Committee Meeting Information

August 24, 2005

UW Outreach Building

Casper, Wyoming

Committee Members Present

Senator Hank Coe, Chairman

Representative Elaine Harvey, Chairman

Senator John Hines

Senator Mike Massie

Representative Bruce Barnard

Representative Rosie Berger

Committee Members Absent

Representative John Hastert

Legislative Service Office Staff

Gerald W. Laska, Staff Attorney
Don Richards, Senior Research Analyst

Others Present at Meeting

Please refer to Appendix 1 to review the Committee Sign-in Sheet
for a list of other individuals who attended the meeting.

Call To Order

Vice chairman Harvey called the meeting to order at 8:00 a.m..  The following sections summarize the Committee proceedings by topic.  Please refer to Appendix 2 to review the Committee Meeting Agenda.

Approval of Minutes

Minutes from the April 18, 2005 Committee meeting were approved by a voice vote.

Pre-School Study

Dr. Linda Goetze of the Early Intervention Research Institute, reported to the Committee on her progress and preliminary results in conducting the study of developmental preschool services in Wyoming.  She presented a PowerPoint presentation (Appendix 3) to illustrate generally:

·         study goals and objectives;

·         activities completed to date;

·         current activities;

·         a profile of clients and results of a survey of families' experiences and feelings about developmental preschool services;

·         a profile of service providers and results of a survey of providers' perceptions;

·         regional and provider cost data;

·         Part B and Part C expenditures per child by expense category;

·         expenditures by region and expense category of state funding sources;

·         providers' salary and benefits compared to school district teachers';

·         general categories of state funding options.

Committee members discussed generally the difficulty and large cost of moving all developmental pre-school workers to the school district salary schedule, and that the cost of capital facilities would have to be included in any funding proposals.  Chairman Harvey requested that the report include a comparison to teachers and state employees for salary and benefits.  Dr. Goetze distributed the schedule of teacher salaries used in her comparisons (Appendix 4).  Senator Massie stated that the Committee would need a simplified per-student funding model for developmental pre-schools in order to avoid annual funding disputes and provider competition, with a standard service model and funds distributed to regions in a way similar to block grants.

Representative Berger asked Dr. Goetze about information on "best practices."  Dr. Goetze replied that there is not much reliable data yet, as there can be no control group and much of the information is therefore theoretical and limited.  Dr. Goetze will include recommendations in the report to the extent they are available in the literature.

 Child Development Services 

Kathleen Orton and Clark Burden addressed the committee.  Ms. Orton stated that there will be great variation in provider costs, as facilities are either donated, shared, rented or purchased.  The system was never designed to be uniform before.  Expense data from Dr. Goetze is interesting, but does not catch all of the costs involved.  Providers need more training resources, a currently unmet need.  A service model exists now in the sense that the Developmental Disabilities Division audits providers for appropriateness of services. 

            Continued Committee Discussion and Public Comment on the Preschool Study

The Committee generally discussed the feasibility of a statewide or regional cost model, or a basic model supplement for high-need children.  Mr. Burdon advised the committee that the providers' association has already been studying best practices models, and that any requirements could easily be put in the providers' contracts with the division.  Cliff Mikesell, Developmental Disabilities Division Administrator, stated that any model would need to account for Wyoming's sparse population where the need is light but otherwise unavailable at a reasonable distance, perhaps by means of a minimum funding level regardless of population.  The Committee requested and actual cost model to review and an executive summary in the final report.

Special Education Funding  06LSO-0052.W1

Don Richards, Senior Research Analyst with the Legislative Service Office, reviewed with the Committee his report regarding problems with the statutory formula for distribution of federal funds to the Developmental Disabilities Division (Appendix 5).  He described the conclusion of the federal Department of Education that the formula is inconsistent with federal law and the Wyoming Attorney General's opinion that the formula is ambiguous at best.  Mr. Richards presented a draft of legislation prepared by staff, 06LSO-0052.W1, that would remove the offending language and provide a formula for the distribution of funds to the DD Division consistent with the informal agreement that had existed between the Department of Education and DD Division.

            State Department of Education – testimony on special education funding

Stephanie Weaver, Wyoming Department of Education, stated that the Department is in the process of adopting rules consistent with federal law, and is proposing a formula that would actually provide more funds to the DD Division than the prior agreement would.  The Committee discussed the Department's proposed formula, whether the new director had yet authorized it and whether it would fulfill the requirement of the Individuals with Disabilities Education Act that cooperation between the Departments of Health and Education be defined.

