Funding for Housing Services Great Lakes Indian Housing Association - - PowerPoint PPT Presentation

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Funding for Housing Services

Great Lakes Indian Housing Association 11.2019

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YOUR PRESENTER

Ashley Hesse Senior Consultant/ Policy Director

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Our Purpose

We are on a mission to create health equity for American Indians and Alaska Natives In One Generation.

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WHO WE ARE

+ +

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Outcome:

STRATEGY – SERVICE DEVELOPMENT

4 Peaks - How We Work

A Guided Journey to Enhance Indigenous Health Models Healthier Lives for Citizens, Families, and Non Natives Increased Financial Performance to Strengthened Sovereignty Improved Community for Future Generations Your tribal culture Indigenous pact consultancy Indigenous pact collaboratives Vision Design Deploy Sustain

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OVERVIEW SLIDE / TABLE OF CONTENTS

Funding: Supportive Services Housing as Health Current state-Tribal housing needs Housing Instability and SDOH Housing & support services Future State- Tribal housing

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CURRENT STATE OF HOUSING IN INDIAN COUNTRY

What have we learned about Tribal housing needs

HUD Housing Needs Study 2011 Capacity Funding ‘road maps’ Planning Processes Rules and Regulations

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CAPACITY

A need for capacity building at the Tribal level in many areas.

• Enhancements of general administrative abilities
• A need for specialized training in such areas as finance and environmental monitoring
• Grant writing technical assistance and technical knowledge to secure federal funding
• Stronger energy use assessment, planning, and visioning

What Is:

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PLANNING PROCESSES

A need for Tribes to have more comprehensive planning processes.

• Focus on such issues as prioritization of housing services needs
• Increase health prevention and mitigation activities
• Develop comprehensive energy planning
• Build capacity for the efforts mentioned

What Is:

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FUNDING RESOURCES

Tribes need to develop “road maps” that can give guidance regarding funding resources.

• Information about the availability of non-federal funding
• Funding resources for supportive housing services*
• Develop comprehensive plan and a united effort to draw from breadth of resources

What Is:

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REGULATION AND PROCESS

There is a need to simplify and make more consistent the regulations of the various federal and state programs that provide funding and services in Indian Country.

• Conflicting rules and regulations effectively limit housing development.
• Various application processes can make it difficult for Tribes to effectively access many available

resources.

What Is:

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HOUSING INSTABILITY & HOMELESSNESS

Self-Actualization Esteem Belongingness Physiological Needs Self-fulfillment, achieve individual potential Self-esteem, respect from others Love, family, friendship Safety and Security Air, water, food, shelter

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Persons with HIV/AIDS Victims of domestic violence Homeless veterans Alcohol and drug addiction Fire, Flood and other natural disasters Serious and persistent mental illness Many reasons for housing insecurity and homelessness Job loss and unemployment Homeless adults Discrimination Incarceration Homeless adults with children (families) Physical or developmental disabilities

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HOW DOES HOUSING AFFECT HEALTH?

3 Primary Interrelated aspects that affect health:

These factors not only shape home and neighborhood conditions but also affects the overall ability of families to make healthy choices. Housing impacts all SDOH domains Health Care

Social Determinants

• f Health

Education Economic Stability Social & Communit y Context Neighborhood & Environment The physical conditions within homes Conditions in the neighborhoods surrounding homes Housing affordability

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In general the nature of supportive housing is to provide housing options and supportive services to homeless individuals and families transitioning from homelessness into transitional and permanent housing with the goal of living as independently as possible.

SUPPORTIVE AND PERMANENT SUPPORTIVE HOUSING

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NO CLEAR PATH OR SINGULAR SOLUTION

Federal Programs including HUD/ ONAP/DOI/USDA-RD/EDA/RCAC//USDA- RUS/DOJ/USDA/DHS/FEMA/SAMHSA and

• ther programs
• Indian Housing Block Grant Competitive

Grant

• Indian Housing Block Grant
• Indian Community Development Block

Grant

• Section 184 Home Loan Guarantee
• Title VI Leveraging
• Tribal HUD-VASH
• Hawaiian Programs

