1. Division of Senior and Disabilities Services
February 25, 2014
Duane Mayes, Director
Department of Health & Social Services

2. Mission Statement Statutory Missions
Senior & Disabilities Services promotes health, well being and safety for individuals with disabilities, seniors and vulnerable adults by facilitating access to quality services and supports that foster independence, personal choice and dignity.
Statutory Missions
Adult Protective Services
Grants (Seniors & people with disabilities - DD)
Home and Community Based Services
Long Term Care Services

3. Continuum of Care Medicaid Program Institutional Placements
Total: $2,893,263
Number Served: 18
Federal 50%
State 50%
Total: $98,151,646
Number Served: 808
Federal 50%
State 50%
Total: $7,883,449
Number Served: 88
Federal 50%
State 50%
Total: $138,998,008
Number Served: 1,704
Federal 50%
State 50%
Total: $10,687,904
Number Served: 269
Federal 50%
State 50%
Intermediate Care Facility for Intellectual and Developmental Disabilities
$160,737
/avg.
Total: $75,209,387
Number Served: 2,830
Federal 50%
State 50%
Total: $124,150,174
Number Served: 5,214
Federal 50%
State 50%
Nursing Home
$121,475
/avg.
Total: $13,395,320
Number Served: 2,199
State 94%
Interagency 4%
MHTAAR 2%
Adults with Physical & Developmental Disabilities Waiver
$89,585
/avg.
Intellectual and Developmental Disabilities Waiver
$81,572
/avg.
Children w/ Complex Medical Conditions Waiver
$39,732
/avg.
Total: $14,419,340
Number Served: 33,795
Federal 87%
State 11%
MHTAAR 2%
Alaskans Living Independently Waiver
$26,576
/avg.
Personal Care Assistance Program
$23,811
/avg.
Developmental Disabilities Grant
$ 11,917
/avg.
Intermediate Level of Care
Intermediate Level of Care
Senior Community Based Grant
$ 427
/avg.
Nursing Facility Level of Care
Nursing Facility Level of Care
Nursing Facility Level of Care
Nursing Facility Level of Care
Medicaid Program
Approx. 110% Federal Poverty Level
Home & Community Based Waivers
Up to 178% Federal Poverty Level
$25,560/ yearly income
Institutional Placements
Up to 178% Federal Poverty Level
Grants Programs
**Grant recipients can also be eligible for PCA.
**The average costs are based on FY 2013 data. The final data will be available 7/1/2014 due to the Medicaid billing cycle.

4. Impacts of Federal Sequestration
Pre-Sequestration Federal Allocation
Sequestration
Federal FY 2013
Final Federal FY 2013 Federal Allocation
FY 2014/FY 2015
Impact To Programs
SDS Administration
Elder Services Case Management
$ ,004.6 $
No reduction.
Senior Community Based Grants
Nutrition Services Incentive $
$ (17.9) $
No further reductions projected.
Senior Medicare Patrol $
$ (13.4) $
Return to pre-sequestration funding levels.
Title III: Supported Services
$ ,823.3
$ (87.4)
$ ,736.0
Title III: Congregate Meals
$ ,181.9
$ (104.5)
$ ,077.4
Title III: Home Delivered Meals
$ ,077.5
$ (51.6)
$ ,025.9
Title III: Preventive Health $
$ (5.6) $
Title III: National Family Caregiver $
$ (36.6) $
Title VII: Elder Abuse Prevention $
$ (1.5) $
Title VII: Ombudsman $
$ (4.1) $
State Health Insurance Assistance Program $
$ (9.2) $
Governor's Council on Disabilities & Special Education
Integrated Employment Initiative $
$ (7.8) $
State Developmental Disabilities Council $
$ (27.2) $
Totals
$ ,762.6
$ (366.7)
$ ,581.4