Senator Coe moved that the draft bill be amended to include the Department of Education proposed formula.  The amendment passed on a voice vote.  Senator Coe moved and Representative Barnard seconded that the Committee sponsor the bill as amended.  The motion carried 5-0-1, with Senator Massie abstaining due to a conflict of interest.

Meeting Recess

The Committee recessed at 12:00 noon for lunch and reconvened at 1:10 p.m.

Discussion of Wyoming State Training School

Senator Cale Case and Diane Hudson, Superintendent of the Wyoming State Training School ("WSTS"), addressed the committee.  Chairman Harvey reminded Senator Case that the Committee does not have jurisdiction over WSTS issues.   Senator Case made the following points:

·         The Department of Health is in violation of court decisions by refusing services to developmental disability clients at WSTS;

·         WSTS cannot be closed and has been greatly improved in recent years; and

·         The national trend in DD services is toward small home community settings instead of nursing homes, such as the Greenhouse Project.

·         The goals of WSTS are, in order, to provide therapy, living and growth needs of clients; to respect clients' choices; and to be cost effective;

·         WSTS programs are unexcelled, costs are already fixed, underutilization does not save money and new clients would not significantly increase costs.

Ms. Hudson stated that she was charged with re-evaluating the role of WSTS when she was hired, that the federal audit rates WSTS programs as some of the best in the country, and that the plan for the facility is to expand emergency and short-term services.  The Committee discussed the numbers of clients served by WSTS and suggested that a name change may be appropriate.  Senator Case advised that the Joint Interim Labor Committee will be reviewing any possible statutory barriers to expanded use of WSTS.

Protection and Advocacy System, Inc.

Buck Gwyn, Protection and Advocacy Staff Attorney, addressed the Committee and distributed his written comments (Appendix 6).  He advised the Committee that relevant court decisions require the option of community services, and the choice is only a real choice when the same services are provided in the communities.

Governor's Planning Council on Developmental Disabilities

Brenda Oswald addressed the Committee regarding the results of community forums on that the Governor's Planning Council has been conducting throughout the state (Appendix 7).  She stated that there is not a high level of dissatisfaction among clients and their families, but commonly stated needs were for more dental care, greater accessibility in public places, information centers, greater disability awareness and easier payment systems for caregivers.

Regional Service Providers

Ruth Sommers and Shawn Griffin addressed the committee.  Ms. Sommers stated that rules and regulations should be in place before any consideration of moving clients to WSTS, and that the rules need to protect civil rights and access to community services.  There are already good programs for acquired brain injury in most communities, but choice will not equal until community services mirror those offered at WSTS.  The Select Committee should be continued.  Staffing and pay issues improved for a while but are deteriorating again with the economic boom in Wyoming.  Mr. Griffin advised the committee that a large study needs to be made of provider costs, that personnel retention problems are increasing, and that a one-time capital facilities fund would improve service availability throughout the state.

The Committee discussed generally the legitimacy of the issues raised and how those might be addressed by a continuation of the Select Committee or referral to other standing committees.

Wyoming Department of Health-Division of Developmental Disabilities

Cliff Mikesell, Administrator, reported to the Committee on the Division's recent activities.  He distributed a summary of an application for a Real Choice System Change federal grant (Appendix 8) and a child waiver billing satisfaction survey (Appendix 9).  Chris Newman described a pilot web-based billing system and distributed a new policy statement for area resource specialists (Appendix 10).

Mr. Mikesell advised that the Division is revising its contract with Navigant Consulting to collect more provider cost data and to standardize reporting.  Data will be used to developing a formula for payment as is done for nursing homes.

Iris Oleske, State Medicaid Agent, explained the cost-based payment system for the waiver programs and nursing homes, and that the Department is following through on its plan to develop a cost-based model for non-institutional providers.  The methodology will be adopted via rules and regulations next year.

Mr. Mikesell and Ms. Oleske distributed copies of draft rules (Appendices 11, 12).  Mr. Mikesell explained how budget footnote nine allowed the elimination of the waiting lists, and the continuing decrease in the federal matching funds rate.

Committee Directives

The Committee discussed continuation of the Select Committee to follow up on changes already recommended and in progress at the Developmental Disabilities Division, the success of the 'footnote 9' budget transfer for the waiting list, a permanent funding solution to the wait list and any legislation resulting from the pre-school study.  The Committee requested staff to prepare a draft report as required by the Committee's enabling legislation.  The next meeting was scheduled for September 21 at 2:00 p.m. in Casper.

Meeting Adjournment

There being no further business, Co-Chairman Harvey adjourned the meeting at 4:55 p.m..

Respectfully submitted,

Senator Hank Coe,  Vice Chairman

Representative Elaine Harvey,  Vice Chairman