Blake Elliott, an entrepreneur in the Medicaid-funded home-services business for the disabled, is gaining traction with a year-old program designed to cut government cost while increasing value for clients and underpaid caregivers.
Elliott, 39, was a rental-property owner when he started Bridges, which provides group homes and services for the developmentally disabled. He became interested in such services after his younger brother suffered traumatic brain and other injuries in a 2003 car crash.
There were no group homes in Melrose, Minn., where the family lived. And Elliott saw how his brother fared better at home with their parents, in a nurturing, familiar environment, rather than a nursing home.
Group homes for disabled folks who meet income guidelines, plus related home-health services, can run up to $100,000 in state-federal funded Medicaid expenses annually. There are nearly 20,000 Minnesotans in group homes, out of nearly 45,000 disabled Minnesotans assisted by Medicaid.
And, as I wrote in July, the state Legislature, hit with the budget-busting pandemic, declined to pass bills that would have increased the reimbursement rate to home-health agencies who pay personal-care attendants a median income of about $13 an hour.
And there is a shortage of these home-health aides.
The crew at Bridges, based in West St. Paul, with approval from the Minnesota Department of Human Services, launched “Rumi” last year to create a relationship-based model between developmentally disabled folks and full-time roommates who care for them in their homes.
Rumi is short for “ruminate,” which the client and potential caregiver do over several meetings to learn if they are a fit and can be “roomies” or roommates.
“We want to kill Bridges with Rumi,” Elliott said. “The current system is inefficient and antiquated. We spend billions caring for the disabled in Minnesota. We can do better.
“[The] four-person group home was a good first step [beyond state institutions of 50 years ago]. There’s a need to push innovation harder. You are still segregated in a four-person home. You live with three other people and staff. A group home is about $100,000 a year, whether you need 24-hour staff or not. Instead, for some people, they can move in with the caregiver, or the caregiver moves in with them, or you rent a home together.”
Under a state waiver that now covers 100 Rumi relationships, the licensed caregiver can also get that $13-an-hour wage doubled. That can mean $46,500 for working up to 50 hours a week with a disabled roommate. Such money helps the roommates cover housing expenses.
“That’s life-changing,” Elliott said. “And the IRS allows people who provide disability services in their own home to take that money tax exempt. And normally it would cost $100,000 on average per individual in a group home. The typical savings is about $65,000 a year.”
Bridges tends to focus on individuals with high needs, who otherwise would be in a group home or even in the remaining state hospitals or a ward of Hennepin County Medical Center. The Bridges crew received two $100,000 annual grants from the Minnesota Department of Human Services, in addition to what Blake has said was a much larger investment by Bridges, to build the Rumi system. It is made available to all who are interested.
“We think of ourselves as social entrepreneurs and we’re getting more and more confident in this model,” Elliott said.
Vacancies for group-home beds are scarce. That means that clients often must leave their home community and go to group-home settings with two or three people they don’t know.
Rumi is designed to give them options. And it also is designed to attract personal-care workers who want to make more than $13 an hour through a live-in commitment to one disabled person.
Safety concerns are allayed by background checks on personal-care applicants, plus interviews and several face-to-face meetings until it’s agreed that the parties are comfortable with each other. Rumi staff provides continued contact and compliance checks.
About 15% of the time, the two parties live in the caregiver’s house or apartment and about 15% of the time, they live in housing that is owned or rented by the person with disabilities. Otherwise, Bridges helps them find an apartment and they split the rent.
This venture has been met with bipartisan interest at the State Capitol, including Sen. Jim Abeler, the veteran Republican who leads the relevant committee. He quipped that this is the first time he could remember a health care agency not coming to the state to ask for more money for services.
Rumi bears exploring as part of the solution to a higher level of service for home-health services at a more economical cost.