DBHDS Virginia Department of Behavioral Health and Developmental
DBHDS Virginia Department of Behavioral Health and Developmental Services My Life, My Community Update July 2015 Dawn Traver, M. Ed. Waiver Operations Director Department of Behavioral Health & Developmental Services http: //www. dbhds. virginia. gov/ Dawn. Traver@dbhds. virginia. gov Page 1
DBHDS Virginia Department of Behavioral Health and Developmental Services Waiting List and Slot Assignment Page 2
DBHDS Virginia Department of Behavioral Health and Developmental Services IDD Waivers’ Waiting List One Waiting List Community Living Building Independence Family & Individual Page 3
DBHDS Slot Allocation Virginia Department of Behavioral Health and Developmental Services • [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 4
DBHDS Virginia Department of Behavioral Health and Developmental Services Accessing Slots in New Waivers • DD Diagnosis Eligibility • Level of Care • Waiting List: urgent & non-urgent Urgency • Most urgent individual receives available slot • Waiver Slot Assignment Committees Slot Assignment Page 5
DBHDS Slot Assignment Virginia Department of Behavioral Health and Developmental Services • [slot] + [uh-sahyn-muh nt]: the pairing of an available funding opportunity (slot) with the individual in most urgent need at the time Community Members lot S r ive ment a W ign es s e t s t A mi m Co Trained Facilitator Groupings of neighboring CSBs Page 6
DBHDS Virginia Department of Behavioral Health and Developmental Services Service Packages & Supports Budgets Page 7
DBHDS Looking Things Over Virginia Department of Behavioral Health and Developmental Services Access Supports Budget Supports Assessment Eligibility Set Level Assignment Understanding the Process Service Mix and Amount Rate Schedule Service Packages by Level and Residence Service Planning The Supports Budget Personal Preferences Service Delivery Quality Monitoring Arranging for Service Delivery Voicing Complaints The Service Plan Service Delivery Exceptions Paying for Services Monitoring Making Changes Supporting Policies, Rules & Regulations, and Communication Page 8
DBHDS Virginia Department of Behavioral Health and Developmental Services Assessment of Support Needs Menu of Services Policy Intentions Service Packages Supports Budget Tiered Rate Reimbursement Schedule Page 9
DBHDS Virginia Department of Behavioral Health and Developmental Services Page 10
DBHDS What goes into a supports budget? Virginia Department of Behavioral Health and Developmental Services Level Assignment SIS Interview Supplemental Questions Policy Intentions Verification Menu of Services Residential Service Packages Assigned Level Personal Care Residence Day Services Anticipated Service Use (Type & Amount) Supports Budget By Level & Type of Residence Tiered Rate Schedule Pay Rate per Unit of Service Different Tiers of Intensity Page 11
DBHDS Focus on: Assigned Level Virginia Department of Behavioral Health and Developmental Services Support Needs Low 1 3 6 7 2 4 High 5 Modest support needs & some behavioral support needs Significant Medical support need Significant Behavioral support need Page 12
DBHDS Virginia Department of Behavioral Health and Developmental Services Focus on: Service Menu s e c i v n Ser o d d A Base Services Page 13
DBHDS Virginia Department of Behavioral Health and Developmental Services Focus on: Base Budget & Add-ons Base Budget Services Potential Add-On Services § Residential Supports § Transportation § Personal Care § Crisis Services § Day Services § Therapeutic Consultation § Skilled Nursing § Environmental Modifications Page 14
DBHDS Virginia Department of Behavioral Health and Developmental Services Focus on: Tiered Rates 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. Page 15
DBHDS Virginia Department of Behavioral Health and Developmental Services 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: Where Person Lives Living Alone With Family Sponsored Residential Supported Living Group Home Page 18
DBHDS Virginia Department of Behavioral Health and Developmental Services A Few Examples 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 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 24
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 http: //www. dbhds. virginia. gov/individuals-andfamilies/developmental-disabilities Page 25
- Slides: 25