State Programs Private and Corporate Foundations NGOs Medicaid Waivers/ Demonstrations Etc… Tribe DOJ NGO HUD-VASH HUD USDA-RUS RCAC FEMA DHS EDA USDA-RU ONAP SAMHSA STATE USDA DOI

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MEDICAID WAIVER & SUPPORTIVE SERVICES

Medicaid is a shared State- Federal health care program with broad reaching and varied services and programs

Medicaid waiver is an agreement that allows states to waive certain Medicaid program requirements Home & Community-Based Services 1915(c)(i)(j)(k)– Waivers: variety of unlimited state tailored services to meet needs of targeted groups (age, diagnosis, HIV/AIDS, etc.) Can provide medical and non-medical services. States can propose ‘other’ types of services to assist in diverting or transitioning people from institutional settings into their home of community. 1115 Demonstration Waivers: Gives Secretary of HHS authority to approve experimental, pilot, demonstration projects that promote the objectives of Medicaid.

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GENERAL SUPPORTIVE SERVICES (HOUSING)

4.1. General Supportive Services Name of Service Provider (*Tribal

• r Non-Tribal

Legal Entity) On-site or Off-Site State Medicaid program equivalent (Yes/No- details) Tenant orientation/move-in assistance Tenant’s rights education/tenants council Case management Coordination of all resident services Psychosocial assessment Individualized service planning Individual counseling and support Referrals to other services and programs Crisis intervention Peer mentoring Support groups (list below) - Life Skills Recreational/socialization opportunities Legal assistance Transportation Meals Other nutritional services Emergency financial assistance (specify) Including but not limited to: Assistance with obtaining identification Bus Passes (as necessary) Co-pay for prescriptions (as necessary) Furnishings Other (specify):

19 4.1. General Supportive Services Name of Service Provider (*Tribal or Non-Tribal Legal Entity) On-site or Off-Site State Medicaid program equivalent (Yes/No- details) Tenant orientation/move-in assistance Tenant’s rights education/tenants council Case management Coordination of all resident services Psychosocial assessment Individualized service planning Individual counseling and support Referrals to other services and programs Crisis intervention Peer mentoring Support groups (list below) - Life Skills Recreational/socialization opportunities Legal assistance Transportation Meals Other nutritional services Emergency financial assistance (specify) Including but not limited to: Assistance with obtaining identification Bus Passes (as necessary) Co-pay for prescriptions (as necessary) Furnishings Other (specify):

MA SPECIALIZED TRANSPORTATION (WAIVER):

MA Specialized Transportation

Service offered in order to enable individuals to gain access to community services, activities, and resources specified by the plan

• f care. Specialized transportation services

include those services that assist in improving the person’s general mobility in the community, increase independence and participation, and prevent institutionalization. Transportation services shall be offered in accordance with the individual’s plan of care. Specialized transportation services may consist of material benefits such as tickets, or

• ther fare medium, or a payment covering all

costs associated with the conveyance of program participants and their attendants.

Examples of Services and Supports for this category Y – Currently Provide N – Do Not Provide Cost to Provide (If Known) Pre-purchase or provision of tickets, passes, vouchers, or

• ther fare medium

Direct payment to providers covering the cost of transport Other services not listed

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INDEPENDENT LIVING SKILLS (HOUSING)

4.2. Independent Living Skills Name of Service Provider (*Tribal

• r Non-Tribal

Legal Entity) On-site or Off-Site State Medicaid program equivalent Communication skills Conflict resolution/mediation training Personal financial management & budgeting Credit counseling Representative payee Entitlement assistance/benefits counseling Training in cooking/meal preparation Training in personal hygiene and self-care Training in housekeeping Training in use of public transportation Assistance with activities of daily living Other (specify):

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DAILY LIVING SKILLS TRAINING (WAIVER)

Examples of Services and Supports for this category Y – Currently Provide N – Do Not Provide Cost to Provide (If Known) Money management and financial literacy skills training Training of basic home care maintenance and housekeeping Training of selfcare skills and personal hygiene Training of skills necessary for accessing and using community services Training in use of public transportation systems and mobility access Training in cooking/meal preparation Conflict resolution and mediation training Other training and assistance you provide that is not listed Daily Living Skills Training Daily Living Skills Training (DLST) is the provision of education and skill development to teach members the skills involved in performing activities of daily living, including skills intended to increase the member’s independence and participation in community life. DLST may include teaching money management, home care maintenance, food preparation, mobility training, selfcare skills, and the skills necessary for accessing and using community

• resources. Daily living Skills Training may

involve training the member or the natural support person to assist the member.

