SELECT COMMITTEE ON DEVELOPMENTAL PROGRAMS

Committee Meeting Information

June 16, 2004

Capitol Building Room 302

Cheyenne, Wyoming

 

Committee Members Present

Senator Irene Devin, Chairman

Representative Elaine Harvey, Chairman

Senator Rae Lynn Job

Representative John Hastert

 

Committee Members Absent

Senator John Barrasso

Representative Rosie Berger

Representative Bob Brechtel

 

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

Chairman Devin called the meeting to order at 8:30 a.m.  The following sections summarize the Committee proceedings by topic.  Please refer to Appendix 2 to review the Committee Meeting Agenda.

 

 

 

LSO Staff Overview

Don Richards, LSO Senior Research Analyst, described LSO's program evaluation on the adult waiver program for persons with developmental disabilities, and the provisions of 2004 SF 84.  The legislation created the select committee and charged it with two main topics:  studying Wyoming's and other states' developmental disabilities programs and identifying potential system improvements; contracting for a study of the costs and various delivery models for developmental health and educational services to qualifying preschool children.  Results of the first study are to be reported to the governor and the legislature by October 1, 2004.  A preliminary report on the preschool study is due by November 1, 2004 and a final report by October 1, 2005.

 

LSO Program Evaluation Summary

Barbara Rogers, LSO Program Evaluation Manager, described generally the function of the program evaluation section and the management council's listed areas of study for the developmental disabilities evaluation.  Those areas included eligibility, adequacy of rules, cost effectiveness and service purchase/monitoring procedures.

 

Kelley Pelissier, LSO senior program evaluator, used a Powerpoint presentation (Appendix 3) to describe the major findings of the evaluation.  The adult waiver program is one of seven programs administered by the Developmental Disabilities Division, but represents 55% of the budget.  Ms. Pelissier described:

o     investigation of program/funding alternatives to the waiver program

o     more substantive program procedural and eligibility guidance in formal division rules

o     independent evaluation of the DOORS model

o     accountability systems for emergency case expenditures

o     expanded cost justification and auditing for service providers.

 

The committee generally discussed the evaluation, the DOORS model and the procedures for establishing an individual's service needs and budget.

 

Adult Development Disabilities/Department of Health

Representatives of the Wyoming Department of Health next addressed the committee.  They included: Deborah Fleming, Department Director; Robert Clabby, Developmental Disabilities Division Administrator; Jon Fortune, Deputy Division Administrator for Community Services; and Iris Oleske, Medicaid Program Manager.

 

Dr. Fleming presented a handout of statistics concerning the Wyoming adult waiver program (Appendix 4).  She stated that Wyoming's adult waiver program has existed since 1991 and was just renewed for five years, that the program passed its latest federal review and was ranked 3rd out of 25 states in program quality and choice.  Mr. Clabby added that the program ranked 26th out of 50 states in cost per client. 

Jon Fortune used a Powerpoint presentation to explain eligibility criteria and the DOORS individual case budgeting model.  He stated that Wyoming is 25th among the states in cost per capita and 27th in cost per client.

 

Mr. Clabby distributed and explained:  Listing of DDD Things To Do in 2004 (Appendix 5); Promising Practices in Home and Community-Based Services (Appendix 6); 2004-2009 Adult Home and Community Based Waiver renewal notice and application materials (Appendix 7); graph of Wyoming client population (Appendix 8); Forecast of Service Demand in Wyoming (Appendix 9); and Doing the Right Thing (Powerpoint presentation, Appendix 10).

 

Following Mr. Clabby's presentation, the committee generally discussed: the process of establishing case budgets and caps; due process procedures in division determinations; the respective authority of the client/family, planning team and case manager in selection of services; the appropriateness of the case manager being an employee of a service provider; the adequacy of case outcomes documentation; the shortage of caregivers, especially habilitation and nursing services for difficult clients; and the division's progress in adopting rules and regulations, which the division anticipates will be adopted by January.

 

Study of Preschool Health and Education Services

The committee was addressed by Morita Flynn, Child Development Services board member and Executive Director of the Development Preschool and Daycare in Laramie in Rawlins, and Kathleen Orton, Educational Consultant for Child Development Services.  They distributed and discussed the following materials:

 

The presenters provided an overview of the program's funding, including federal Part C funding for birth to age 3, Part B funding for ages 3 to 5, and local match funds which constitute 10% of overall funding and can be in cash or in-kind.  Eligibility guidelines are federally established and applied by a multi-disciplinary team.  There are current 2800 clients, of whom 750 are under age 3.  Prospective eligibles are referred from any source, including preschool, medical providers and families. 

 

The committee generally discussed: the need to establish credibility for the numbers served; the need to validate eligibility testing; the lack of a comprehensive study of the costs of early intervention programs; the need for the most cost effective system using best practices; the effect of the methamphetamine problem on client numbers; whether the school facilities commission actions could lead to the loss of pre-school facilities if K-12 schools are closed.

 

Jon Fortune and Shelldon Skelcher, Developmental Disabilities Division, and Joan Gaston, Department of Education, commented.  A study of developmental preschool costs is necessary, and the chosen contractor should understand  the §619 funding component and special problems of providing the services in Wyoming, such as the travel time involved, dispersed population, low student/staff ratios.  Mr. Skelcher stated that mental health services for infants is an increasingly important topic due to drug-addicted parents.  He added that there is an epidemic of methamphetamine use, which leads to diagnosable conditions such as autism but also an increase in domestic violence and child neglect.  There is a need for long-term longitudinal studies of children served in developmental preschools and receiving mental health services.

Project Scope of Study

The committee reviewed and approved the RFP for the study.  In addition to the items specified in the draft RFP, the committee wants the study to include a matrix comparing similarities and differences in the 14 service regions, a comparison of flat fee versus individualized budgeting, and a statistical analysis of costs that includes ranges and outliers in addition to averages.

 

The committee tentatively scheduled a meeting on August 11th to review proposals received in response to the RFP.

 

Meeting Adjournment

There being no further business, Chairman Devin adjourned the meeting at 12:50 p.m..

 

Respectfully submitted,

 

 

 

Senator Irene Devin, Chairman

 

 

 

Representative Eileen Harvey, Chairman

 

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