michael p. hansen director rick scott governor public meeting december 9, 2011
TRANSCRIPT
Michael P. HansenDirector
Rick Scott Governor
Public MeetingPublic MeetingDecember 9, 2011December 9, 2011
Overall iBudget Goals
• Customer self-direction and choice• Equitable distribution of appropriated Medicaid waiver
funds• Business process efficiencies using technology
2
iBudget Background• 2009 General Appropriations Act (GAA) required plan by
February 2010
– APD researched other states’ systems and best practices
– APD worked with iBudget Florida Stakeholders’ Group to design plan
• iBudget implementation authorized in s. 393.0662, Florida Statutes, in 2010
3
QSI ASSESSMENT1) Functional Score2) Behavioral Score3) Ability to: Transfer, Self-Protect, and Maintain Hygiene
AGE LIVING SETTING
Determines Individual Budgets
4
iBudget Allocation Formula
LEAST FLEXIBLE:•Residential Services•Therapeutic Supports and Wellness
MOST FLEXIBLE:•Life Skills Development•Supplies and Equipment•Personal Supports•Support Coordination•Transportation•Dental Services
CONSUMER CHOICE(12,196 Combinations
of Services)
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Consumer Flexibility in Spending
Create Overall Plan
Technical/Process
Finalize Deployment Strategy
Implement in Phases Statewide
Transition Areas 1 & 2 In Progress
iBudget Phase-In Plan
In Progress
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• The results of the initial proposed model would likely lead to about 2/3 of people getting reductions with many of these having large reductions (over 40% reduction in cost plan compared to current cost plan).
• The initial proposed model could result in about 45% of people not having enough in their budgets to fund their current core services.
iBudget ImplementationChallenges and Impacts
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Non-Core and Core Services
8 8
Core Services Amount
Behavior Services $51,826,726
Consumable Medical Supplies $15,706,045
Durable Medical Equipment $125,541
In-Home Supports $112,798,827
Nursing Services $26,276,542
Occupational Therapy $3,881,908
Personal Care Assistance (PCA) $84,876,522
Physical Therapy $8,030,342
Residential Habilitation $375,049,588
Respiratory Therapy $624,467
Special Medical Home Care $2,081,789
Supported Employment $9,955,184
Supported Living Coaching $30,531,145
Waiver Support Coordination $41,862,739
Portion of Personal Supports (based on In-Home Support and
PCA)$10,794,055
SUBTOTAL - CORE $774,421,419
Non-Core Services Amount
Adult Day Training $84,667,539
Companion Services $41,473,432
Dental Services $3,598,353
Dietician Services $297,508
Environmental Adaptations $210,378
Specialized Mental Health Services
$3,025
Respite Care $22,160,859
Speech Therapy $5,061,633
Transportation $38,339,635
Portion of Personal Supports (based on Companion and
Respite)
$5,992,966
SUBTOTAL - NON-CORE $201,805,327
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Models’ Impact on Individuals67%
32%
45%46%
4%0%
0%
10%
20%
30%
40%
50%
60%
70%
Receiving Reductions Receiving Reductionsover 40%
Core Services Not Funded
Initial Proposed Model Model A
9Note: The initial proposed model would set aside about $100 million for extraordinary needs as well as other required costs not in the algorithm such as waiver support coordination.
• Uses current cost plan and initial proposed iBudget amount as starting point.
• Does not increase any cost plan. Does not decrease any cost plan more than 50%.
• Uses core services to approximate “extraordinary needs.”
• Additional savings from other cost-containment strategies and individual cost plan reviews would continue.
Model AKey Features
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Example 1
$39,813
$19,906
$32,613
$47,804
$39,813
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 2$70,458
$35,229
$55,967
$76,109$70,458
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 3$33,813
$16,906
$11,992 $13,226$16,906
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
$40,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 4$44,802
$22,401
$39,546
$28,283
$39,546
$0$5,000
$10,000$15,000$20,000$25,000$30,000$35,000$40,000$45,000$50,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 5$126,953
$63,477
$125,550
$43,821
$125,550
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 6$68,032
$34,016
$60,611
$42,695
$60,611
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 7$128,698
$64,349
$128,410
$79,771
$128,410
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 8$29,260
$14,630
$5,991
$23,471 $23,471
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 9$76,965
$38,483
$51,039
$68,929 $68,929
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Percentage of Individuals by Funding Approach
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