Delaware Department of Health and Social Services Division of Developmental Disabilities Services Joint Finance Committee Hearing Fiscal Year 2013 Jane J. Gallivan Division Director Wednesday, February 22, 2012

Delaware Health and Social Services

Vision Statement The people we serve live fulfilling lives. Mission Statement To provide leadership for a service system that is responsive to the needs of the people we support by creating opportunities and promoting possibilities for meeting those needs.

Delaware Health and Social Services Overview Populations Served: Intellectual Disabilities Autism Prader Willi Syndrome Asperger’s Disorder

Overview Serve over 3,375 individuals and their families 981 individuals in Residential Services 66 Residents of Stockley Center 2,329 live at home with their families 39 Authorized/Contracted Day and Residential Providers

Delaware Health and Social Services DDDS Population Approximately 70% of the DDDS population live at home with their families

Delaware Health and Social Services Eligible Applicants The population served includes both an increase in the number of applicants for services and the number determined eligible for services.

Delaware Health and Social Services Eligible Applicants DDDS Eligible Applicants Age Distribution

Delaware Health and Social Services Eligible Applicant Diagnoses Data

Delaware Health and Social Services A System’s Change Environmental Scan of the State of Delaware’s Division of Developmental Disabilities Services Project Report By Michael S. Chapman Chesapeake Management Consulting August 2011

Delaware Health and Social Services Medicaid 1915(c) HCBS Waiver State HCBS Waiver programs must: Ensure that services follow an individualized and person- centered plan of care Ensure the protection of people’s health and welfare Provide adequate and reasonable provider standards to meet the needs of the target population Demonstrate that providing waiver services won’t cost more than providing these services in an institution

Delaware Health and Social Services Medicaid Supported Employment June Inconsistencies in provider Supported Employment (SE) service delivery and billing practices were discovered September DDDS meets with all SE providers and agrees to an interim rate proposed by the providers October DDDS initiates biweekly meetings with national consultants and SE providers to address SE issues and rate for service

Delaware Health and Social Services Medicaid Supported Employment (Cont.) January Weekly internal conference calls initiated with DDDS, DMS and DMMA to address rate and billing practices January DDDS postpones implementation of revised rate July 2011 – DDDS again postpones implementation November $49.02 final hourly rate announced at provider meeting; the rate was effective January 1, 2012

Delaware Health and Social Services Medicaid Supported Employment (Cont.) Supported Employment Rate Comparison Chart StateHourly Delaware (DDDS)$49.02 Delaware (DVR)$52.00 Maryland$15.45 New Jersey$40.00 Pennsylvania$53.20

Delaware Health and Social Services Supported Employment Funding Sources Supported Employment is funded by Medicaid Waiver Funds, Medicaid State Plan Funds and General Funds

Delaware Health and Social Services Accomplishments Placed 32 people out of 75 budgeted residential placements since July 1, 2011 Placed 109 out of 140 budgeted special school graduates in day program placements to date in FY 12

Delaware Health and Social Services Accomplishments Educated over 100 families about Early Start to Supported Employment –Referred 56 students to the Early Start to Employment program; a total of 361 students have been referred to the program since in inception in FY 2006 Provided scholarships for new Direct Support Professional Certificate Implemented improved certification process for residential services

Delaware Health and Social Services Accomplishments Enhanced awareness of Gold Alerts for people with intellectual disabilities Supported community placements of DPC residents

Delaware Health and Social Services Trends Census Growth Pre-18 request for out-of-home placement Aging impact on residential and day services Complexity/intensity of support needs

Delaware Health and Social Services Trends Families providing more/extended support

Delaware Health and Social Services Employment First Initiative Employment as a primary goal of day services

Delaware Health and Social Services FY 2013 Governor’s Recommended Budget $335.9 for 1% Day and Residential Provider Increase Purchase of Service: Special School Graduates FY 2012 Placements Annualized in FY 2013 FY 2013 Pro-Rated $ Months Annualized Funding for 140 Grads in FY 2012 $1, Months Pro-rated Funding for 170 Grads in FY 2013

Delaware Health and Social Services FY 2013 Governor’s Recommended Budget Purchase of Care: Residential Placements FY 2012 Placements Annualized in FY 2013 FY 2013 Pro-Rated $2, Months Annualized Funding for 75 Emergency/Urgent Placements $2, Months Pro-rated Funding for 75 New Residential Placements from the Urgent and High Risk Categories of the DDDS Registry

Delaware Health and Social Services Thank You