COBI 2015 - Acquired Brain Injury Waiver

Overview
Issues
Performance
Background
Financials

Sources Uses

FY 2016 Appropriation

The Acquired Brain Injury Home and Community-based Services Waiver is for people who have a documented brain injury, are 18 years of age or older, and require the level of care provided in a nursing facility. The waiver allows the use of Medicaid funds outside of institutional settings.

Funding History

Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $3,408,000 from all sources for Acquired Brain Injury Waiver. This is a 0 percent change from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $1,011,500 from the General/Education Funds, an increase of 0.6 percent from revised Fiscal Year 2015 estimates.

Appropriation Adjustments

In addition to statewide compensation and internal service fund cost increases, the following appropriation adjustments were made during the 2015 General Session:

DescriptionOngoingOne-Time

Staff Analysis

For the most recent completed fiscal year, the following information represents the purposes for which the money was used:

Acquired Brain Injury Waiver Detailed Purposes

Acquired Brain Injury Waiver Expenditures by Category

The Acquired Brain Injury Waiver is considered a statewide program including all rural areas and is open to all residents of Utah with intellectual disabilities eligible for care. There is no statutory requirement for distribution of funds or allocation of slots by geographic region. The Division of Services for People with Disabilities (DSPD) "does not distribute funds based on location, but rather based on the unique needs of the individual receiving services. Persons are not brought into DSPD services based on location but rather the severity of their needs, and those with the most severe needs are brought into services first . . . DSPD serves Utahns in greatest need of services without consideration of their location."

Percent of providers meeting fiscal requirements of contract

Percent of providers meeting non-fiscal requirements of contract

Services provided under this waiver include:

Case Management: Assists people in gaining access to needed services
Respite Care Services: Gives regular caregivers short-term relief
Supported Employment: Pays wages for a job coach for persons who require assistance on the job
Specialized Medical Equipment: Includes special equipment designed to assist with mobility and communication
Chore Services: Assists in keeping a home or apartment clean, sanitary, and safe
Emergency Response System: Provides a device that lets high-risk individuals call for help in cases of emergency
Companion Services: Offers non-medical care, supervision, and social activities given to adults who have a difficult time functioning
Family Training: Provides training and counseling services to families to assist with the care of the person receiving waiver services
Structured Day Programs: Offers supervised activities to help maintain independence
Residential Habilitative Supports: Provides intensive to intermittent residential services in host homes, supervised apartments, and supported living

Intent Language

SB0002: Item 83

The Legislature intends the Division of Services for People with Disabilities (DSPD) in the Department of Human Services provide to the Office of the Legislative Fiscal Analyst no later than September 1, 2015 a report that includes a(n): 1) response to each specific audit recommendation found in A Performance Audit of the Division of Services for People with Disabilities (October 2014 - Audit No. 2014 - 10), 2) identification of specific efficiencies gained by DSPD through implementing the audit's recommendations, 3) estimate of savings, if any, achieved through implementation of each recommendation, and 4) measures that demonstrate effective implementation of each recommendation. The Legislature further intends the Office of the Legislative Fiscal Analyst provide the report to the Office of the Legislative Auditor General (OLAG) and that OLAG review the report in order to assess: 1) if the measures accurately demonstrate effective implementation of the recommendations and 2) the accuracy of the savings estimates, if any. The Legislature further intends OLAG report its review of the DSPD report to the Social Services Appropriations Subcommittee.

SB0002: Item 83

The Legislature intends that for the building block titled "DSPD - Direct Care Staff Salary Increase," the Division of Services for People with Disabilities (DSPD) shall: 1) Direct funds to increase the salaries of direct care workers; 2) Increase only those rates which include a direct care service component, including respite; 3) Monitor providers to ensure that all funds appropriated are applied to direct care worker wages and that none of the funding goes to administrative functions or provider profits; 4) In conjunction with DSPD community providers, report to the Office of the Legislature Fiscal Analyst no later than September 1, 2015 regarding: 1) the implementation and status of increasing salaries for direct care workers, 2) a detailed explanation with supporting documentation of how DSPD providers are reimbursed, including all accounting codes used and the previous and current rates for each accounting code, and 3) a conceptual explanation of how DSPD community providers realize profit within the closed market of providing DSPD community services.

SB0003: Item 134

The Legislature intends that the $400,000 in Beginning Nonlapsing provided to respite care for individuals with disabilities in the Division of Services for People with Disabilities is dependent upon up to $400,000 funds not otherwise designated as nonlapsing to the Department of Human Services - Division of Substance Abuse and Mental Health line item being retained as nonlapsing in FY 2015.

SB0003: Item 134

The Legislature intends that the $75,000 in Beginning Nonlapsing provided to respite care for individuals with disabilities in the Division of Services for People with Disabilities is dependent upon up to $75,000 funds not otherwise designated as nonlapsing to the Department of Human Services - Executive Director Operations line item being retained as nonlapsing in FY 2015.

SB0007S01: Item 28

The Legislature intends that the Division of Services for People with Disabilities (DSPD) use Fiscal Year 2016 beginning non-lapsing funds to provide services for individuals needing emergency services, individuals needing additional waiver services, individuals who turn 18 years old and leave state custody from the Divisions of Child and Family services and Juvenile Justice Services, individuals court ordered into DSPD services and to provide increases to providers for direct care staff salaries. The legislature further intends DSPD report to the Office of Legislative Fiscal Analyst on the use of these non-lapsing funds.

SB0007S01: Item 28

The Legislature intends that the Department of Human Services report on the following performance measures for the Services for People with Disabilities line item: (1) Community Supports, Brain Injury, Physical Disability Waivers, Non-waiver Services - % providers meeting fiscal requirements of contract (Target = 100%), (2) Community Supports, Brain Injury, Physical Disability Waivers, Non-waiver Services - % providers meeting non-fiscal requirements of contracts (Target = 100%), and (3) People receive supports in employment settings rather than day programs (National ranking) (Target = #1 nationally) by January 1, 2016 to the Social Services Appropriations Subcommittee.

Display By:

Funding Source

Expenditure Category

Appropriation Type:

Appropriation History by

Sources of Finance	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
General Fund	764,100	854,100	1,022,900	1,117,000	1,005,200	0	1,005,200	6,300	1,011,500
General Fund, One-time	(112,200)	0	0	0	0	0	0	0	0
American Recovery and Reinvestment Act	165,800	(1,200)	0	0	0	0	0	0	0
Transfers - Medicaid	1,984,100	2,226,600	2,381,700	2,540,700	2,402,700	100	2,402,800	(6,300)	2,396,500
Closing Nonlapsing	(7,900)	(21,200)	(4,100)	(39,500)	0	0	0	0	0
Total	$2,793,900	$3,058,300	$3,400,500	$3,618,200	$3,407,900	$100	$3,408,000	$0	$3,408,000

Show Table | Show Additional Information

Categories of Expenditure	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
Other Charges/Pass Thru	2,793,900	3,058,300	3,400,500	3,618,200	3,407,900	100	3,408,000	0	3,408,000
Total	$2,793,900	$3,058,300	$3,400,500	$3,618,200	$3,407,900	$100	$3,408,000	$0	$3,408,000

COBI contains unaudited data as presented to the Legislature by state agencies at the time of publication. For audited financial data see the State of Utah's Comprehensive Annual Financial Reports.