Date: 01/15/2015
Final
Briefing on the Waiting Lists for Persons with IDD
COMMITTEE ON JOINT HEALTH AND HUMAN SERVICES
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02:55 PM -- Briefing on the Waiting Lists for Persons with Intellectual and Development
Megan Davisson, JBC staff, presented the briefing on the Waiting Lists for Persons with Intellectual and Developmental Disabilities as required by Section 25.5-10-207.5 (2), C.R.S. Ms. Davisson provided the committee with a JBC Staff Memorandum (Attachment C) which details the following: the number of individuals with intellectual and developmental disabilities (IDD) waiting for waiver services and services through the Family Supported waiver; the number of individuals who are receiving some Medicaid services and who are also waiting for IDD waiver services and the Family Support Services Program; the JBC staff projected cost to provide services for all individuals currently waiting for services; and a summary of the FY 2015-16 funding request. Ms. Davisson responded to questions from the committee.
150115 AttachC.pdf
Emily Blanford, Assistant Director, Division for Intellectual and Developmental Disabilities in HCPF, discussed the provisions of House Bill 14-1051, which require HCPF to develop a strategic plan to ensure that Coloradoans with IDDs and their families will be able to access the services and supports they need and want at the time they need and want those services and supports. Ms. Blanford provided a handout to the committee that outlines the recent efforts of HCPF in regard to House Bill 14-1051 (Attachment D). She told the committee that the goal is to have all eligible clients enrolled in a Medicaid waiver program by 2020.
150115 AttachD.pdf
03:14 PM
Ms. Blanford also told the committee that House Bill 14-1252 provided an additional $4.2 million to increase system capacity. The funds were distributed to community-centered boards (CCBs) and to direct service providers. Thus far, 54 percent of the funding has been spent. The majority of the funding has been spent on recruiting and training new staff and building capacity with direct service providers. Committee discussion ensued regard expenditures related to the waivers. Ms. Blanford told the committee that the Adult Comprehensive Waiver is the most expensive waiver with an average cost of $66,000 per year per client. Committee discussion continued concerning direct services, administrative overhead, and the process used to eliminate the waitlists for the waivers.
03:21 PM
Randy Brodersen, Executive Director, North Metro Community Services, Inc., and Mark Wester, Regional Director, West Central Region, Bethesda Lutheran Communities, came to the table. Mr. Brodersen discussed the waitlist. He stated that progress has been made in the last two years on reducing the number of individuals on the waitlists. He talked about his experience of offering services to individuals on the supported living services (SLS) waiver waitlist who do not accept the services at the time they are offered because they have other supports provided through either other programs or family support. He further explained that these individuals sometimes do request services after they have declined the services due to a change in their circumstance, such as a caregiver passes away. He discussed the comprehensive waiver waitlist and explained that many individuals on the waitlist who were classified as needing emergency services have been provided with services. He told the committee that funds used by CCBs are spent mostly on case management and a portion is used for supported living services. Mr. Brodersen discussed the challenges that provider agencies face when providing services for inadequate rates. He told the committee that provider agencies are businesses and must make sound business decisions when deciding whether to hire more providers. He expressed his opinion about the adequacy of rates paid to service providers under the waivers.
03:30 PM
Mr. Wester discussed developing capacity to provide services to additional individuals. He explained that it takes time to identify adequate funding to expand programs and staff, and to develop new services. He told the committee that Bethesda is addressing work force development and was thankful for the government's recent focus on individuals in the disabled community. He explained that supported living services provided by his organization lose money, but that Bethesda continues to offer these services since they are part of the agency's mission. He explained that the agency makes up the cost from other areas and by fundraising.
03:35 PM
Marijo Rymer, Executive Director, the Arc of Colorado, told to committee about her experience being involved in the 2008 ballot initiative to end the developmental disabilities waitlist. She discussed how economic cycles and funding have affected waiver clients. She discussed the challenges related to educating individuals who are on the waitlists about the services they will be eligible for, as well as accurately maintaining the waitlist and keeping track of the individuals registered on the waitlist. She stated that she would like to see cooperation between DHS, the school districts, and other entities that serve the IDD population to identify individuals eligible for services and reach out to them. She told the committee that DHS, HCPF, and other stakeholders are working on developing a new waiver that would provide a continuum of services to individuals as situation in their lives change. She also suggested that the Medicaid state plan include some benefits for services and supports for developmentally disabled clients so they can receive supports without getting on a waiver.