5. Total Cost Differential Waiver Actuals vs. Institutional Care
FY 2013 Home and Community Based Services Compared to Institutional Care Costs
SDS Medicaid Services
FY 2013
Paid Claims
Total Expenditures
Cost If
In Institutional Care
Total Cost Differential
Waiver Actuals vs. Institutional Care
Nursing Home Authorizations
$98,151.6
+$428,258.0
+129.4%
Intellectual and Developmental Disabilities Waiver
$138,998.0
$273,895.8
Adults with Physical and Developmental Disabilities Waiver
$7,883.4
$10,689.8
Children with Complex Medical Conditions Waiver
$10,687.9
$32,676.8
Alaskans Living Independently Waiver
$75,209.4
$343,774.3
Totals
$330,930.3
$759,188.3

6. Nursing Facility Programs
Nursing Facility Medicaid Authorizations
PASRR Screenings
Nursing Facility Transitions

7. Medicaid Authorizations
SNF/ICF/ICFIDD/Swing Bed/Admin Wait Bed
Approximately 50 Medicaid authorizations per week sent to Xerox for entry into the Enterprise System
Standard initial authorization or reauthorization is 7 day turnaround
Approximately 100 PASRR (Mental Illness/IDD) screenings per month
Standard Level II evaluation is 10 day turnaround

8. Nursing Facility Transitions
Average of 50 transitions per year
FY ‘14 YTD transitions is 42
Average transition is $1,550
Covers: Case by case basis
Short term PCA services
Environmental modifications
Transportation
Security deposits and 1st month rent
Cleaning

9. ALH License and Bed Count by Region
Northern Region
Type
Homes
Beds
RCCF/RPTC 4 42
ALH - SS 1 12
ALH -DDMH 5
DUAL
Interior
Type
Homes
Beds
RCCF/RPTC 14
675
ALH - SS 13
184
ALH -DDMH 15 69
DUAL
Anchorage
Type
Homes
Beds
RCCF/RPTC 15
140
ALH - SS
184
1178
ALH -DDMH
226
843
DUAL 18
196
Mat Su
Type
Homes
Beds
RCCF/RPTC 6 74
ALH - SS 29
271
ALH -DDMH 68
200
DUAL 2 10
Southwest/Western
Type
Homes
Beds
RCCF/RPTC 3 38
ALH - SS 1 15
ALH -DDMH 19
DUAL
Gulf Coast
Type
Homes
Beds
RCCF/RPTC 3 15
ALH - SS 20
151
ALH -DDMH 36 75
DUAL 4 25
South East
Type
Homes
Beds
RCCF/RPTC 13
623
ALH - SS 6
211
ALH -DDMH 38
DUAL 1 5
FY 2013

10. Assisted Living Homes 683 Licensed Assisted Living Homes in Alaska
322 Homes Accept Senior & Disabilities Services General Relief Payments
$70-96 a day
Not on Medicaid Services
251 Homes Certified with Senior & Disabilities Services Medicaid Programs
Alaskans Living Independently and Adults with Physical and Developmental Disabilities Waivers
<5 Beds, $ a day
6-16 Beds, $ a day
17+ Beds, $ a day
Acuity Add On, $ a day
81 Group Homes Certified with Senior & Disabilities Services Medicaid Programs
Adults with Physical and Developmental Disabilities, Children with Complex Medical Conditions, Intellectual and Developmental Disabilities Waivers
Group Home Habilitation, $ a day
Acuity Add On, $342.59
SDS Medicaid FY 2013
$47.7 Million Assisted Living Homes
$52.6 Million Group Home Habilitation

11. Efficiencies and Effectiveness
Aging and Disability Resource Center
Technologies
Elder Services Case Management
Improved Assessment Consistency
Material Improvement Review Process
Quality Assurance\Fraud & Abuse Investigations
Tribal Partnerships
Recipient Employment

12. Questions? Division of Senior and Disabilities Services
Duane Mayes, Director
Division of Senior and Disabilities Services
Department of Health & Social Services