Report to the Legislature DDD ASSESSMENT

Transcription

1 Report to the Legislature DDD ASSESSMENT Prepared in Response to Recommendation #1 in Division of Developmental Disabilities Analysis of How Services are Prioritized Report by the Joint Legislative Audit and Review Committee, issued July 31,27 Department of Social & Health Services Aging and Disability Services Administration Division of Developmental Disabilities P.O. Box 4531 Olympia, WA (36) Fax: (36)

2 TABLE OF CONTENTS Executive Summary...3 Purpose...3 Total DDD Assessments...4 Acuity Levels...4 Program and Service Requests...7 Integration with the Case Management Information System...8 Conclusion...8 Appendix A: Breakdown of Program and Service Requests...9 DDD Assessment Project Final Report to JLARC Page 2 of 12

3 Executive Summary Recommendation One of the JLARC Report entitled Division of Developmental Disabilities Analysis of How Services are Prioritized (July 27) 1 requested a report by January 29 on the Division s implementation of its standardized assessment process and case management information system. Specifically, it requested data on: The number of assessments completed, How Division staff have applied the case management information system, and Development and implementation of future stages of the two initiatives. This report is the Department s response and provides the data requested in Recommendation One. The report regarding Recommendations Two and Three was provided to JLARC in September 27. Purpose The purpose of this report is to provide information on the implementation of the DDD Assessment Project and Case Management Information System Project as requested in the JLARC Report Division of Developmental Disabilities Analysis of How Services are Prioritized. Recommendation One of that report stated: The Department of Social and Health Services should provide a report to the Legislature by January 29 on implementation of its standardized assessment process and case management information system, which should include detailed information on the following: Assessments completed How Division staff have applied the case management information system Development and implementation of future stages of the two initiatives The data included in this report reflects DDD Assessments from June 1, 27 January 2, Division of Developmental Disabilities: Analysis of How Services are Prioritized, (retrieved 1/2/9). DDD Assessment Project Final Report to JLARC Page 3 of 12

4 Total DDD Assessments Total number of assessments for No Paid Services clients; Support Assessment module only: 1,37 Total number of assessments for Paid Services clients; Support Assessment, Service Level Assessment and Individual Support Plan included: 39,711 Total Assessments 6/1/7-1/2/9 Total = 41,18 Pd Svc Assmts 39,711 97% NPS Assmts 1,37 3% Acuity Levels The following charts outline the Acuity Levels (high, medium, low and none) for all clients including assessed supports needs in the categories requested in the report. Note: Some of the totals vary between acuities. This is because some scales have a different algorithm for children and adults, or because the question is not mandatory. a. Functional Activities of Daily Living (ADL) Acuity Levels 9252 Total Individuals = 19, High Medium Low None DDD Assessment Project Final Report to JLARC Page 4 of 12

5 b. Behavior Acuity Levels 2 Total Individuals = 2, High Medium Low None c. Caregiver Acuity Levels Total Individuals = 19, Immediate High Medium Low None d. Protective Supervision Acuity Levels Total Individuals = 2, High Medium Low None DDD Assessment Project Final Report to JLARC Page 5 of 12

6 e. Medical Acuity Levels Total Individuals = 2, High Medium Low None f. Mobility Acuity Levels Total Individuals = 19, High Medium Low None g. Interpersonal Support Acuity Levels Total Individuals = 19, High Medium Low None DDD Assessment Project Final Report to JLARC Page 6 of 12

7 Program and Service Requests The following charts outline the volume of the top programs and services requests recorded by the DDD Assessment. (See Appendix A for complete breakdown of program and service requests). Total All Others, 532, 1% Residential, 17, 2% Basic+ Wvr w/pers. Care 142 3% Basic Wvr w/pers. Care, 145, 3% Basic Wvr, 187, 4% Program Requests Total Requests = 5,413 FS Oppty, 275, 6% IFS % MPC, 1153, 21% FS Trad, 496, 1% County Prgs, 468, 9% Core Wvr, 278, 6% Service Requests Total Requests = 3,693 FS- Other Svcs; 1; 3% Total All Others; Therapy -Behav 1388; 38% Mgt & Consult; 111; 3% Pers to Pers; 152; 4% Spptd Living; 165; 4% FS - Budget; 173; 5% Respite (State Ind Emplymt; or VPP); 244; 225; 6% 7% Pers Care; 69; 16% Respite; 267; 7% IFS - Annual; 259; 7% DDD Assessment Project Final Report to JLARC Page 7 of 12

8 Integration with the Case Management Information System Through the development of the Case Management Information System (CMIS) Phase IV, the Division has integrated the following client information into CARE as of March 31, 28: a. Medically Intensive b. Specialized Clients including Quarterly Visit Data c. State Supplementary Payment (SSP) d. Voluntary Placement Program Data, including Quarterly Visit Data e. Waiver Participants and Waiver Requests f. Exception to Rule/Exception to Policy (ETR/ETP) g. County Billing and Performance Data h. Residential Habilitation Center / State Operated Living Alternatives (RHC/SOLA) Short Term Stay i. Tickler and Alerts Integration Additionally, the project eliminated nine separate documents (forms) by incorporating their functionality into the CARE system (mostly related to ETR/ETP processes) and offers 22 Ticklers to assist and support Case Resource Managers workload processes. A detailed description on what new information is now being collected in the CARE system is available in the CMIS Phase IV Business Requirements Document, available on CD upon request. The CMIS Project, Phase V development nearly complete and implementation is planned for May 4, 29. This phase of the project will add more functionality into the CARE system to support additional business processes and provide tools that assist Case Resource Managers. This includes: Individual and Family Services Program Planned Action Notices Quality Assurance/Employment Outcomes Request Lists (Waiver, IFS, VPP) implemented November 28 Incident Reports interface implemented November 28 Additional and Enhanced Ticklers and Reports Detailed description on what new information will be collected in the CARE system is available in the CMIS Phase V Business Requirements Document, available on CD upon request. Conclusion The DDD Assessment and Case Management Information System projects have met the requirements of JLARC by improving business processes and making client information accessible. The Assessment has enabled DDD to meet the Centers for Medicare and Medicaid Services requirement that we assess for the unique support needs of individuals with developmental disabilities. DDD Assessment Project Final Report to JLARC Page 8 of 12