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HEALTH / MEDICAL SERVICES (HOUSING)

4.3. Health/Medical Services Name of Service Provider (*Tribal

• r Non-Tribal

Legal Entity) On-site or Off-Site State Medicaid program equivalent Routine medical care Medication management or monitoring Observation of medication regimen can be provided although specific management and monitoring is not included in this scope of service Health and wellness education Nursing/visiting nurse care Home health aide services Personal care HIV/AIDS services Pain management Other (specify):

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MENTAL HEALTH SERVICES (HOUSING)

4.4. Mental Health Services Name of Service Provider (*Tribal

• r Non-Tribal

Legal Entity) On-site or Off-Site State Medicaid program equivalent Individual psychosocial assessment Individual counseling Group therapy Support groups (specify below) Peer mentoring/support (describe below) Medication management/monitoring (specify below) Observation of medication regimen can be provided although specific management and monitoring is not included in this scope of service Education about mental illness Education about psychotropic medication Psychiatric services (specify below) Liaison with psychiatrist (describe) Psychiatric nurse Other (specify):

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BEHAVIORAL HEALTH CREDENTIALING AND RESOURCES (EXAMPLES)

MICHIGAN LINKS TO REFERENCES AND RESOURCES

• Michigan Medicaid State Plan
• Medicaid Provider Manual, July

2019

• State Plan Amendment, January

2018

Note: (1) Qualified Behavioral Health Professional must be Physician or licensed practitioner (e.g., APRN, Psychologist, LCSW, PA, etc.) with specialized training and experience or hold minimum

• f Masters in a mental health field or a BACB approved degree.

MICHIGAN Medicaid Expansion: Yes Non-Physician Eligible Providers MICHIGAN PROVIDER TITLE TYPICAL MINIMUM DEGREE (FIELD) Psychologist Doctorate (Psychology) Limited Licensed Psychologist [LLP] Doctorate (Psychology) Pharmacist Doctorate (Pharmacy) Physician Assistant [PA] Completion (PA Program) Registered Nurse [RN] Completion (RN Program) Licensed Practical Nurse [LPN] Completion (LPN Program) Nurse Practitioner [NP] Masters (Nursing) Psychiatric Mental Health Nurse Masters (Nursing) Licensed Social Worker [LSW] Masters (Social Work) Social Worker Bachelors (Social Work) Licensed Clinical Social Worker [LCSW] Masters (Social Work) Licensed Marriage and Family Therapist [LMFT] Masters (Marriage and Family Therapy or Related Field) Licensed Professional Counselor [LPC] Masters (Counseling or Related Field) Substance Abuse Specialist [SAS] Masters (Human Service Field) Board Certified Behavior Analyst [BCBA] Masters (Behavior Analysis or Related Field) Board Certified Assistant Behavior Analyst [BCaBA] Bachelors (Behavior Analysis or Related Field) Behavior Technician High School Diploma; Completion (Training Program) Community Health Worker [CHW] High School Diploma; Completion (CHW Program) Peer Support Specialist High School Diploma; Completion (Training Program) Registered Art Therapist, Masters (Art Therapy or Related Field) Qualified Behavior Health Professional See Note (1)

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SUBSTANCE ABUSE SERVICES (HOUSING)

4.5. Substance Abuse Services Name of Service Provider (*Tribal or Non- Tribal Legal Entity) On-site or Off-Site State Medicaid program equivalent Recovery readiness services (tenants with active addictions) Relapse prevention and recovery planning Substance abuse counseling (individual) Substance abuse counseling (group) Methadone maintenance Harm-reduction services (specify) AA/NA/CA Sober recreational activities Other (specify):

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BEHAVIORAL HEALTH CREDENTIALING AND RESOURCES (EXAMPLE)

Note: (1) Qualified Treatment Trainee [QTT] is a graduate student or graduate (but not yet credentialed) in following fields: psychology, social work, MFT, nursing, or counseling.

