Data Specifics Required by HEA 1102 February 23, 2018 Boonville, 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) • Prevocational Services • Adult Day Services • Recreational Therapy • Behavioral Support Services • Residential Habilitation and Support (CIH • Community Based Habilitation – Individual Only) (provided either under a daily or hourly (CHIO) and Group (CHG) rate) • Community Transition • Respite • Electronic Monitoring • Extended Services • Environmental Modifications • Transportation • Facility Based Habilitation – Individual (FHIO) and Group (FHG) • Workplace Assistance • Family and Caregiver Training • Participant Assistance and Care (FSW Only) • Music Therapy • Structured Family Caregiving (CIH Only) 4
How Many Individuals Receive Services in Indiana* 5 * House Enrolled Act No. 1102 – Sec. 4 (b) (1) (A)
Total Waiver Recipients by Waiver Type Over Time 6 Source: Milliman Quarterly Financial Review
Total Waiver Recipients by Waiver Over Time 7 Source: Milliman Quarterly Financial Review Based on Paid Claims
Waiver Type by Age Age Range by Waiver 25,000 20,000 15,000 10,000 5,000 0 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 CIH FSW Grand Total 8 Source: DDRS Insite Data System – Based on enrollment Based on Enrollment
Age by Group Home 3134 3500 3000 2500 1459 2000 1025 1500 379 258 1000 13 500 0 14-18 18-21 22-40 41-65 66+ Grand Total Average SGL Type Number 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 9 Extensive Support Needs (ESN) 81 31.25 18 63 3,134 36.35 14 93 Source: DDRS DART Data System
Group Homes by County 10 Source: DDRS DART Data System
Percent of Total IDD Population in County that Receives Waiver and Group Home Services Max. % with Waiver & Group Home 12 Source: Milliman Quarterly Financial Review
Where Individuals Live WHERE INDIVIDUALS LIVE - BY NUMBER WHERE INDIVIDUALS LIVE - BY PERCENTAGE Supported Supported Living Alone, Group Living, Group Living Living Alone 1,893 Foster Home 3,134 Foster Home 11% 7% (child), 57 (child) 0% Shared Living, Shared Living 5,418 19% Living in Structured Living in Family Care Living with Structured Home Family Living with Family Care 1% 62% Family, 17,313 Home, 211 14 N = 28,026 Source: DDRS Insite Data System
Where Individuals Live by Waiver Where Individuals Live - CIHW Where Individuals Live - FSW Shared Living, Living Alone, Living Alone, 61 1,194 699 Living with Family, 2,473 Shared Living, 5,357 Living in Structured Living with Family Care Family, Home, 211 14,840 15 Source: DDRS Insite Data System
Waiting list for Services* Where Individuals are Waiting for Services** 16 * House Enrolled Act No. 1102 – Sec. 4 (b) (1) (C) **House Enrolled Act No. 1102 – Sec. 4 (b) (1) (E)
Number on FSW Waiting List by Region 1381 1381 1400 1200 1000 800 478 478 600 224 224 400 143 143 85 85 159 159 114 114 75 75 103 103 200 0 District 1 - District 2 - District 3 - District 4 - District 5 - District 6 - District 7 - District 8 - Total Northwest North Northeast Eastern Central Eastern Southwest Southeastern Indiana Central Indiana Indiana Indiana Indiana Indiana Indiana Indiana 17 Source: DDRS DART Data System
FSW Waiting List by Age Range 14-18 15% 18-21 8% 5-14 36% 21-55 12% 55 + 2% 0-3 18 3-5 12% 15% Source: DDRS DART Data System
Nature of Available Services* 20 * House Enrolled Act No. 1102 – Sec. 4 (b) (1) (B)
BDDS Spend by Funding Stream – SFY 2016 ICF/ID Total, $268,281,597, 28% CIH Waiver Total, $586,424,243, 61% Family Supports Total, $104,521,550, 11% ICF/ID Total Family Supports Total CIH Waiver Total 21 Source: Milliman Quarterly Financial Review
Total Spend Individuals Served by BDDS SFY - 2016 State Plan Services ICF/ID Total, Total, $165,223,674 $268,281,597 Family Supports Total, CIH Waiver Total, $104,521,550 $586,424,243 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 Source: Milliman Quarterly Financial Review
Total Expenditures and State Share Over 10 Years Waiver and State Plan Services $1,000,000,000.00 $900,000,000.00 $800,000,000.00 $700,000,000.00 $600,000,000.00 $500,000,000.00 $400,000,000.00 $300,000,000.00 $200,000,000.00 $100,000,000.00 $0.00 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% 27 Source: Milliman Quarterly Financial Review
Top Services Utilized – CIHW - SFY 2016 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 RHS Behavior Transport Communi Behavior RHS Daily Wellness Facility Pre- Communi Music Facility Respite Hourly Managem ation (all ty Managem (all levels) Habilitatio Vocationa ty Therapy Habilitatio ent levels) Habilitatio ent 10 n Group l (all Habilitatio n n (all ratios) ratios) n Group Individual Individual (all ratios) 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 28 Source: BDDS INsite Database
Top Services Utilized – FSW SFY 2016 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 Participant Behavior Respite Behavior Facility Transportatio Music Pre- Community Community Facility Assistance Management Management Habilitation n (all levels) Therapy Vocational Habilitation Habilitation Habilitation and Care 10 Group (all (all ratios) Individual Group (all Individual ratios) ratios) 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 29 RHS = Residential Habilitation Services Source: BDDS INsite Database
FSW Spend – SFY 2016 $120,000,000 $100,000,000 $80,000,000 $60,000,000 $40,000,000 $20,000,000 $0 Adult Day Behavioral Case Day Services Respite Care Therapies Participant Other Waiver Family Supports Services Support Services Management Other Assistance and Services Total Care 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 30 Day Services include Community and Facility Habilitation, Pre-Vocational and Extended Services Therapies include Music and Recreational Therapy Source: Milliman Quarterly Financial Review
CIHW Spend – SFY 2016 $600,000,000 $500,000,000 $400,000,000 $300,000,000 $200,000,000 $100,000,000 $0 Structured Adult Day Behavioral Case Day Residential Respite Therapies Waiver Monitoring Wellness Other CIH Waiver Family Services Support Manageme Services Habilitation Care Other Transporta System Coordinati Waiver Total Caregiving Services nt and tion on Services Support 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 31 Day Services include Community and Facility Habilitation, Pre-Vocational and Extended Services Source: Milliman Quarterly Financial Review Therapies include Music and Recreational Therapy
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