Transcript of Developing and Sustaining a Part C Finance System: Connecticut.
- Slide 1
- Developing and Sustaining a Part C Finance System:
Connecticut
- Slide 2
- Ongoing Monitoring of: Demographics Expenditures State
Economics Political Context
- Slide 3
- Demographic Information Trends in Children Served Fiscal Year
2003
- Slide 4
- Demographic Information Eligibility Moderate eligibility
criteria (-2SD in one area, -1.5 SD in two areas) Children with
other diagnosed conditions plus mild delays are also eligible
Children with -2SD in speech only plus a biological factor are
eligible List of diagnosed conditions with high probability of
resulting in a developmental delay
- Slide 5
- Alaska2.21 Montana1.84 Oklahoma1.83 North Dakota1.59 D.C. 1.45
Missouri1.28 Arizona1.27 Nevada1.03 Massachusetts 5.29 Hawaii3.64
Indiana3.42 Delaware2.93 Wyoming2.86 New Hampshire2.63 Florida2.57
Wisconsin2.56 Arkansas2.56 Rhode Island2.51 Kansas2.41
Pennsylvania2.38 Vermont2.38 Maryland2.34 Maine2.28 South
Dakota2.15 West Virginia2.26 Colorado2.26 Virginia2.07 Michigan1.78
Ohio1.70 Mississippi1.65 Minnesota1.56 North Carolina1.51 Iowa1.46
New Mexico1.41 Washington1.32 Louisiana1.21 Alabama1.18 New
York4.15 Connecticut2.97 Kentucky2.39 Idaho2.15 Tennessee2.09
Illinois1.93 Utah1.93 New Jersey1.92 Texas1.86 Puerto Rico1.71
California1.67 Oregon1.42 Nebraska1.36 South Carolina1.31
Georgia0.98 IDEA Part C Percentage of children under the age of 3
receiving services as of 12/1/2001 (excludes at-risk) = 2% level
Broad Eligibility Moderate Eligibility Narrow Eligibility Data
Source: Westat
- Slide 6
- Funding Sources Direct Services State Funds80.8% Federal IDEA
(B&C) 8.7% Commercial Insurance 10.5% Family Feesnegligible
Medicaid-federal portion only (8.7%) to gen. fund
- Slide 7
- Data Source: Monthly Invoices Expenditures Funding deficits in
each of previous three years covered by transfers from other
department accounts
- Slide 8
- State Economics Budget Surpluses & Deficits Fiscal Years
1985 - 2002 Data Source: Legislative Office of Fiscal Analysis
- Slide 9
- Political & Economic Context Democratic majorities in House
& Senate but not veto-proof. No obvious champions. Republican
Governor - proposes to end entitlement The states worst budget
crisis since 1991 = chaos layoffs - January early retirements -
June lead agency reorganizes to 3 regions - June no budget
agreement until August Strong provider trade association. Birth to
Three providers function as part of a much larger group
- Slide 10
- Redesign the Finance System Decrease expenditures for direct
services by modifying some payment rules for programs Increase
revenue for direct services Decrease number of eligible children
(or at least prevent further increases) 1. Family cost
participation 2. Shift in Part C allocation 3. Increase in
insurance revenue
- Slide 11
- Change demographics through small, measurable eligibility
changes Review diagnosed conditions list Revise modifications that
expanded eligibility Provide safety net of enhanced developmental
monitoring
- Slide 12
- Expand Funding Sources State Funds 80.8% Federal IDEA (B&C)
8.7% Commercial Insurance 10.5% Family Fees Negligible
Medicaid-Federal only or other federal funds such as TANF To State
General Fund only Expand coverage to include all services
Reallocate admin costs saved by reorganization Charge families on
sliding scale
- Slide 13
- Change payment policies within Connecticut political and
economic context Make small changes that do not affect larger
overall provider community 1.Change policy on continuing to pay
programs for up to 8 consecutive weeks of no service to no payment
for any month of no service (cancellations by family less than
24-hours in advance excluded) 2.Change payment of additional
fee-for-service rates for children needing intensive services. Pay
for those hours over 15 instead of 13.
- Slide 14
- Infrastructure Changes Statutes - family fees, insurance
coverage Regulations - family fees, credentialing Provider
Contracts - modifications to payments Procedures - eligibility,
family fees, provider payments, insurance Data System -
eligibility, provider payments, family fees Billing contractor -
for family fees
- Slide 15
- Guidance and ongoing support New materials for primary referral
sources & families Two forums for program directors with
follow- up New procedures - hard copies, cds, website Letter to
families, phone calls from families Questions and answers - hard
copies, posted on data network
- Slide 16
- Ongoing Monitoring
- Slide 17
- Slide 18
- Percent of all eligibility determinations Families Declining
Initial Evaluation
- Slide 19
- Percentage of children exiting due to withdrawal by their
parents Percent of all withdrawals Letter announcing fees sent to
all families