In our recent review of the field, The 2019 OPEN MINDS National Innovation Survey: 2019 Innovation Adoption Among Specialty Provider Organizations found that new innovations among providers of intellectual/developmental disabilities (I/DD) services were focused on telehealth use and medication adherence programs. And, this group reported an 18% increase in establishing “center of excellence” contracts with payers.
This piqued my curiosity. What new approaches has the market adopted to meet the needs of the I/DD community? It turns out that in 2019, states have been extremely busy adjusting their approaches to serving this population.
Indiana—Following a new state law in Indiana, the state is now developing a series of new programs for consumers with I/DD, including the development of a new statewide crisis assistance system program; the creation of job placement services for individuals with I/DD; and changes to Indiana First Steps program to make it easier for individuals to enter and stay in the program (see Indiana To Develop Statewide Crisis Assistance Program For People With Intellectual/Developmental Disabilities).
Illinois—In Illinois, the Department of Human Services (IDHS) is ramping up to launch new independent service coordination (ISC) contracts (valued at $40 million) with eight provider organizations that will serve as the primary regional connection between consumer of I/DD services and the IDHS Division of Developmental Disabilities (DDD). These provider organizations will offer outreach, initial intake, management of the Prioritization of Urgency of Need for Services (PUNS) database, eligibility determinations, person-centered planning, linkage to services, and coordinating service delivery (see Illinois Selects Vendors For New I/DD Independent Service Coordination Contracts).
New Mexico—In New Mexico, the Department of Health (DOH) and the Human Services Department (HSD) is to develop a new Medicaid home- and community-based services (HCBS) supports waiver program for consumers with I/DD with the goal of creating new service options for consumers already on the Developmental Disabilities (DD) Waiver and the Mi Via Waiver waitlists (see New Mexico To Develop New I/DD Supports Waiver). The DOH and HSD are currently researching how the other states with supports waivers administer their waivers, to counter the current 13.3 year wait list for the other two waivers.
Tennessee—In Tennessee, the state is changing its approach to billing for I/DD employment and day services from a six-hour daily rate to 15-minute fee-for-service (FFS) rates so that consumers in these programs can receive up to 60 hours of services within each 14-day billing period, with no daily limit on the number of services or hours (see TennCare To Change Billing For I/DD Day Services From Daily Rates To 15-Minute FFS Units). Consumers will have more control over how, when, and where the services are provided, and the change will eliminate billing for a supported employment per diem when no job coaching is provided.
New Jersey—In New Jersey, the current proposed budget for 2020 includes $22.5 million in new funding for waiver slots and a health home pilot for consumers with I/DD (increasing the budget for I/DD benefits to $800 million); another $20 million to increase pay for direct-service providers who care for these consumers; and the directive to create more home- and community-based services slots and a Medicaid behavioral health home pilot program (see New Jersey Governor Proposes $22.5 Million I/DD Funding Increase For Waiver Slots & Health Home Pilot).
Missouri—Missouri announced it is becoming a Technology First state and will focus on evaluating and implementing technology-related solutions that improve the quality of life for individuals. Missouri DMH intends that “Technology First” designation will support self-directed services (see Missouri Launches ‘Technology First’ Approach For People With I/DD). “Technology First” initiatives are plans to expand access to technology for people with developmental disabilities, with the goal of promoting their ability to live as independently as possible in the community (see Are You In A ‘Technology First’ State? What Does That Mean?).
New York—In New York, the state began accepting applications for free, specialized identification cards for consumers with I/DD, with the intention to help first responders better interact with consumers who have limited communication ability (see New York Launches ID Cards For People With Developmental Disabilities). While not mandatory, the cards are available upon request and will show the consumer’s name, address, date of birth, emergency contact information, and information such as how the person’s disability may interfere with compliance with law enforcement and emergency services personnel.
California— A 2013 state law called on The California Department of Developmental Services (DDS) to expand self-determination statewide, which the state began doing last year with the Self-Determination Program, or SDP (see California To Launch Self-Determination Program For Individuals With I/DD). In June 2018, The Centers for Medicare & Medicaid Services (CMS) approved a waiver to implement the plan, and in July 2018, the state began finalizing the plan. In October 2018 the state launched the program by selecting the initial 2,500 participants with I/DD for the first three years of the SDP (see California Selects Participants For I/DD Self-Determination Program To Launch In 2019). The initial selected participants enrolled at the regional centers and must complete an orientation and establish an individual budget by November 15, 2019, and the last 500 participants are on track to complete the mandatory orientation by the November deadline (see Self-Determination Program Enrollment). Once the participants have received orientation, they will be granted employer and budget authority. After the phase in period is completed (June 7, 2021), the program will be available statewide with no participant quota (see Self-Determination Program).
These state initiatives provide insight into “what payers want” in the I/DD space—the information that executive teams of specialty provider organizations in this market can use for new service line development. Ask yourself, are you the “right service package” for this population? What will it take to answer “yes”? For more on navigating the I/DD space, check out these resources from the OPEN MINDS Industry Library:
- Two Approaches To Bring Quality To I/DD Services
- I/DD & Managed Care – What Are The Early Lessons For Providers?
- The Medicaid Vertical Carve-Out Model Comes To I/DD
- For I/DD Services, Answering The Value Questions
- I/DD & Managed Care? There Will Be Requirements
- Planning For A Risk-Based, Community-Focused I/DD Market
- Living In The Community—The Landscape For Adults With I/DD
- For I/DD, The Question Isn’t Managed Care Or Not—It’s Residential Care Or Not
- Disruption (& Strategic Planning) Come To The I/DD Space
- What Does ‘Value-Based’ Look Like In The I/DD Field?
For more, join me on October 28 for The OPEN MINDS Children’s Services Leadership Summit, where we will discuss autism service delivery and the financing with Yagnesh Vadgama, BCBA, Vice President, Clinical Care Services Autism, Magellan Health and Katherine Wooten, LCSW, BCBA, Clinical Director – Corporate Programs, New Directions.