WISCONSIN Medicaid Expansion State: No Non-Physician Eligible Providers WISCONSIN PROVIDER TITLE TYPICAL MINIMUM DEGREE (FIELD) Psychologist Doctorate (Psychology) Licensed Psychotherapist Masters (Psychology) Registered Nurse [RN] Completion (RN Program) Licensed Practical Nurse [LPN] Completion (LPN Program) Advanced Practice Nurse Practitioner [APNP] Masters (Nursing) Nurse Practitioner [NP] Masters (Nursing) Psychiatric Nurse Masters (Nursing) Advanced Practice Nurse Prescriber [APNP] Masters (Nursing) Psychiatric and Mental Health Nurse Practitioner - Board Certified [PMHNP-BC] Masters (Nursing) Clinical Nurse Specialist [CNS] Masters (Nursing) Licensed Clinical Social Worker [LCSW] Masters (Social Work) Advanced Practice Social Worker [APSW] Masters (Social Work) Licensed independent Social Worker [LISW] Masters (Social Work) Master Social Worker [MSW] Masters (Social Work) Licensed Professional Counselor [LPC] Masters (Counseling or Related Field) Licensed Marriage and Family Therapist [LMFT] Masters (Marriage and Family Therapy or Related Field) Certified Substance Abuse Counselor [CSAC] High School Diploma; Completion (Training Program) Certified Substance Abuse Counselor in Training [CSAC-T] High School Diploma; Completion (Training Program) Certified Clinical Substance Abuse Counselor Associates (Behavioral Science Field) Licensed Behavior Analyst [LBA] Masters (Behavior Analysis or Related Field) Behavioral Treatment Therapist Bachelors (Behavior Analysis or Related Field) Behavioral Treatment Technician High School Diploma; Completion (Training Program) Focused Treatment Therapist Bachelors (Behavior Analysis or Related Field) Qualified Treatment Trainee [QTT] See Note (1)

WISCONSIN LINKS TO REFERENCES AND RESOURCES

• Wisconsin Medicaid State Plan
• Mental Health / Substance Abuse

Services – Terms of Reimbursement

• 4.19-B Non-Institutional Services
• Forward Health Medicaid Provider

Home Page

• Provider Enrollment for Behavioral

Treatment Benefit October 2015

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EMPLOYMENT SERVICES (HOUSING)

4.6. Employment Services Name of Service Provider (*Tribal

• r Non-Tribal

Legal Entity) On-site or Off-Site State Medicaid program equivalent Job skills training Education Job readiness training: resumes, interviewing skills Job retention services — support, coaching Job development/job placement services Opportunities for tenants to volunteer Other (specify):

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EMPLOYMENT SERVICES (SUPPORT SERVICES)

4.7. Services for Families Name of Service Provider (*Tribal

• r Non-Tribal

Legal Entity) On-site or Off-Site State Medicaid program equivalent Support group for parents Support group for children Support group for families Assistance in accessing entitlements Parenting/child development classes All-day childcare After-school care Temporary childcare during parent’s illness, detox, etc. Tutoring children Other children’s services provided (specify): Referral to other children’s services (specify): Domestic violence services Family advocacy (specify): Family reunification (specify): Other family services (specify):

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• Land acquisition, restoration, and timing of fee-to-trust transactions
• Internal and external challenges to housing quality and community wellness
• Community re-integration/ placement of frail elders, disabled, addicted or incarcerated individuals
• Comprehensive community planning to include public, private, and Tribal resources to drive the vision of the

future

• Emerging knowledge markets to sustain housing (entrepreneurship, business development, energy, finance,

construction tech and more…)

• Leverage all resource- reduce reliance on federal grants and strive to access all sources of capital
• Maintain and assert tribal sovereignty and educate non-AIO/AN legal and administrative systems
• Development, operations, and maintenance costs
• A Home is more than just a shelter

FUTURE OF TRIBAL HOUSING

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Thank You

CONTACT US

P H O N E

920-530-8200

E M A I L

hello@indigenouspact.com

W E B S I T E

indigenouspact.com