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Adult Services 

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Adult Service Coordination (ASC)

Adult services are available to provide assistance to eligible individuals over the age of 21 with intellectual disabilities, autism spectrum disorders, cerebral palsy and other developmental disabilities. Services are also available for adults with disorders such as traumatic brain injury, multiple sclerosis, Huntington’s disease, and other degenerative brain disorders.

Adult services are tailored to the needs of the individuals receiving supports and those closest to them who share their vision. Adult Service Coordinators help individuals, their families, guardians, friends, and staff develop and maintain the system of supports and services that enable individuals to live in their communities, work, develop meaningful relationships, and enjoy life to the fullest.

Adult Service Coordinators work with individuals and their families to:

  • Create an environment that empowers individuals to speak out for themselves and receive the highest quality services available;
  • Search for opportunities, connections and ways to make the seemingly impossible probable;
  • Offer information, explore options and network with others;
  • Increase community awareness of the talents and gifts those with disabilities can offer.

Determine eligibility and start the
intake process for an adult:

Families and individuals can choose from a variety of Service Coordination Agency options. Adult Service Coordinators assist adults with developmental and related disabilities as they identify personal goals, and then secure the supports and resources required to achieve them. Adult Service Coordinators partner with a number of state-approved Provider Agencies individual services. Links provided below.

Self-Directed Services (SDS)

Self-Directed Services (also known as Participant Directed and Managed Services PDMS) are family-managed services created to help individuals to reach certain outcomes. SDS promotes individuals’ independence, health, safety and emotional well-being. The intent of SDS is to increase flexibility regarding service delivery, staffing, and funding to accommodate a variety of consumer needs and preferences.

Some commonly asked questions:

With SDS, the individual and the family representative first design a service plan and then develop a budget. This allows more freedom in deciding what services are provided and how much to pay for each specific service in accordance with state guidelines. The individual and family representative choose who they want to hire to provide services and are responsible for finding supports and creating a back-up plan in case of a staff person calling out of a shift (natural supports or paid). The family representative is also responsible for paperwork that includes monthly progress notes, attendance sheets, time sheets and invoice submission to the SDS Service Coordinator and fiscal agent and MDS Fiscal Management Service Representative.

To help design services, to provide financial guidance and assist with budget management. With SDS, MDS is the employer of record, which means all potential supports need to go through a hiring process with the HR Director and complete their criminal record check prior to starting to work in SDS programs.

SDS is not for everyone–SDS is open to families who wish to direct services with their family member and to individuals who are eligible for funding or who receive in-home supports. SDS is NOT open to families who are not involved in directing services and decision making or who receive in-home supports.

SDS Service Coordinator:

  • The family is in charge, hands-off role
  • Monthly contact
  • Certification
  • Budget development and analysis (monthly actuals)
  • Processing invoices
  • Insuring audit compliance and training
  • Identify resources for families and individuals

Traditional Service Coordinator:

  • Involved in the oversight of services
  • Monthly contact with individuals, family and provider agencies
  • Scheduling and facilitating team meetings
  • Developing individual service agreement
  • Oversight of paperwork
  • Crisis intervention coordination
  • Identifying local resources for individuals 

Contact the SDS Director or your
Service Coordinator with questions

Environmental Modifications

Environmental Modifications (E-mods) are physical adaptations to a person’s home that are necessary to ensure the health, welfare and safety of the person. E-mods may also be made to a vehicle if it is the primary source of transportation to a person who receives services. Examples of E-mods include wheelchair ramps and lifts, hand rails, roll-in showers, lifts, automatic door openers and widened doorways and hallways. E-mods enable a person to live with greater independence. For individuals with unsafe wandering and running behaviors, outdoor fencing may be a needed e-mod. E-mods do not include the purchase of a vehicle or improvements to a home or vehicle that are not medically necessary or are not needed for a person’s independence in their home or community.

Residential Services

Housing options for individuals with disabilities depend on particular situations and the level of care needed.

Those who want to live independently should work closely with a Service Coordinator who can:

  • help determine an appropriate housing situation;
  • help to fill out applications for vouchers or apartments;
  • assist in finding roommates;
  • help put together a living plan to ensure success.

Similarly, those individuals who need more assistance and care should use their Service Coordinator to help them identify a properly staffed residence or an appropriate home provider.

If someone you know is homeless, shelters are available throughout the region. Again, it is important to call the Service Coordinator if that person has a developmental disability or acquired brain disorder. In an emergency, call 911 for immediate assistance.

has an array of programs and services for individuals, families and seniors including Public Housing, Section 8 Voucher Program, Congregate Housing Services Program, and Resident Self Reliance Program.

has affordable housing units for both families and seniors in eleven different towns throughout Cheshire and Sullivan counties. Most rents include heat and hot water. You can check out apartment availability on their website.

promotes, finances and supports affordable housing opportunities and related services for New Hampshire families and individuals, and is a good source of housing information.

