Hutchinson Agreement. The agreement was initiated in 2008 and updated in 2013.

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2 Hutchinsn Agreement Hutchinsn v. Patrick is a federal class actin lawsuit brught n behalf f ver 9,000 persns with brain injuries wh are unnecessarily cnfined t nursing facilities in Massachusetts. The agreement was initiated in 2008 and updated in (Taken frm Center fr Public Representatin;

3 As a result f Hutchinsn Agreement, The Massachusetts Rehabilitatin Cmmissin and MassHealth, in cnjunctin with UMass Medical Schl and the Department f Develpmental Services, ffer tw hme- and cmmunity-based services waivers t help Medicaid-eligible persns with acquired brain injury (ABI) mve t the cmmunity and btain cmmunity-based services. In additin, MassHealth ffers tw Hme- and Cmmunity-Based Services (HCBS) waivers called the Mney Fllws the Persn Waivers (MFP Waivers), which helps Medicaid-eligible persns with a qualifying disability mve t the cmmunity and btain cmmunitybased services.

4 DDS perates all 24/7 staffed Residential Prgrams assciated with the ABI and MFP waivers. The fllwing mdels are as fllws: 2-4 persn grup hmes (mst cmmn) Shared Living Services Assisted Living

5 Must be living in a nursing facility r a chrnic r rehabilitatin hspital and have resided there fr at least 90 days; have experienced an acquired brain injury at age 22 r lder. An acquired brain injury can result frm a strke, brain trauma, infectin f the brain (such as encephalitis), brain tumr, r anxia (lack f xygen)*; meet the clinical requirements and need f the waiver services available; and meet the financial requirements t qualify fr MassHealth. Special financial rules exist fr waiver participants. Must be able t be safely served and is defined as the ability t remain in the cmmunity withut risk f significant harm t self r thers. *See What is an Acquired Brain Injury, MFP Transitin Entity Training April 2014.

6 Day service Supprted emplyment Transprtatin Occupatinal therapy Physical therapy Speech therapy Specialized medical equipment Transitinal assistance

7 Must be living in a nursing hme r lng-stay hspital fr at least 90 cnsecutive days, excluding Medicare rehabilitatin days be 18 years ld r lder and have a disability, r be age 65 r lder; meet the clinical requirements fr and be in need f MFP waiver services; be able t be safely served* in the cmmunity within the terms f the MFP waivers; meet the financial requirements t qualify fr MassHealth. Special financial rules exist fr waivers participants; In additin t the abve, t qualify fr the MFP-RS waiver, yu as an applicant must need residential supprt services with staff supervisin 24 hurs a day, seven days a week. *Safely served is defined as the ability t remain in the cmmunity withut risk f significant harm t self r thers.

8 Day Services Occupatinal Therapy Peer Supprt Physical Therapy Prevcatinal Services Specialized Medical Equipment Speech Therapy Supprted Emplyment Transprtatin Transitinal Assistance

9 A Transitin Meeting is scheduled rughly 2-3 mnths in advance f a persn mving and is intended t make plans and trublesht any issues in preparatin fr a participant s mve t the cmmunity. There are typically 2 r 3 meetings depending n the needs f a persn. Cmmn tpics f discussin include: Wh will I live with? Wh will help me with my care? Wh will give my medicatins? Wh will rder my medical equipment? What if my family desn t want me t mve? What if my dctr desn t want me t mve? What if I m nt happy after I mve?

10 Scial Wrker First pint f cntact Tends t knw the persn well Organizes the rest f the nursing hme team Nursing Staff Knws the persn s medical needs Knws the persn s persnal care needs Rehabilitatin Department Includes Physical, Speech, and Occupatinal Therapies Have knwledge f equipment needs Can rder equipment thrugh Masshealth

11 Service Crdinatr Organizes all transitin meetings Serves as liaisn between the Nursing Hme, Prvider, Participant, and Family Nurse Cnsults with team abut health cncerns and hw they will be managed in the future residential placement Risk Manager Cnsults with team abut present risk issues and risk issues that may arise pst-placement

12 Prgram Directrs Cnsistent presence in the hme Can serve as liaisn between staff, participants, and DDS Service Crdinatr Nursing Staff Ensures that staff are trained n necessary medical prtcls Mnitr verall physical well-being f participants Clinical Staff Ensures that staff are trained n the mental health needs f participants Develps and implements Psitive Behavir Supprt (PBS) plans

13 Participant Family Legal Guardian Friends

14 The Waiting Game It takes an average f 354 days frm enrllment t placement fr Prvider Based Residential Placements Weather, building permits, and ther unfreseen circumstances can delay a mve Equipment Depending n the needs f a participant, prper medical equipment can take sme time t rder Finding new medical prviders Medicatins

15 Adapting t Cmmunity Living Relatinships Lifestyle cnsideratins Receiving help frm ther peple Cmmunal Living

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