1. DDRB Targeted Case Management
Peg Capo, MBA
Executive Director
Robyn Peyton
Case Management Director

2. DDRB Mission: The DDRB is a leader, ensuring that individuals with developmental disabilities living in St. Charles County have quality opportunities and choices to be fully included in society. DDRB Vision: People have what they need to live the lives they choose.

3. History
Political subdivision of St. Charles County established in 1977
Hired dedicated staff to support Board in 1993
Separate funding and provision of services
Funding Approach
“Last Dollar In” >> Partnership
Not supplant other public funding sources

4. Regional Office Caseloads Skyrocketed DDRB lapsed funds increased
The Environment
County growth
81% population increase (1990 – 2015)
245% DDRB tax revenue increase (1990 – 2015)
Regional Office Caseloads Skyrocketed
DDRB lapsed funds increased
By 2005, 16 counties provided targeted case management

5. Leadership: DDRB Finance Committee
The Decision (2005)
Leadership: DDRB Finance Committee
Use of St. Charles County tax funds
Do not supplant state’s responsibility
Start-up/One-Time Funding expected
Partnership
Experienced County Boards
DMH Division of DD, St. Louis Regional Office
Stakeholders
Agreement with DMH/DD
Keep SLRO staff in St. Charles County
Keep level of funding in St. Charles County
Manage Medicaid-eligibility (Serve Adults 18+)

6. The Timeline
September 2005 – Board approval
January 2006 – Robyn Peyton hired as Case Management Director
April 2006 – Hired Case Management Supervisor, 4 case managers and Administrative Assistant
May 2006 Case Management Program Opens
May 2006 First TCM Billing

7. Current Status
Currently serving 1200 customers
Current staffing includes 36 case managers (3 of which are mentors), 3 supervisors, assistant director of case management and director of case management.
Target staffing ratio is 1:35
Average growth per year was 150 customers
Staff were added as needed for growth

8. Lessons Learned - Program
Caseload size
Choice
Continuity of staff
Commitment to no waitlist
Communication
Flexibility

9. Lessons Learned - Financial
Risk is related to Medicaid Eligibility
Contract requires Case Management be provided to everyone, regardless of Medicaid-eligibility
Non-Medicaid Case Management Uncompensated
Break even at current $103/hr Medicaid rate requires 70 – 75% Medicaid eligibility
Things Change!
Current Medicaid Rate ($103/hr) under review
Conflict Free Case Management affecting much of the state

10. Questions