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Presentation transcript:

Page 1 DBHDS Virginia Department of Behavioral Health and Developmental Services My Life, My Community Update Dawn Traver, M.Ed. Waiver Operations Director Department of Behavioral Health & Developmental Services July 2015

Page 2 DBHDS Virginia Department of Behavioral Health and Developmental Services Waiting List and Slot Assignment

Page 3 DBHDS Virginia Department of Behavioral Health and Developmental Services IDD Waivers’ Waiting List One Waiting List Family & Individual Building Independence Community Living

Page 4 DBHDS Virginia Department of Behavioral Health and Developmental Services Slot Allocation [slot] + [al-uh-key-shuh n]: the distribution by DBHDS of funding opportunities (slots) to Community Services Boards When there are more than 40 … When there are fewer than 40...

Page 5 DBHDS Virginia Department of Behavioral Health and Developmental Services Accessing Slots in New Waivers Eligibility DD Diagnosis Level of Care Urgency Waiting List: urgent & non-urgent Most urgent individual receives available slot Slot Assignment Waiver Slot Assignment Committees

Page 6 DBHDS Virginia Department of Behavioral Health and Developmental Services Slot Assignment [slot] + [uh-sahyn-muh nt]: the pairing of an available funding opportunity (slot) with the individual in most urgent need at the time Groupings of neighboring CSBs Trained Facilitator Community Members Waiver Slot Assignment Committees

Page 7 DBHDS Virginia Department of Behavioral Health and Developmental Services Service Packages & Supports Budgets

Page 8 DBHDS Virginia Department of Behavioral Health and Developmental Services Access Supports Budget Service Planning Service Delivery Quality Monitoring Eligibility Understanding the Process Supports Assessment Set Level Assignment Service Mix and Amount Rate Schedule Service Packages by Level and Residence The Supports Budget Personal Preferences The Service Plan Exceptions Arranging for Service Delivery Service Delivery Paying for Services Voicing Complaints Monitoring Making Changes Supporting Policies, Rules & Regulations, and Communication Looking Things Over

Page 9 DBHDS Virginia Department of Behavioral Health and Developmental Services Assessment of Support Needs Menu of Services Policy Intentions Tiered Rate Reimbursement Schedule Service Packages Supports Budget

Page 10 DBHDS Virginia Department of Behavioral Health and Developmental Services

Page 11 DBHDS Virginia Department of Behavioral Health and Developmental Services What goes into a supports budget? Service Packages Assigned Level Residence Anticipated Service Use (Type & Amount) Supports Budget By Level & Type of Residence Policy Intentions Level Assignment SIS Interview Supplemental Questions Verification Menu of Services Residential Personal Care Day Services Tiered Rate Schedule Pay Rate per Unit of Service Different Tiers of Intensity

Page 12 DBHDS Virginia Department of Behavioral Health and Developmental Services Low Support Needs High Significant Behavioral support need 7 Significant Medical support need 6 Modest support needs & some behavioral support needs 3 Focus on: Assigned Level 1245

Page 13 DBHDS Virginia Department of Behavioral Health and Developmental Services Base Services Add-on Services Focus on: Service Menu

Page 14 DBHDS Virginia Department of Behavioral Health and Developmental Services Base Budget Services  Residential Supports  Personal Care  Day Services Potential Add-On Services  Transportation  Crisis Services  Therapeutic Consultation  Skilled Nursing  Environmental Modifications Focus on: Base Budget & Add-ons

Page 15 DBHDS Virginia Department of Behavioral Health and Developmental Services How are reimbursement rates constructed? A rate study was completed to establish: Units of service for each service in the menu. The amount that is paid per unit of service. BUT, we also took into account that some services are delivered with varying intensity. This results in “tiered rates” for some services. The tiers account for the varying intensity. Focus on: Tiered Rates

Page 16 DBHDS Virginia Department of Behavioral Health and Developmental Services Focus on: Tiered Rates

Page 17 DBHDS Virginia Department of Behavioral Health and Developmental Services Focus on: Tiered Rates

Page 18 DBHDS Virginia Department of Behavioral Health and Developmental Services Living Alone With Family Sponsored Residential Supported Living Group Home Focus on: Where Person Lives

Page 19 DBHDS Virginia Department of Behavioral Health and Developmental Services A Few Examples

Page 20 DBHDS Virginia Department of Behavioral Health and Developmental Services A Few Examples

Page 21 DBHDS Virginia Department of Behavioral Health and Developmental Services A Few Examples

Page 22 DBHDS Virginia Department of Behavioral Health and Developmental Services A Few Examples

Page 23 DBHDS Virginia Department of Behavioral Health and Developmental Services A Few Examples

Page 24 DBHDS Virginia Department of Behavioral Health and Developmental Services What about exceptions? Everyone is unique! The supports budgeting process may account for most people. Yet some people will have exceptional needs and must be considered one by one. The Exceptions Process is designed to assure that these individuals have their needs met.

Page 25 DBHDS Virginia Department of Behavioral Health and Developmental Services For More Information “Supports Intensity Scale and Assessment Levels Information Brief” (November 2014) Validation Study Reports (May/June 2015) –Full report –Family friendly version families/developmental-disabilities