Wyoming Legislature

Committee Meeting Summary of Proceedings

Select Committee on Developmental Programs

 

November 22, 2004

Univ. of Wyoming Outreach Building

Casper, Wyoming

 

Meeting Attendance (Present)

 

Committee Members

Senator Irene Devin, Co-Chairman

Representative Elaine Harvey, Co-Chairman

Senator John Hines

Senator Rae Lynn Job

Representative Rosie Berger

Representative Bob Brechtel

Representative John Hastert

 

 

Legislative Service Office

Gerald W. Laska, Staff Attorney

Don Richards, Senior Research Analyst

 

Others Present

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

 

 

Written Meeting Materials and Handouts

All meeting materials and handouts provided to the Committee by the Legislative Service Office (LSO), public officials, lobbyists, and the public are referenced in the Meeting Materials Index, attached to the minutes. These materials are on file at the LSO and are part of the official record of the meeting. 

 

Call To Order

Chairman Devin called the meeting to order at 9:07 a.m.  The following sections summarize the Committee proceedings by topic.  Please refer to Appendix 2 to review the Committee Meeting Agenda.

 

Developmental Disabilities Division: Supplemental Budget Need; Interagency Transfers; On-Going Committee Education and Oversight

 

Phyllis Sherdard, Department of Health Deputy Director for Programs, and Cliff Mikesell, Developmental Disabilities Division Administrator, reviewed the status of the Division for the committee.  Mr. Mikesell stated that the Division had filed the five reports required by the legislature and had substantially completed a revision of the Division's rules with the assistance of their assistant attorney general, contract outside counsel and an informal advisory group.  Draft rules for all of the Division's programs will be circulated to providers and other interested parties before formal adoption.

 

            Mr. Mikesell advised the committee of the Division's supplemental budget request of approximately $1.2 Million to increased pre-school program participants.  The committee discussed generally the dates and client counting methods used in the Division's contract and budget projections.

 

Shelldon Skelcher, Developmental Disabilities Division, explained that the Division uses an average based on the December and May counts, and that counts are increasing despite the overall decline in student population because of a new screening program for pre-2 year olds, because of new DFS referrals under a mandatory federal program, because of the methamphetamine problem and because of improved identification generally.  Mr. Skelcher distributed and reviewed for the committee a summary of the Division's early intervention education program (Appendix 3).

 

Mr. Mikesell distributed and reviewed for the committee a packet of materials, including a copy of the working group's proposed changes to Medicaid rules on the adult home and community based waiver program (Appendix 4A); a summary of the emergency waiver referral cases (Appendix 4B); a summary of the waiting list status as of November 19, 2005 (Appendix 4C); a projection of the adult DD wait lists to June 30, 2006 (Appendix 4D); a summary of the on-going review of the "DOORS" budgeting model (Appendix 4E); and a summary of DD adult staff wages and turnover rate from 2001 through 2004 (Appendix 4F).

 

The committee discussed generally the legislature's frustration with changing numbers on the wait list and budget projections and lack of tracking information about the possible increase in ultimate costs resulting from delay in services, especially to brain-injured clients.  Chairman Devin commented that it is sometimes foolish to wait-list clients because available federal funds are not leveraged while the person is on a wait list.  Cliff Mikesell and Phyllis Sherard explained that current funding is probably adequate to serve more clients if the statutory client caps were increased.  The committee generally discussed the effect of budget limitations, clients caps and budget transfers.

 

Mr. Mikesell advised the committee that the Department has contracted with Navigant Consulting to assess provider cost and service levels, and that Navigant's report due December 31, 2004, would address: an examination of the DOORS budgeting model; the turnover rate in the DD provider staff; moving area resource specialists into a program integrity function; extending provider certifications from one year to two or three years; reviewing the role of area resource specialists and reducing their administrative functions.  Mr. Mikesell advised that CMMS review of the children's waiver program found the program to be in substantial compliance with federal requirements in all areas, with some recommended changes.

