Recommendations for Safer Senior Living

MLTSS – success!

Mom is in the MLTSS program! Whoopee!

At the end of March 2016 we received a letter from CCDSS that 20 days to provide info on the CDs that we had cashed in to buy her pre-paid funeral arrangements. We sent that in right away (we found faxing documents to be a great way to get a receipt that they had been sent).  On April 27, 2016 Mom was approved for the MLTSS Global Options Program, effective date 1/1/2016.

This was very exciting, until the next day when we went to the CVS to pick up her prescriptions, and found that she had already been dis-enrolled from the PAD program, and we had to pay cash for her prescriptions. I was told that Medicaid would cover that now, but we hadn’t received any info about that.

After calls and waiting etc, finally we were told that we had to choose a plan to have the Medicaid administered through. Her doctor’s office said they accept Horizon NJ Health and so I sent in the paperwork for that. We received the cards (with wrong doctor name) in mid-May.  (In July we received the correct card).

On June 23, a social worker from Horizon NJ Health visited Mom, and did an intake and needs evaluation interview.  She set up Mom to get a (subsidized) LifeLine service, and free frozen meals.  We could have gotten an automated med dispenser but it was more similar to R2D2 than anything, and wouldn’t work for Mom.  On July 6, a nurse from Horizon NJ Health came by to do a medical assessment.

A very nice thing is that because the Medicaid was backdated, we are receiving reimbursements for medical and medication expenses we paid in 2016.  I asked the social worker is this money will put Mom over the financial limits, and she advised that we keep careful records of where the money is spent.

Next week Mom has a doctor’s appointment with her regular physician, and hopefully the transfer to the new insurance will go smoothly.






MLTSS in NJ – update since last post

I met with an eligibility worker in Camden on December 12, 2015. The line at the CCBSS building was almost out the door, but because I had an appointment, the security guard directed me to a room where fewer people were waiting. I was called on time to go to an office for the meeting.

The worker was friendly, and we were both glad that I had most of the documents necessary to determine Mom’s eligibility. (The county had included a list of necessary documentation to bring with me, included on the letter that had the appointment time. The meeting took about an hour.

On 12/15/15, I received a letter from the worker that had a listing of the items still needed to establish eligibility for the MLTSS-Comm Program.
The letter said: “This notification is to advise you of the following decision concerning your eligibility for the Medicaid program: Pending for 30 days until 1/14/2016.

The documents Mom still needed to provide were:
Proof of all resource 12/20/2010 to present. I already had the 5 years of bank statements, but I had to present and submet bank verification of all withdrawals and deposits of $1000 and up, and all transfers in that amount. They actually went through all 5 years, and gave me a list of the dates and amounts that I had to provide verification for. Yikes! They wanted deposit slips and verification of how the money was spent. We didn’t have receipts from every transaction, but I knew that my brothers visited at the time of the withdrawals, so I wrote a signed paper that said the money was used to host her children’s visit. I don’t know if that will be enough, because I haven’t heard back from the county.

Also, they needed to make sure that the AARP payment was just for membership, and not a life insurance premium.

IMPORTANT: Mom doesn’t file taxes any more, so I was unable to provide tax returns for her, although the County required them. I had to send a form to the IRS to request a transcript of the last 5 years. Since she didn’t file returns, the IRS didn’t have her address, and so didn’t send the transcripts in time! I had to file a Form 8822 (change of address) and resubmit IRS Form 13873-T. I don’t know if this will cause a problem.
I recommend that you immediately get the previous 5 years of tax returns when you decide to ask for Medicaid. It was a mistake to just let it go since Mom doesn’t file.

The paperwork sent from CCBSS on December 15, 2015 also included paperwork to request a Fair Hearing. It said the appeal must be filed within “20 days of the date of this letter.” I don’t know yet if we will have to file for a Fair Hearing until the decision is made.

MLTSS in New Jersey – December 2015

MLTSS and how to apply for this program in Camden County, NJ

Managed Long-Term Support and Services is Medicaid/SSI program run by the State of New Jersey that offers a variety of ways to help elderly people stay in their homes, and will cover assisted living and nursing homes if your insurance company won’t.

MLTSS on the NJ Website

I am in the process of applying for MLTSS because I want to get help for my mother to stay in her (senior) apartment, until she can’t stay safe there independently, so I also need to get the ball rolling for an assisted living placement. This process takes time and energy, and you have to do it yourself, so get started as soon as you can. Here are the steps in the order I did them.

