7.7 million on home modifications

• Doesn’t include VR Title I dollars

Home and Community Based Waiver- Aged and Disabled

Assistive Technology and Supports

Home Modifications

• Increase abilities to perform activities of daily living

• Control the environment in which s/he lives

• $5,000 cap

• Function with greater independence in the home and is

• Necessary to keep the individual in their home

• $5,000 cap

Process - The Checklist

• Referral is made

• Identify a SolutionDiagnosis/Progression, Functional Abilities/Limitations, Roles, Assistance Available

• Assessment write-up

Process - The Checklist

• Verify ownership of property

• Draw blueprints & write specifications

• Consumer/Landlord approval

• Quote packets

• Award the project

• Update database

Process - The Checklist

• Send approval paperwork to Lincoln

• Monitor construction process

• Final inspection

• Project completion paperwork

Home Modifications-5 years• Bath mods $3,531,000

• Exterior Lifts $1,143,000

• Ramps $1,295,000

• Entrance mods $436,000

• Interior Lifts $430,000

• Other Home mods $556,000

2,173 Waiver projects

Half of the individuals are under the age of 55 and half of the individuals are over the age of 55.

Birth - 3

three - 17

18 - 20

21 - 54

55 - 64

65 - 74

75 – 84

85 and older

Home Modification Funding Resources• Aged and Disabled Medicaid Waiver

$7,190,000• Vocational Rehabilitation Part B

$354,000• Aid to Aged, Blind, and Disabled

$291,500• Nebraska Veteran’s Aid Fund

$141,000

Home Modification Funding Resources• Disabled Childrens Program

$108,000• Disabled Persons and Family Support

$137,000

• Barrier Removal (CDBG)

$125,500• Making Homes Accessible (HOME)

$788,500

System Outcomes

• More contractors• More appropriate and

cost effective solutions• Consumer satisfaction

• More funding / cost savings• Increased collaboration• Starting point and a defined process• Geographic access