 

Mr. Mikesell presented the committee with a chart showing, for each year from 1999 to 2004, the number of clients, average amounts expended and total expenditure in the child waiver, adult DD waiver and adult ABI waiver programs (Appendix 5).

 

 

Consideration of Draft Legislation

The committee discussed draft legislation requested at the previous meeting.

 

            05LSO-0125.W2.  Department of health service providers.  The bill would create a new section, W.S. 42-4-120, giving the Department of Health specific authority to enter into contracts with HCBW service providers, to adopt rules for certification of service providers, to place conditions upon or revoke the certification of service providers and to impose a civil penalty upon service providers who are found to have a continuing condition creating extreme danger to the health, safety or welfare of HCBW services recipients.  The committee adopted the following amendments to the draft:

·        Page 3-line 2:  change the grounds for civil penalty from "extreme danger" to "serious detriment";

·        Page 2-line 20 thru page 3-line 9:  reverse paragraphs (d) and (e) regarding contract penalties and civil fines.

Chairman Devin moved that the committee sponsor the bill.  The motion carried on a vote of 7-0.

 

 

Public Comment

            Shawn Griffin, as president of the Rehabilitation Service Providers Association, stated: that the association appreciates the cooperative relationship developing with the Developmental Disabilities Division; that a costing study would be very helpful and that the per client costs may be higher in Wyoming as a sole-source state; that the association supports a bill to put teeth in the state's contracting authority; and that the association will continue working with the Governor's Council on broader issues.  As owner of Community Entry Services, Ms. Griffin stated that there should be an ABI/DD advocate position created and that the wait list problem needs to be addressed as the list will continue to grow and the state is in a financial position to afford a solution now.

 

 

Luncheon Recess

The Committee recessed at 12:20 p.m.  Co-chairman reconvened the meeting at 1:38 p.m.

 

 

Consideration of Draft Legislation (cont'd)

05LSO-0126.W1.  Select committee on developmental programs.  The bill would amend the select committee's 2004 enabling legislation by requiring an additional report from the committee to the legislature and governor by October 1, 2005.  Chairman Devin moved that the committee sponsor the bill.  The motion carried on a vote of 7-0.

 

 

Explanation of Federal Education Funding for Pre-Schools

            Joan Gaston and Stephanie Weaver, Department of Education explained the flow-through of federal Section 619 funds and Section 611 funds from the U.S. Department of Education Office of Special Education, through the Wyoming Department of Education and to the Department of Health.  The committee discussed the Department of Education's and the Department of Health's respective roles in oversight and accountability for those funds.  Ms. Gaston stated that DD's Individual Education Plan determines the service goals and budget, that the Department of Education monitors compliance with those goals and submits an annual report to the U.S. Office of Special Education.  Shelldon Skelcher referred the committee to Appendix 3, page 10 regarding the monitoring of Part C and Part B Services, and that the Disability Division will probably re-impose a testing component to determine IEP outcome success.

 

Pre-School Study Report

            Dr. Linda Goetze, Early Intervention Research Institute, reported to the committee on the progress of the contracted evaluation of pre-school services and costs in Wyoming.  Dr. Goetze made a Powerpoint presentation (Appendix 6).  The study protocols have been designed and submitted to the Department of Health and the Utah State University Institutional Review Board for Approval on November 9th.

 

Committee Discussion

            The committee generally discussed recommendations and directives for the Developmental Disability Division.   The committee discussed its need for more and better data on the wait lists, including realistic cost of services to those wait listed, and a permanent solution for the wait list that includes a realistic increase in authorized slots and a funding solution that does not rely on the transfer of unused funds from other programs.  The committee, on an informal vote of 7-0, approved the communication of its recommendations to the appropriations committee.

 

Meeting Adjournment

There being no further business, Chairman Harvey adjourned the meeting at 3:00 p.m.

 

Respectfully submitted,

 

 

 

Elaine Harvey, Chairman
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