(The program my mom needed was formerly the “GO Program”:Global Options for Long-Term Care Program (GO).
These programs have provided a combination of both traditional medical services (i.e. dental services, skilled nursing services) as well as non-medical services (i.e. respite, case management, and environmental modifications) to those who meet both the established clinical and financial criteria. These programs were implemented to provide support services to an individual in the community to: prevent placement in an institutional setting (e.g. nursing home or hospital) or provide support to individuals who are re-entering a community setting after a period of institutionalization.)

(If you don’t already have Power of Attorney, get it now. Some people I spoke with said they couldn’t legally speak with me about Mom’s case without it.)

10/24/2015 Camden County Board of Social Services: Danielle (856) 858-2438
Over the phone, Danielle asked a series of general questions about Mom’s situation, focusing on safety (medications, personal care needs, transportation) and asked some general questions about Mom’s finances.
Danielle determined that Mom would be appropriate for the program. She gave me the general CCBSS number to call to schedule an appointment, and I tried it forever, couldn’t get through to anyone.

This is a one page form to be completed by the family physician. The form requires short answers about “Medical Care Needs” such as primary diagnosis, physical/cognitive limitations, and the last question is “Is there reasonable indication that the patient might need hospital or nursing home care within 30 days without home and community-based services?” Mom’s doctor answered yes to this.
The doctor completed this form on 11/16/2015, mailed it back to me, and then on 11/18/2015 I mailed a copy of it to:
Camden County Board of Social Services
Attn: Medical Unit A
600 Market Street
Camden, NJ 08102

(609) 704-6050 State of NJ Department of Human Services. They told me Mom’s case had been assigned to a nurse, and the nurse would be calling to schedule a home visit for assessment.
I haven’t yet received an application for SSI, I don’t know why. But mailed with the PA-4, there was a list of financial documents that would be required for the application. I have been getting those together.

11/25/2015 Julie Kobian, RN came to Mom’s apartment (609) 704-6050
The state nurse was here for 2 hours. During that time she reviewed the discharge paperwork from Mom’s hospitalizations/medications, read reports from the doctors, performed a quick physical, and observed Mom move around the apartment. She also asked Mom about her safety. At the end of the meeting, the nurse told us that she deemed Mom medically eligible for SSI. This eligibility is good for one year, so we have time to get the financial steps completed.

In order to qualify for Medicaid you must be 65 years old or blind or disabled and either a US Citizen (or lawfully admitted for permanent resident) and a resident of New Jersey.
Documents which should be included include but are not limited to:
Age: US passport, birth certificate, driver’s license, baptismal certificate, state-issued ID.
Citizenship: US passport, birth certificate, naturalization papers, alien registration card, final adoption decree.
Identity: US passport, photo license, school ID, US military ID
Marital Status: marriage certificate, divorce decree, death certificate, separation papers.
(If the senior’s insurance doesn’t cover assisted living, this is what they need)

You are allowed only $2,000 in resources.
You must meet certain income criteria and be resource eligible. The income can be earned or unearned. You’ll need to gather documents that can prove how much money you receive each month, and what other financial resources you have (assets, social security, pensions, alimony, etc). Pre-paid, irrevocable burial arrangements and other policies with cash value are considered in this assessment, so have this documentation as well. You must provide the last 5 years of printed bank statements. (This may take up to two weeks to get.)
They also want to see Living Expenses: rent receipts, telephone bills, electric bills, water/sewer bills, health insurance bills, mortgage statements, gas/oil bills, renter insurance, unpaid medical bills, real estate tax bills, homeowner insurance, outstanding loans.
In addition to the documentation above, bring documents that show there is a designated Power of Attorney or Third Party Signator.

12/1/2015 Camden County Board of Social Services (856) 225-8264
I finally managed to schedule an appointment to go to Camden County BSS on Tuesday, December 15th at 10am. The worker said that Camden County had received the PA-4, and the medical approval (from the state nurse’s home visit). The worker said they would mail an application and the list of financial documents that I must bring with me to that appointment.

