DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
My Life, My Community Update
July 2015
Dawn Traver, M.Ed.
Waiver Operations Director
Department of Behavioral Health
& Developmental Services
http://www.dbhds.virginia.gov/
Dawn.Traver@dbhds.virginia.gov
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Waiting List and Slot
Assignment
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
IDD Waivers’ Waiting List
One Waiting List
Community
Living
Building
Independence
Family &
Individual
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DBHDS
Slot Allocation
Virginia Department of
Behavioral Health and
Developmental Services
• [slot] + [al-uh-key-shuh n]: the distribution
by DBHDS of funding opportunities (slots)
to Community Services Boards
When there are
more than 40 …
When there are
fewer than 40 ...
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Accessing Slots in New Waivers
• DD Diagnosis
Eligibility • Level of Care
• Waiting List: urgent & non-urgent
Urgency • Most urgent individual receives available slot
• Waiver Slot Assignment Committees
Slot
Assignment
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DBHDS
Slot Assignment
Virginia Department of
Behavioral Health and
Developmental Services
• [slot] + [uh-sahyn-muh nt]: the pairing of an
available funding opportunity (slot) with the
individual in most urgent need at the time
Community
Members
Trained
Facilitator
Groupings
of
neighboring
CSBs
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Service Packages &
Supports Budgets
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DBHDS
Looking Things Over
Virginia Department of
Behavioral Health and
Developmental Services
Access
Supports
Budget
Supports
Assessment
Eligibility
Set Level
Assignment
Understanding
the Process
Service Mix and
Amount
Rate Schedule
Service
Packages by
Level and
Residence
Service
Planning
The Supports
Budget
Personal
Preferences
The Service
Plan
Exceptions
Service
Delivery
Quality
Monitoring
Arranging for
Service
Delivery
Voicing
Complaints
Service
Delivery
Paying for
Services
Monitoring
Making
Changes
Supporting Policies, Rules &
Regulations, and Communication
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Assessment
of Support
Needs
Menu of
Services
Policy
Intentions
Service
Packages
Supports
Budget
Tiered Rate
Reimbursement
Schedule
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Page 10
DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
What goes into a supports budget?
Level Assignment
SIS Interview
Supplemental Questions
Policy Intentions
Verification
Menu of Services
Residential
Service
Packages
Assigned Level
Personal Care
Residence
Day Services
Anticipated
Service Use
(Type & Amount)
Supports
Budget
By Level &
Type of
Residence
Tiered Rate Schedule
Pay Rate per Unit of Service
Different Tiers of Intensity
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DBHDS
Focus on: Assigned Level
Virginia Department of
Behavioral Health and
Developmental Services
Support Needs
Low
1
3
6
7
2
4
High
5
Modest support needs & some
behavioral support needs
Significant Medical support need
Significant Behavioral support need
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Focus on: Service Menu
Base Services
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Focus on: Base Budget & Add-ons
Base Budget Services
Potential Add-On Services
 Residential Supports
 Transportation
 Personal Care
 Crisis Services
 Day Services
 Therapeutic Consultation
 Skilled Nursing
 Environmental Modifications
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Focus on: Tiered Rates
How are reimbursement rates constructed?
A rate study was completed to establish:
• Units of service for each service in the menu.
• The amount that is paid per unit of service.
BUT, we also took into account that some services
are delivered with varying intensity.
This results in “tiered rates” for some services. The
tiers account for the varying intensity.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Focus on: Tiered Rates
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Focus on: Tiered Rates
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
Focus on: Where Person Lives
Living Alone
With Family
Sponsored Residential
Supported Living
Group Home
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
A Few
Examples
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
A Few
Examples
Page 20
DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
A Few
Examples
Page 21
DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
A Few
Examples
Page 22
DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
A Few
Examples
Page 23
DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
What about exceptions?
Everyone is unique!
The supports budgeting process may
account for most people.
Yet some people will have exceptional
needs and must be considered one by
one.
The Exceptions Process is designed
to assure that these individuals have
their needs met.
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DBHDS
Virginia Department of
Behavioral Health and
Developmental Services
For More Information
• “Supports Intensity Scale and Assessment Levels
Information Brief” (November 2014)
• Validation Study Reports (May/June 2015)
– Full report
– Family friendly version
http://www.dbhds.virginia.gov/individuals-andfamilies/developmental-disabilities
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