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Division of Developmental Disabilities: Analysis of How Services Are Prioritized
Proposed Final Report to the
Joint Legislative Audit & Review Committee
July 31, 2007
Cynthia L. Forland
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Division of Developmental Disabilities 2July 31, 2007
Presentation Overview
• Study Mandate
• What JLARC found and recommends:− Limited legislative direction− Primary Division initiatives scheduled to be
implemented soon− Shortcomings in assessing clients not
receiving paid services
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Division of Developmental Disabilities 3July 31, 2007
Study Mandated by 2006 Supplemental Operating Budget
JLARC “to conduct a review of how the
Department of Social and Health Services
Division of Developmental Disabilities
prioritizes and allocates services.”
Report Page 1
STUDY
MANDATE
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Division of Developmental Disabilities 4July 31, 2007
Limited Legislative Direction for Prioritizing Services
• No clear priorities in permanent state law
• Specific entitlement services establish a
type of priority (MPC, institutions)
• Priorities attached to particular allocations
of funding for specific types of services in
State Operating Budgets
Report Pages 7-8
WHAT
JLARC
FOUND
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Division of Developmental Disabilities 5July 31, 2007
Full Assessment Being Implemented Last Month
Report Pages 9-11
Clients not authorized for paid service
Case management services only
Clients authorized for paid service
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Division of Developmental Disabilities 6July 31, 2007
Information System Planned To Be Implemented in March 2008
Case Management Information System (CMIS) is planned to:
− Provide centralized information system to help staff assist clients and plan for future needs
− Combine functions of several current separate information systems
Report Pages 15-16
WHAT
JLARC
FOUND
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Division of Developmental Disabilities 7July 31, 2007
Primary Initiatives To Be Implemented Soon
Recommendation 1:
The Department of Social and Health Services should provide a report to the Legislature by January 2009 on implementation of its two primary initiatives.
Report Page 17
JLARC
RECOMMENDS
DSHS and OFM concur
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Division of Developmental Disabilities 8July 31, 2007
Mini-Assessments of 34% of Clients Not Receiving Paid Services
• Division changed its priorities for completing assessments to address backlog in its system
• Division did not set up mechanism for tracking priorities
• Division will be continuing to assess remaining clients not receiving paid services
Report Pages 19-20
WHAT
JLARC
FOUND
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Division of Developmental Disabilities 9July 31, 2007
Division Ineffectively Managing Client Mini-Assessment ProcessRecommendation 2:
The Division of Developmental Disabilities should:
− Establish a clear set of priorities for case managers to follow in assessing the remaining clients; and
− Track which of the specific priorities apply to each client.
Report Page 20
JLARC
RECOMMENDS
DSHS and OFM concur
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Division of Developmental Disabilities 10July 31, 2007
Division Combines Two Definitions of “High Level of Need”
Report Pages 20-21
High Level of Need2,012
High Level of Need
749
Mini-Assessment
Tool2,954
Enrolled in Medicaid?
Clients Going Through Process
3,703(as of Feb 2007)
No Mini-Assessment
ToolYes
No
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Division of Developmental Disabilities 11July 31, 2007
Client Assessment Results Are Not Clearly Identified
Recommendation 3:
The Division of Developmental Disabilities should clearly distinguish clients who are likely eligible for the Medicaid Personal Care program from clients whose Mini-Assessment score identifies their high level of need.
Report Page 21
JLARC
RECOMMENDS
OFM concurs
DSHS partially concurs
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Division of Developmental Disabilities 12July 31, 2007
Contact Information
Cynthia L. Forland
http://www.leg.wa.gov/jlarc