These are things that Mom needs, that MLTSS will qualify her for:

The Personal Preference Program
(609) 292-7800

The Personal Preference Program allows consumers to:
• Choose services they want
• Individually hire workers, people they know/trust including relatives, friends and neighbors
• Schedule services to meet their needs
• Exercise greater control over their lives (helpful!) and (academic) and (this link is pretty useless)

MLTSS Services
Managed Long Term Supports and Services

(Administered through SSI)

• TBI (traumatic brain injury) behavioral management
• Assisted Living (ALR/CPCH)
• Assisted Living Program in Subsidized Housing (ALP)
• Adult Family Care (AFC)
• Respite Care: daily and hourly
• Social Adult Day Care
• Residential Modifications
• Home-Delivered Meal Service
• Hospice
• Community Transition Services
• Caregiver/Participant Training
• Transitional Care Management
• Personal Emergency Response System (PERS): Set-up and monitoring
• Specialized Medical Equipment and supplies
• Chore services
• Transportation
• Attendant Care
• Home-based Supportive Care (HBSC)
• Physical Therapy (group and individual)
• Medication Dispensing Device: set-up and/or monthly monitoring
• Nursing Facility Services: Custodial
• Occupational Therapy (group and individual)
• Private Duty Nursing
• Speech, language and hearing therapy
• Structured Day Program
• Supported Day Services
• Vehicle Modifications
• MLTSS Personal Care Assistanct (PCA)
• Cognitive Therapy (group and individual)
• Non-medical transportation

More information I found to support a senior wants to stay at home:

Camden County Senior and Disabled Services
Aging and Disability Resource Center (856) 858-3220 or (877) 222-3737

Fifth Legislative District
MacKenzie Belling, Constituent Services Representative (856) 547-4800

Project Lifesaver: This program is offered by the Camden County Sheriff’s Office in an effort to provide enhanced support and assistance to residents with Alzheimer’s disease or a related dementia disorder. Participants wear a special wrist bracelet that –should they become lost, can assist local law enforcement in locating them using the mobile locator tracking system. (856) 225-5470

Helping Hands: a community outreach program designed to assist aging adults by providing help with non-medical tasks. (856) 757-3270 (M-F mornings only)

Senior Safe Home Program: Home safety repair for senior citizens in Camden County
(856) 663-1717

Sen-Han Transit: Non-emergency medical transportation, shuttle service, shopping, personal business, nutrition sites (856) 456-3344

Homemaker Assistance Network: HAN homemaker service helps you with home management and maintenance so you can continue to live as independently as possible. (856 456-1121

SNAP (Food Stamp) Outreach (856) 662-4884 ext. 144

Yale President Doesn’t Comply with ADA Standards

Developer Accused in Disabled-Access Suit

(from the article)
“A long-running dispute between the federal government and some New York developers over whether their buildings are accessible to the disabled escalated Monday with a lawsuit filed by the U.S. Department of Justice.

The suit charges one of New York’s biggest developers and two prominent architects—including the dean of the Yale School of Architecture—with violation of two federal laws, the Fair Housing Act and the Americans with Disabilities Act.

The complaint listed construction and design issues that it said made buildings inaccessible to people with disabilities, especially those who use wheelchairs, including: mailboxes or outlets that are too high; doorways that are too narrow; ramps that are too steep; and unnavigable steps to storage areas.

“We will not allow developers and architects who deprive people with disabilities of accessible housing,” said Preet Bharara, the U.S. attorney in Manhattan, in a news release, “to evade the consequences of their failure to comply with clear, long-standing federal civil rights law.”

Aging in Place Ideas for Renovations

Here’s a link to an article I wrote about Brooklyn apartments.
It was posted on – an excellent resource for all things Ocuupational Therapy.

Smarter appliances could assist with safer eating

Some older people don’t have good eating habits, and sometimes even food that started healthy can become dangerous unless is remains fresh. This technology can help keep track of what’s in the fridge.
“The computer could know how long a product has been there and alert users to impending expiration dates.”
Read the full article at Popular Science May 2013

Protected: Accessibility on the subway

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Spring Progress!

Super exciting that accessible cabsprivate urban transportation is getting more accessible! Now if only public transportation could do the same.

Cool Art, Cool People, and Useful Light Switches

I attended the Architectural Digest Home Show in Manhattan yesterday.
I spoke with Jason Tackmann at SoBro Studios about maybe casting grippable surfaces inside a shower stall, instead of installing ugly grab bars. We will stay in touch about that.
Also, I saw some really cool light fixtures made by Donna Brady at Re-Surface. Such beautiful lighting!
These light switches by LeGrand are exciting to me.

Bike storage and a closet shelf

bike storage
I built this for a nice family in the neighborhood. The walls are drywall, so it is bolted to studs. A bike and scotter rack tucked behind the door keeps the floor clear.
This shelf added a more storage space inside the closet.

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