COBI 2015 - Non-waiver Services

Overview
Issues
Performance
Background
Financials

Sources Uses

FY 2016 Appropriation

Non-waiver Services includes services provided to individuals who are not eligible for any of the Medicaid waivers due to either income and asset issues or the nature of the disability. Non-waiver Services also includes non-Medicaid eligible services provided to individuals in the waiver program, such as psychological assessments used to determine eligibility, residential start-up costs, housing assistance, and special needs funding. These expenditures do not draw down matching Medicaid funds.

Funding History

Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $1,785,500 from all sources for Non-waiver Services. This is a 0 percent change from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $451,400 from the General/Education Funds, a change of 0 percent from revised Fiscal Year 2015 estimates.

Staff Analysis

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

Non Waiver Services Detailed Purposes

Non-Waiver Services Expenditures by Category

Non-waiver Services 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

Efforts to Limit Expenditures in this Service Category

There has been a concerted effort to qualify and move individuals from this state-funded-only program over to the Medicaid waiver program. Since 1999, over 515 individuals have moved from non-waiver to waiver (Medicaid) funding. In FY 2014, there were 112 people remaining in this program. Some individuals receiving services under this program would qualify for Medicaid but refuse to either apply for Medicaid or spend down their income and assets in order to qualify. These individuals have had their service funding reduced to a commensurate level that the state would provide under the waiver program. Individuals who do not meet the waiver level of care requirements must submit a Graduated Fee Assessment Form to the division.

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	(725,000)	344,000	451,400	849,900	451,400	0	451,400	0	451,400
General Fund, One-time	950,000	0	140,000	0	0	0	0	0	0
Federal Funds	1,215,400	1,079,000	1,215,500	1,106,000	2,327,100	(1,000,000)	1,327,100	0	1,327,100
Dedicated Credits Revenue	0	0	0	0	7,000	0	7,000	0	7,000
Closing Nonlapsing	(15,700)	(227,900)	(396,300)	(198,500)	0	0	0	0	0
Total	$1,424,700	$1,195,100	$1,410,600	$1,757,400	$2,785,500	($1,000,000)	$1,785,500	$0	$1,785,500

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	1,424,700	1,195,100	1,410,600	1,757,400	2,785,500	(1,000,000)	1,785,500	0	1,785,500
Total	$1,424,700	$1,195,100	$1,410,600	$1,757,400	$2,785,500	($1,000,000)	$1,785,500	$0	$1,785,500

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.