data specifics required by hea 1102day services include community and facility habilitation,...

Data Specifics Required by HEA 1102

February 23, 2018Boonville, IN

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Definitions and Terms

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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

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Total Waiver Recipients by Waiver Over Time

Source: Milliman Quarterly Financial ReviewBased on Paid Claims

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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

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Group Homes by County

Source: DDRS DART Data System10


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

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Where Individuals Live by Waiver

Living Alone, 1,194


Living in Structured Family Care Home, 211

Shared Living, 5,357

Where Individuals Live - CIHW

Living Alone, 699


Shared Living, 61

Where Individuals Live - FSW

Source: DDRS Insite Data System

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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


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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%


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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


BDDS Spend by Funding Stream – SFY 2016

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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


Total Spend Individuals Served by BDDS SFY - 2016

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Cost per Individual by Waiver Type Over Time

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25


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$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%


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

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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

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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

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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

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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

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$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


State Plan Spend (BDDS) – SFY 2016

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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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http://stateofthestates.educationsuperhighway.org/?postalCd=IN

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

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

https://www.in.gov/indot/files/2016 INDOT Transit Annual Report.pdf

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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