Committee Meeting Information

December 17, 2007

Riverton Public Library

1330 W. Park Avenue

Riverton, Wyoming

 

Committee Members Present

Representative Elaine Harvey, Cochairman

Senator Pat Aullman

Senator Mike Massie

Representative Bernadine Craft

Representative Dan Dockstader

 

Committee Members Absent

Senator Hank Coe, Cochairman

Representative Rosie Berger

 

Legislative Service Office Staff

Gerald W. Laska, Staff Attorney

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.

 

 

Meeting Summary

 The Committee met for approximately four hours on December 17, 2007.  Representatives of Navigant Consulting, on contract with the Developmental Disabilities Division, presented the results of their study and a recommendation for a cost-based model for calculating reimbursements to service providers in the adult, children and acquired brain injury waiver programs.  The Committee discussed discrepancies between the Governor's proposed budget and on-going programs established by prior legislation sponsored by the Committee.  No further meetings were scheduled.

 

Call To Order

Co-Chairman Harvey called the meeting to order at 9:00 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 October 9, 2007 Committee meeting were approved.

 

Proposed legislation: 08LSO-0154.W2  Developmental programs-cost based payments.

Cliff Mikesell and Kevin Malm from the Department of Health, with Jim Pettersson and Sarah Barry from Navigant Consulting, addressed the Committee.

 

Mr. Pettersson and Ms. Barry, using a PowerPoint presentation (Appendix 3), explained the rate setting methodology they prepared, their recommendations, the differences between rate setting and setting of individual budget amounts, and the impacts of the recommendations on provider payments to developmental disability service providers.  Ms. Barry explained three rate setting methodology options: retrospective cost-based; prospective standardized cost-based; and prospective standardized model-based with cost-based variables.  The consultants recommended the latter method, with parity among the waiver programs and no local geographic adjustments, to be implements as individual budget amounts come up for renewal.

 

Committee members generally discussed with Department of Health staff and the consultants the pros and cons of the three rate setting methodologies, the source of cost and wage data, and the impact on various subsets of the disability service provider community.

 

According to Mr. Peddersson, the proposed model would result in five of the 20 largest providers experiencing a decrease in payments of approximately $450,000 out of the $20 Million they currently receive.  He distributed a rate setting impact analysis under the proposal for the 2009/2010 biennium (Appendix 4).  Several service provider representatives commented, generally in favor of the bill but concerned about the revenue loss for a few of the larger providers.

 

The Committee considered the proposed bill (Appendix 5) and amendments to the bill proposed by Ruth Sommers of Regional Service Providers of Wyoming (Appendix 6).  Ms. Sommers also distributed to the Committee a letter from her association regarding their position on the bill and related funding issues (Appendix 7).

 

The Committee adopted the following amendments:

·         Revise the title of the bill to refer to "home and community based waiver programs for persons with developmental disabilities and acquired brain injury" instead of "developmental disability home and community based waiver programs";

·         Throughout the bill, reference "cost based reimbursement system" instead of "cost based payment system";

·         Page 2-line 21      Add language to direct the Department to request  in its budget sufficient funds for rebasing the rates model every 2-4 years;

·         Change the appropriation from $2,933,264.00 to $3,886,115.00.

 

Senator Massie, seconded by Representative Craft, moved that the Committee sponsor the bill as amended.  The motion passed unanimously, with Senators Massie and Aullmann and Representatives Craft, Dockstader and Harvey voting aye.

 

 

Funding Issues for Developmental Pre-Schools and Developmental Disability Waiver Programs

Brent Sherard, Department of Health Director, gave the Committee an overview of the budget process, including Department requests, budget office review and the preparation of the governor's budget proposal.  The Committee discussed with Dr. Sherard and Cliff Mikesell how the budget for out-of-home placements was calculated and whether that would be sufficient for the anticipated number of applicants.  Mr. Mikesell testified that the expected the amount requested would be sufficient, as the number of applicants has been fewer than projected.

 

The Committee likewise discussed the adequacy of the Governor's proposed budget for moving children off of the children and adult waiver waiting lists.  Mr. Mikesell stated that there were 186 adults and 50 children on the waiting lists during the current biennium.  Senator Massie stated that the proposed budget numbers suggest that the waiting lists will double by the end of next biennium.  Mr. Mikesell did not disagree with Senator Massie's projection.

 

The Committee discussed the lack of proposed funding for social-emotional services in the pre-schools.  Mr. Mikesell stated that the budget office concluded the current funding was one-time funding only, but that the Department is prepared to bring a proposed amending to the Joint Appropriations Committee in January to fund those services.  Senator Massie stated that the prior bill was clear that the program should be included in the standard budget request.

 

Public Comment

Sue Sharp, Education Consultant for Child Development Services of Wyoming, addressed the Committee and distributed a fact sheet (Appendix 8) regarding eligibility determinations and the number of children eligible for early intervention services.

 

Brenda Oswald, Governor's Planning Council on Developmental Programs, thanked the Committee for its work on behalf of persons with developmental disabilities and reminded them that any waiting list is too long for the affected persons.

 

Dr. Sherard thanked the Committee for its hard work and progress over four years and the great strides that have been accomplished in taking care of persons with developmental issues.

 

Shawn Griffin, CEO of Community Entry Services in Riverton, advised the Committee that there should be regular cost-of-living increases built into the budget process for developmental disability service providers, so that the providers don't have to keep coming back to lobby the legislature to keep from falling behind.

 

Ruth Sommers, Regional Service Providers of Wyoming, reminded the Committee that hundreds of additional persons are receiving needed services because of this Committee's, that program integrity is good, that standardized funding methods are in place and that there are now rules for eligibility and procedures – all as a result of this Committee.  She stated that the education cost adjustment and social-emotional pilot project initiated by the Committee are receiving national attention and are being copied by other states.  She expressed her thanks to the current and previous Committee members, whom she listed.

 

Meeting Adjournment

There being no further business, Co-Chairman Harvey adjourned the meeting at 1:55 p.m.

 

Respectfully submitted,

 

 

 

Senator Hank Coe, Co-Chairman

 

 

 

 

Representative Elaine Harvey, Co-Chairman

 

 

 

 

 

 

 

 

 

Appendix		Appendix Topic		Appendix Description		Appendix Provider
1		Committee Sign-In Sheet		Lists meeting attendees		Legislative Service Office
2		Committee Meeting Agenda		Provides an outline of the topics the Committee planned to address at meeting		Legislative Service Office
3		Proposed legislation: Developmental programs-cost based payments.		PowerPoint Presentation: "Overview of Rate Development for Wyoming's Developmental Disability Waivers		Navigant Consulting
4		Proposed legislation: Developmental programs-cost based payments.		HCBS Waiver Rate setting Impact Analysis 2009/2010 Biennium Projections		Navigant Consulting
5		Proposed legislation: Developmental programs-cost based payments.		08LSO-0154.W2 Developmental programs-cost based payments.		LSO
6		Proposed legislation: Developmental programs-cost based payments.		Suggested amendments		Regional Service Providers of Wyoming / Sommers
7		Proposed legislation: Developmental programs-cost based payments.		Letter to Committee from Regional Service Providers of Wyoming		Regional Service Providers of Wyoming / Sommers
8		Funding Issues for Dev'l Pre-Schools and Dev'l Disability Waiver Programs		Funding Fact Sheet 2008 – Wyoming Developmental Preschools		Child Development Services of Wyoming / Sharp