Topeka, Kansas: Topeka Independent Living Resource Center

Topeka Independent Living Resource Center

Since 2013, people in Kansas who want to move out of nursing facilities are initially referred to private, for-profit managed care organizations (MCOs).  These MCOs have contracts with community-based providers to assist people to move into the community. For people in Topeka and three surrounding counties, that’s where the Topeka Independent Living Resource Center (TILRC) comes in.  Each year, TILRC helps 10 to 15 people a year move out of nursing facilities.

The biggest challenge, of course, is finding affordable, accessible housing.  Usually this is accomplished by assisting people transitioning out of nursing facilities in applying for and securing rent-subsidized apartments in high rise developments for people with low incomes in Topeka. TILRC staff help those it assists fill out applications and communicate with landlords. But often there are more basic tasks that need to be completed before that can be done. Many nursing facility residents don’t have the basic documents needed to submit a housing application, such as state IDs, Social Security cards, and income statements.

Once those things are acquired and housing is secured, TILRC staff use a checklist to help the people they assist determine what furniture and  household items they will need. A budget for purchasing these items is developed and once the MCO approves the budget, TILRC staff help the people shop for items needed when first establishing a home. TILRC covers the cost and is reimbursed by the MCO. Budgets are usually around $150.

From 2007 to 2013, a state agency performed the functions now handled by the MCOs. Funding came mostly from the federal government through Money Follows the Person legislation of 2005. Before 2007, TILRC still helped people transition but no funds were available for paying deposits or purchasing furniture and household goods. In those days, TILRC sought out donations of furniture and turned to agencies like the Salvation Army and Community Action for deposit funds. When a person transitioned, state funds were shifted from the nursing facility budget to the home and community -based services budget to pay for that person’s in-home assistants.

In Kansas, there is a waiting list for people wanting to receive home and community-based services. However, people transitioning out of nursing facilities can bypass that waiting list and start receiving assistance in their new home as soon as they move into the community.

How TILRC has helped Bill

Bill loves working as a mechanic. He’s fixed everything from cars to lawnmowers. He even fixed helicopters when he was in the marines for four years in the 1980s.

He moved to Topeka, Kansas from Freemont, Nebraska in 2002 because he figured mechanic jobs would be more abundant there. Indeed, he found work as a mechanic at a motorsports park. He did everything thing there from mowing grass to shoveling snow. “I loved that job,” Bill says.

Bill proudly drove a 1979 Chevy which he fixed up himself. He tinkered with a lot of vehicles on the side, including a used Harley Davidson motorcycle. One day in April 2015, he took the Harley out on the road. "I took it for a ride around the block. The front tire came off and it flipped over on top of my head."

Bill says he was in a coma for six months. He doesn’t remember the accident. He remembers being in a nursing facility about three hours outside of Topeka and he was trying to figure out how to live with a permanent brain injury. Ten months later, he was transferred to a nursing facility in Topeka. "Believe it or not I got up every morning at four a.m. I took a shower. I got dressed and I spent the day working wherever they needed me." He helped keep the grounds. He mowed grass. Sometimes other residents asked him to fix their wheelchairs.

He remembers one of his rooms being infested with bedbugs. He says the food was "bland and distracting. I like spicy food!" But his main motivation to get out of the nursing home was his strong desire to return to work as a mechanic. So TILRC staff accompanied him to view several apartments before he chose the one-bedroom apartment where he now lives in a rent-subsidized building for people with disabilities and older people with low incomes. After spending 18 months in the Topeka nursing facility, he moved out in July 2017. Assistants come every day to help him with activities of daily living. "The way I got (the apartment)  built now, I love it,"  says Bill. His prize possession is his television with a 50-inch screen. "I’m a lot more free now," Bill says. He likes to walk from his apartment to places like his local Walmart.  He even once walked 64 blocks to a Harley Davidson shop and back.  But when he walked from a nursing facility to Walmart, the staff told him not to do it again. They said it was too dangerous because of the lack of sidewalks. The food Bill eats now is a lot more spicy. And he still hopes to get a job as a mechanic.

How TILRC has helped Albert

The nursing facility Albert abruptly entered in the winter of 2015 called itself a Health and Rehabilitation Center. Albert says, "I was misled. I felt that I would go there for a month or two and get better." It was isolated away in tiny Onaga, Kansas, population 702. It was surrounded by farmland. Once a week, the nursing facility’s bus took residents into town. Once a month, it took them to Walmart. Albert says he felt especially isolated from his three children, who lived about 50 miles away. They are the most important people in his life. He got to see them only about once a month when he was in the nursing facility.

Albert entered the nursing facility after a leg wound he sustained in an accident got so infected that the leg had to be amputated. Prior to that, he worked as a chef in a restaurant in Manhattan, Kansas. But after the amputation, he needed to use a wheelchair and his home was no longer accessible to him. At age 49, Albert was significantly younger than any other nursing facility residents. "I felt like a prisoner," he says. Moving out of the nursing facility was not presented as an option to him by any of the staff, even though he repeatedly made it clear that he wanted to get out. "They were getting a big chuck of money from me, so they weren't in any hurry to see me leave." Nevertheless, Albert remembered that there was an apartment complex for people with low incomes in the town of Marysville (population 3,000), which was near where his kids lived. When he inquired, he learned there was an opening for a one-bedroom apartment there. He applied and was accepted. By the summer of 2018 he was ready to move out of the nursing facility and into the apartment in Marysville. But he needed assistance with covering the some of the cost of moving out, such as purchasing furniture.

Fortunately, a staff member from TILRC came to the nursing facility and Albert connected with them. It still took Albert a few months to move out, mostly because the social worker at the facility seemed very unfamiliar with the process of helping a resident leave, he says. "They weren't used to anybody getting out." But Albert persevered and he moved to Marysville in October 2018 after spending nearly three years in the nursing facility. TILRC purchased his furniture. One the day he moved out, Albert says, "I felt great. I was close to my kids."

These days, Albert sees his kids at least once a week.

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