Community Support Services

Community Support Services are designed for a person who is living independently or is working to develop the skills to live independently in the community. These skills include daily living, transportation and community integration. Community Support Services must increase personal growth and relate to their goals and desired outcomes as they are identified in their service agreement. A person can receive up to 30 hours per week of Community Support Services. These services may begin and continue for up to 24 consecutive months (two years) while the person is still living with their family.

Community Participation Services

Community Participation Services help the person to be a contributing and valued member of their community. These services are designed to support a person’s participation in and transportation to a variety of community activities and settings. Community Participation Services are governed by regulation number He-M 507. The purpose of this rule is to establish standards for community participation services as part of a comprehensive array of community-based services for person with developmental disabilities and acquired brain disorders. 

Community Participation Services must meet a person’s goals and desired outcomes as they are identified in their service agreement, related to community opportunities for volunteering, employment, socialization, recreation, communication, mobility and personal care. The services are primarily provided in a community setting and help a person be more independent and promote their health and safety. Some examples are managing personal funds, shopping for personal items and participating in community events. 

Project SEARCH Employment Training

Project SEARCH provides a comprehensive approach to employment training and career advancement for individuals between 18-34 years of age with developmental disabilities. The program provides real world skills training through a series of internships and classroom learning, all designed to teach marketable skills that will transfer to a variety of employment settings.

Project SEARCH (Students Exploring Alternative Resources Children’s Hospital) began at the Children’s Hospital Medical Center in Cincinnati in 1996, to create an opportunity for individuals between 18-34 years of age with developmental disabilities to obtain marketable employment skills. Since then, Project SEARCH has grown to more than 200 sites across the U.S. and in four other countries. 

In the Monadnock Region Project SEARCH partners are Monadnock Developmental Services, NH Vocational Rehabilitation, and Cheshire Medical Center/Dartmouth Hitchcock (CMC/DH), where the program takes place. CMC/DH offers a wide variety of opportunities for employment training, from stocking to housekeeping to food service to office tasks. The program runs on an academic calendar: Monday through Friday, from 8:00 a.m. to 2:30 p.m. Interested candidates must apply to and be accepted into the program have Medicaid and be on the Developmental Disability waiver.

The minimum requirements for Project SEARCH applicants:

  •  Are receiving services from MDS, have Medicaid and are, or can be, open for the Developmental Disabilities (DD) Waiver.
  • Have current application for, or are receiving active services with New Hampshire Vocational Rehabilitation Services (NHVR).
  • Can pass the required comprehensive background check.
  • Are able to work with some degree of independence.
  • Have a reliable method of communication.
  • Have a desire to gain employment skills and are committed to finding employment at the end of the program.

Graduates work in a variety of jobs. Some work in an office environment, others in retail, manufacturing, environmental services, food service, and recreation. On average, graduates of Project SEARCH earn an hourly wage of $11.16 and work 17.8 hours per week.

Supported Employment

For many people, working is critical to one’s place in their family and community at large, an essential part of living.

Applying for benefits, being awarded benefits, and properly maintaining them are important steps in the process of finding a job, returning to work, or increasing work hours. Many individuals have concerns about the effect of paid employment on existing benefits. It’s important to know that once you are awarded disability benefits, those benefits are protected when you return to work.

Your Service Coordinator can guide and support you in the process by helping you:

  • clarify that benefits won’t go away just because you are employed;
  • identify career interests and skills and help you create a return-to-work plan;
  • connect you with NH Vocational Rehabilitation or other resources to get you started;
  • find training and employment options as you or your family member prepares for employment.

The Department of Health and Human Services (NH-DHHS) and Social Security Administration (SSA) have work incentive systems built in that protect your benefits, including the MEAD Program (Medicaid for Employed Adults with Disabilities). The Granite State Independent Living (GSIL) website has very useful information on the MEAD program. The SSA website  has details on multiple work incentive/safety nets for those returning to work. The Institute on Disability at UNH’s Work Incentives Resource Center (WIRC) has information on benefits planning and work incentives for NH individuals with disabilities.

Other useful sources of employment information are NH Vocational Rehabilitation and the Disability Rights Center.

Contact your Service Coordinator with questions.

Contact the SDS Director or
your Service Coordinator with questions

If you are looking for jobs at MDS, please visit the Careers page.

Respite Services

The respite program at MDS allows family caregivers a much needed break, while giving the individual receiving respite care a chance to spend time in the community and enjoy personal interests with a trusted provider. The majority of individuals who receive respite funding have it covered through Medicaid. For those who do not qualify for Medicaid, MDS has additional limited funds available through a variety of grants such as Cheshire County grant and private donations.

How to use the respite allocation

Those receiving a respite allocation have a number of options, including:

Family Reimbursed Respite

The family pays out of pocket to cover respite hours, then submits a reimbursement form to receive their payment. They can choose whom they would like for a provider.

Respite Provider Hired Through MDS

The provider applies for the position through MDS. They would have an initial meeting with the family to see if it is a good fit. The family will not need to pay out of pocket; staff complete a timesheet, have the family sign off on it, and submit to MDS.

For more information on Respite Services:


Talk to your Service Coordinator.

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