9 Appendix A: Breakdown of Program and Service Requests Program Requests Program # of Requests Rank Individual and Family Services MPC Family Support Traditional County Programs Core Waiver Family Support Opportunities 275 6* Basic Waiver Basic Waiver w/pers. Care Basic Plus Waiver w/pers. Care Residential 17 1 Adult Day Health Core Waiver w/pers. Care Professional Services Family Support Pilot 59 14* Basic Plus Waiver 5 15 Comm. Protection Waiver State Supplemental Payment Voluntary Placement ICF/MR 2 19 Medically Intensive Program 19 2 Private Duty Nursing 6 21 Medically Needy Waiver Services 4 22 COPES waiver services 3 23 Nursing Home Services 3 24 RCL 2 25 CIIBS Waiver 1 26 Total 5,413 Family Support Programs that have been integrated into the Individual and Family Services Program DDD Assessment Project Final Report to JLARC Page 9 of 12

10 Service Requests Service # of Requests Rank Personal Care 69 1 Respite Care Individual and Family Services - Annual Allocation Respite Care (State Funded or VPP) Individual Employment Family Support - Budget award Supported Living Person to Person Therapy -Behavioral Mgt & Consult Family Support - Other Services 1 1 Individual and Family Assistance 9 11 Therapy -Extended State Plan Svcs (OT, PT & Speech) Community Activities Evaluation -Behavioral Mgt & Consult Adult Day Health Nurse Delegation Transportation Medical Equipment/ Supplies/ Specialized Aids Group Supported Employment Pre-Vocational Employment 48 2 Behavior Management Emergency Assistance -Behavioral Mgt & Consult SOLA Environmental Accessibility Adaptations Specialized Psychiatric Services 3 25 Recreation opportunities Community Access Summer Program Group Home Therapies (PT, OT, Speech, Language & Communication) 2 3 Medically Related Services Licensed Staffed Residential RHC Short Term Stay DDD Assessment Project Final Report to JLARC Page 1 of 12

11 Service Requests Service # of Requests Rank VPP - Other Services Medically Intensive Program Evaluation -Extended State Plan Svcs (OT, PT & Speech) Alternative Living Emergency Assistance Medical Equipment/ Supplies/ Specialized Aids SSP - in lieu of Traditional Family Support Nursing Services (also Skilled Nursing) 14 4 PC Mileage Reimbursement SSP - in lieu of Family Support Opportunities ICF/MR (Community IMR) SL Allowance Child Care Psychological Services RHC 9 47 Specialized Medical Equipment & Supplies 9 48 Foster Care 8 49 Mental Health Stabilization Services 8 5 Staff/Fam Consult & Training 8 51 Adult Day Care 7 52 Companion Home 7 53 Evaluation -Nursing Services (also Skilled Nursing) 7 54 Evaluation -Specialized Psychiatric Services 7 55 SSP - CA Legacy 7 56 Architectural & Vehicular Modifications 6 57 Counseling 6 58 Private Duty Nursing 6 59 Emergency Assistance -Specialized Psychiatric Services 6 6 Evaluation -Psychological Services 6 61 Evaluation -Staff/Fam Consult & Training 6 62 Attendant Care 5 63 Child Development Services 5 64 DDD Assessment Project Final Report to JLARC Page 11 of 12

12 Service Requests Service # of Requests Rank Co-pays for medical & therapeutic Svcs 5 65 Emergency Assistance -Extended State Plan Svcs (OT, PT & Speech) 5 66 Emergency Assistance -Nursing Services (also Skilled Nursing) 5 67 Foster Group Care 4 68 Excess medical costs not covered by another source 4 69 Parent/sibling education 4 7 Evaluation -Sexual Deviancy Evaluations 3 71 Emergency Assistance -Environmental Accessibility Adaptations 3 72 Assistive Technology 3 73 Community Guide 2 74 COPES 2 75 Mental Health Crisis Diversion Beds 2 76 Emergency Assistance -Staff/Fam Consult & Training 2 77 MH Stabilization Svcs Specialized Psychiatric Svcs 2 78 Specialized Nutrition & Clothing 2 79 PC ETR 2 8 Medically Needy Residential Waiver 1 81 Emergency Assistance -Transportation 1 82 MH Stabilization Svcs -Behavior Management & Consultation 1 83 SSP - Adult Residential 1 84 Training 1 85 Emergency Assistance - Specialized Medical Equipment & Supplies 1 86 RCL Community Transition 1 87 Total 3,693 DDD Assessment Project Final Report to JLARC Page 12 of 12