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Data Specifics Required by HEA 1102
February 23, 2018Boonville, IN
1
Definitions and Terms
2
The Community Integration and Habilitation (CIH) Waiver is a needs based waiver requiring that specified criteria be met in order to be eligible for this waiver. This waiver has numerous residential options available to individuals in addition to behavioral, day and therapy supports. This waiver was implemented in 2013 and replaced the Autism and Developmental Disabilities (DD) waivers.
The Family Supports Waiver (FSW) has a spending cap of $17,300 per member per year. This waiver includes behavioral, day, some residential and therapy supports. This waiver has a waiting list. This wavier began as the Supports Service Waiver in 2001 and in 2013 was changed to the FSW.
Supported Group Living (SGL), also know as group homes, is a residential option and alternative to waiver placements for eligible individuals with intellectual/developmental disabilities needing services. 3
Services Provided - Waivers
• Case Management (received by all)
• Adult Day Services
• Behavioral Support Services
• Community Based Habilitation – Individual (CHIO) and Group (CHG)
• Community Transition
• Electronic Monitoring
• Environmental Modifications
• Facility Based Habilitation – Individual (FHIO) and Group (FHG)
• Family and Caregiver Training
• Music Therapy
• Prevocational Services
• Recreational Therapy
• Residential Habilitation and Support (CIH Only) (provided either under a daily or hourly rate)
• Respite
• Extended Services
• Transportation
• Workplace Assistance
• Participant Assistance and Care (FSW Only)
• Structured Family Caregiving (CIH Only)
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How Many Individuals Receive Services in Indiana*
* House Enrolled Act No. 1102 – Sec. 4 (b) (1) (A)5
Source: Milliman Quarterly Financial Review
Total Waiver Recipients by Waiver Type Over Time
6
Total Waiver Recipients by Waiver Over Time
Source: Milliman Quarterly Financial ReviewBased on Paid Claims
7
Source: DDRS Insite Data System – Based on enrollmentBased on Enrollment
0
5,000
10,000
15,000
20,000
25,000
0-3 4-5 6-17 18-22 23-40 41-65 65+ Total
CIH 1 68 739 3,522 4,009 803 9,142
FSW 131 260 5,047 2,706 4,174 1,480 94 13,892
Grand Total 131 261 5,115 3,445 7,696 5,489 897 23,034
Age Range by Waiver
CIH FSW Grand Total
Waiver Type by Age
8
Age by Group Home
0
500
1000
1500
2000
2500
3000
3500
14-18 18-21 22-40 41-65 66+ Grand Total
13258
1025
1459
379
3134
SGL Type NumberAverage
Age Youngest Oldest
Adult 2,939 46.32 17 93
Child 33 17.68 14 21
Small Residence for Adults with Extensive Medical Needs 81 50.17 19 78
Extensive Support Needs (ESN) 81 31.25 18 63
3,134 36.35 14 93
Source: DDRS DART Data System
9
Group Homes by County
Source: DDRS DART Data System10
Source: Milliman Quarterly Financial Review
Percent of Total IDD Population in Countythat Receives Waiver
and Group Home Services
Max. % with Waiver & Group Home12
Where Individuals Live
Living Alone, 1,893
Living with Family, 17,313
Living in Structured Family Care Home, 211
Shared Living, 5,418
Foster Home (child), 57
Supported Group Living,
3,134
WHERE INDIVIDUALS LIVE - BY NUMBER
Living Alone7%
Living with Family
62%
Living in Structured Family Care
Home1%
Shared Living19%
Foster Home (child)
0%
Supported Group Living
11%
WHERE INDIVIDUALS LIVE - BY PERCENTAGE
N = 28,026Source: DDRS Insite Data System
14
Where Individuals Live by Waiver
Living Alone, 1,194
Living with Family, 2,473
Living in Structured Family Care Home, 211
Shared Living, 5,357
Where Individuals Live - CIHW
Living Alone, 699
Living with Family, 14,840
Shared Living, 61
Where Individuals Live - FSW
Source: DDRS Insite Data System
15
Waiting list for Services*Where Individuals are Waiting for Services**
* House Enrolled Act No. 1102 – Sec. 4 (b) (1) (C)**House Enrolled Act No. 1102 – Sec. 4 (b) (1) (E)
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Number on FSW Waiting List by Region
0
200
400
600
800
1000
1200
1400
District 1 -Northwest
