Michael P. Hansen Director Rick Scott Governor Public Meeting Public Meeting December 9, December 9, 2011 2011
Jan 21, 2016
Michael P. HansenDirector
Rick Scott Governor
Public MeetingPublic MeetingDecember 9, 2011December 9, 2011
Overall iBudget Goals
• Customer self-direction and choice• Equitable distribution of appropriated Medicaid waiver
funds• Business process efficiencies using technology
2
iBudget Background• 2009 General Appropriations Act (GAA) required plan by
February 2010
– APD researched other states’ systems and best practices
– APD worked with iBudget Florida Stakeholders’ Group to design plan
• iBudget implementation authorized in s. 393.0662, Florida Statutes, in 2010
3
QSI ASSESSMENT1) Functional Score2) Behavioral Score3) Ability to: Transfer, Self-Protect, and Maintain Hygiene
AGE LIVING SETTING
Determines Individual Budgets
4
iBudget Allocation Formula
LEAST FLEXIBLE:•Residential Services•Therapeutic Supports and Wellness
MOST FLEXIBLE:•Life Skills Development•Supplies and Equipment•Personal Supports•Support Coordination•Transportation•Dental Services
CONSUMER CHOICE(12,196 Combinations
of Services)
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Consumer Flexibility in Spending
Create Overall Plan
Technical/Process
Finalize Deployment Strategy
Implement in Phases Statewide
Transition Areas 1 & 2 In Progress
iBudget Phase-In Plan
In Progress
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• The results of the initial proposed model would likely lead to about 2/3 of people getting reductions with many of these having large reductions (over 40% reduction in cost plan compared to current cost plan).
• The initial proposed model could result in about 45% of people not having enough in their budgets to fund their current core services.
iBudget ImplementationChallenges and Impacts
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Non-Core and Core Services
8 8
Core Services Amount
Behavior Services $51,826,726
Consumable Medical Supplies $15,706,045
Durable Medical Equipment $125,541
In-Home Supports $112,798,827
Nursing Services $26,276,542
Occupational Therapy $3,881,908
Personal Care Assistance (PCA) $84,876,522
Physical Therapy $8,030,342
Residential Habilitation $375,049,588
Respiratory Therapy $624,467
Special Medical Home Care $2,081,789
Supported Employment $9,955,184
Supported Living Coaching $30,531,145
Waiver Support Coordination $41,862,739
Portion of Personal Supports (based on In-Home Support and
PCA)$10,794,055
SUBTOTAL - CORE $774,421,419
Non-Core Services Amount
Adult Day Training $84,667,539
Companion Services $41,473,432
Dental Services $3,598,353
Dietician Services $297,508
Environmental Adaptations $210,378
Specialized Mental Health Services
$3,025
Respite Care $22,160,859
Speech Therapy $5,061,633
Transportation $38,339,635
Portion of Personal Supports (based on Companion and
Respite)
$5,992,966
SUBTOTAL - NON-CORE $201,805,327
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Models’ Impact on Individuals67%
32%
45%46%
4%0%
0%
10%
20%
30%
40%
50%
60%
70%
Receiving Reductions Receiving Reductionsover 40%
Core Services Not Funded
Initial Proposed Model Model A
9Note: The initial proposed model would set aside about $100 million for extraordinary needs as well as other required costs not in the algorithm such as waiver support coordination.
• Uses current cost plan and initial proposed iBudget amount as starting point.
• Does not increase any cost plan. Does not decrease any cost plan more than 50%.
• Uses core services to approximate “extraordinary needs.”
• Additional savings from other cost-containment strategies and individual cost plan reviews would continue.
Model AKey Features
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Example 1
$39,813
$19,906
$32,613
$47,804
$39,813
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 2$70,458
$35,229
$55,967
$76,109$70,458
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 3$33,813
$16,906
$11,992 $13,226$16,906
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
$40,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 4$44,802
$22,401
$39,546
$28,283
$39,546
$0$5,000
$10,000$15,000$20,000$25,000$30,000$35,000$40,000$45,000$50,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 5$126,953
$63,477
$125,550
$43,821
$125,550
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 6$68,032
$34,016
$60,611
$42,695
$60,611
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
16
Example 7$128,698
$64,349
$128,410
$79,771
$128,410
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 8$29,260
$14,630
$5,991
$23,471 $23,471
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Example 9$76,965
$38,483
$51,039
$68,929 $68,929
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
Cost Plan Half CostPlan
CoreServices
InitialProposed
Model
Model A
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Percentage of Individuals by Funding Approach
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