Michael P. Hansen Director Rick Scott Governor Public Meeting December 9, 2011.

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

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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

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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


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


CoreServices

InitialProposed

Model

Model A

13

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


CoreServices

InitialProposed

Model

Model A

14

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


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


CoreServices

InitialProposed

Model

Model A

16

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


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


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


CoreServices

InitialProposed

Model

Model A

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Percentage of Individuals by Funding Approach

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Thank You!Please email comments by 12/16/11 to

[email protected]

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Michael P. Hansen Director Rick Scott Governor Public Meeting December 9, 2011.

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Transcript of Michael P. Hansen Director Rick Scott Governor Public Meeting December 9, 2011.