Indiana
District 2 -North
CentralIndiana
District 3 -Northeast
Indiana
District 4 -EasternIndiana
District 5 -CentralIndiana
District 6 -EasternIndiana
District 7 -Southwest
Indiana
District 8 -Southeastern
Indiana
Total
85224
159103
478
143 114 75
1381
Source: DDRS DART Data System
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FSW Waiting List by Age Range
0-312%3-5
15%
5-1436%
14-1815%
18-218%
21-5512%
55 +2%
Source: DDRS DART Data System
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* House Enrolled Act No. 1102 – Sec. 4 (b) (1) (B)
Nature of Available Services*
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ICF/ID Total, $268,281,597, 28%
Family Supports Total, $104,521,550, 11%
CIH Waiver Total, $586,424,243, 61%
ICF/ID Total Family Supports Total CIH Waiver Total
Source: Milliman Quarterly Financial Review
BDDS Spend by Funding Stream – SFY 2016
21
ICF/ID Total, $268,281,597
Family Supports Total, $104,521,550
CIH Waiver Total, $586,424,243
State Plan Services Total, $165,223,674
Source: Milliman Quarterly Financial Review
Total Spend Individuals Served by BDDS SFY - 2016
22
Source: Milliman Quarterly Financial Review
23
Source: Milliman Quarterly Financial Review
Cost per Individual by Waiver Type Over Time
24
Source: Milliman Quarterly Financial Review
25
Source: Milliman Quarterly Financial Review
26
$0.00
$100,000,000.00
$200,000,000.00
$300,000,000.00
$400,000,000.00
$500,000,000.00
$600,000,000.00
$700,000,000.00
$800,000,000.00
$900,000,000.00
$1,000,000,000.00
SFY2004 SFY2005 SFY2006 SFY2007 SFY2008 SFY2009 SFY2010 SFY2011 SFY2012 SFY2013 SFY2014 SFY2015 SFY2016 SFY2017
Total Expenditures Total State Share
SFY2004 SFY2005 SFY2006 SFY2007 SFY2008 SFY2009 SFY2010 SFY2011 SFY2012 SFY2013 SFY2014 SFY2015 SFY2016 SFY2017
State Share % 34.80% 37.35% 37.13% 37.33% 37.33% 29.12% 24.65% 33.48% 33.04% 32.84% 33.08% 33.48% 33.40% 33.26%
Source: Milliman Quarterly Financial Review
Total Expenditures and State Share Over 10 YearsWaiver and State Plan Services
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Source: BDDS INsite Database
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
RHSHourly
BehaviorManagem
ent
Transportation (all
levels)
Community
Habilitation
Individual
BehaviorManagem
ent 10
RHS Daily(all levels)
Wellness FacilityHabilitatio
n Group(all ratios)
Pre-Vocationa
l (allratios)
Community
Habilitation Group
(all ratios)
MusicTherapy
FacilityHabilitatio
nIndividual
Respite
CIH - Number Receiving Service 6,887 5,750 5,480 4,823 4,521 4,516 4,429 3,307 2,333 1,768 1,321 1,205 1,148
Percentage of all CIH 75.37% 62.93% 59.98% 52.79% 49.48% 49.43% 48.47% 36.19% 25.53% 19.35% 14.46% 13.19% 12.56%
CIH - Number Receiving Service Percentage of all CIH
Top Services Utilized – CIHW - SFY 2016
28
Source: BDDS INsite Database RHS = Residential Habilitation Services
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
ParticipantAssistanceand Care
BehaviorManagement
Respite BehaviorManagement
10
FacilityHabilitationGroup (all
ratios)
Transportation (all levels)
MusicTherapy
Pre-Vocational(all ratios)
CommunityHabilitationIndividual
CommunityHabilitationGroup (all
ratios)
FacilityHabilitationIndividual
FSW - Number Receiving Service 3,547 3,384 3,363 2,485 2,252 2,222 2,192 1,811 1,626 1,568 851
Percentage of all FSW 25.53% 24.36% 24.21% 17.89% 16.21% 15.99% 15.78% 13.04% 11.70% 11.29% 6.13%
FSW - Number Receiving Service Percentage of all FSW
Top Services Utilized – FSW SFY 2016
29
Source: Milliman Quarterly Financial Review
Day Services include Community and Facility Habilitation, Pre-Vocational and Extended Services
Therapies include Music and Recreational Therapy
$0
$20,000,000
$40,000,000
$60,000,000
$80,000,000
$100,000,000
$120,000,000
Adult DayServices
BehavioralSupport Services
CaseManagement
Day Services Respite CareOther
Therapies ParticipantAssistance and
Care
Other WaiverServices
Family SupportsTotal
Series2 $584,355 $14,695,737 $17,027,820 $22,956,458 $18,375,494 $5,583,937 $20,860,838 $4,436,912 $104,521,550
FSW Spend – SFY 2016
30
Source: Milliman Quarterly Financial ReviewDay Services include Community and Facility Habilitation, Pre-Vocational and Extended ServicesTherapies include Music and Recreational Therapy
$0
$100,000,000
$200,000,000
$300,000,000
$400,000,000
$500,000,000
$600,000,000
StructuredFamily
Caregiving
Adult DayServices
BehavioralSupportServices
CaseManageme
nt
DayServices
ResidentialHabilitation
andSupport
RespiteCare Other
Therapies WaiverTransporta
tion
MonitoringSystem
WellnessCoordinati
on
OtherWaiverServices
CIH WaiverTotal
Series2 $7,321,261 $1,455,015 $33,873,613 $12,569,044 $48,972,999 $450,328,67 $9,364,199 $4,544,442 $9,782,002 $1,044,371 $4,994,652 $2,173,975 $586,424,24
CIHW Spend – SFY 2016
31
$0.00
$20,000,000.00
$40,000,000.00
$60,000,000.00
$80,000,000.00
$100,000,000.00
$120,000,000.00
$140,000,000.00
$160,000,000.00
$180,000,000.00
InpatientHospital
OutpatientHospital
PhysicianServices
DME andMedicalSupplies
Transportation Pharmacy Dental Services Home HealthServices
State PlanServices Total
Series2 $9,987,826.37 $11,992,958.64 $11,352,713.62 $14,179,734.95 $6,306,759.43 $55,056,123.44 $4,560,225.12 $51,787,332.69 $165,223,674.26
Source: Milliman Quarterly Financial Review
State Plan Spend (BDDS) – SFY 2016
32
Bureau of Developmental Disabilities Services Points of Entry
District 1110 W. Ridge RoadGary, IN 46408219-981-5313
District 2100 W. South StreetSuite 100South Bend, IN 46601574-232-1412
District 3201 E. Rudisill Blvd.Suite 300Fort Wayne, IN 46806260-423-2571
District 430 N. 8th StreetTerre Haute, IN 47801812-232-3603
District 52620 Kessler Blvd.Suite 105Indianapolis, IN 46220317-205-0101
District 6201 E. Charles StreetSuite 130Muncie, IN 47305765-288-6516
District 7700 E. Walnut StreetEvansville, IN 47713812-423-8449
District 81452 Vaxter AvenueClarksville, IN 47129812-283-1040
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More Data Online
State of the States Report:• http://stateofthestates.educationsuperhighway.org/?postalCd=IN
National Core Indicators (NCI):• https://www.nationalcoreindicators.org/upload/state-reports/2014-15_ACS_Indiana_Report.pdf• https://www.nationalcoreindicators.org/upload/state-reports/2014-15_ACS_Indiana_Report.pdf• https://www.nationalcoreindicators.org/upload/state-reports/Indiana_ACS_Report_2015-16.pdf
Staff Stability Survey:
• https://www.nationalcoreindicators.org/upload/core-indicators/2015_Staff_Stability_Survey_Report_V22.pdf
• https://www.nationalcoreindicators.org/upload/core-indicators/2016_Staff_Stability_Survey_Report_Final.pdf
Indiana Public Transit Report Calendar Year 2016• https://www.in.gov/indot/files/2016%20INDOT%20Transit%20Annual%20Report.pdf
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National Core Indicators (NCI)
NCI is collaborative effort between the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI). The purpose is to support state agencies to gather a standard set of performance and outcome measures that can be used to track the state’s own performance over time, to compare results across the states, and to establish national
benchmarks. Indiana participates in the Adult In-Person Survey (IPS). The survey is conducted with individuals who are 18 years of age or older and receive at least one paid waiver service through BDDS in addition to case management. The process includes a collection of
background information on the individual and a face-to-face survey with the individual/guardian.
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Staff Stability Survey
The Human Services Research Institute (HSRI) has developed a Staff Stability Survey, designed to collect information relating to volume, stability, compensation and benefits of Direct Support Professionals
(DSPs) serving individuals (age 18 and over) with intellectual and developmental disabilities (IDDs). The goal is to help states benchmark
their workforce data to those of other states so they can measure improvements made through policy or programmatic changes.
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Questions?
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