Ligas Data Report of 12-31-12 (pdf)

Originally Issued February 15, 2013, Modified April 4, 2013

Paragraph 33 of the Ligas Consent Decree: …Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors' Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants' compliance with the Decree and Defendants progress toward achieving compliance…

This is the third Ligas Data Report. Per the Ligas Consent Decree, the Division of Developmental Disabilities (DDD) will produce reports of data and information regarding implementation of the provisions of the Ligas Consent Decree every six months. The due dates for these reports will typically be February 15th and August 15th of each year. Unless otherwise specified in the body of this report, the data collected for FY 2013 represents a time frame of July 1, 2012 through December 31, 2012.

This modified version of the Ligas Data Report for the period ending December 31, 2012, is issued to correct a typographical error on Page 2 and to update the Ligas budget information on Pages 10 and 11. On Page 2, the number of class members in ICFs/DD who were admitted after June 15, 2011 was originally reported as 21 in the FY13 column. This modified version corrects that number to be 27. The "Budget for Ligas" section of the report on Pages 10 and 11 reflects information from the Governor's Introduced Budget presented subsequent to the release of the original report. This section also now includes additional detail regarding spending for the CILA program.

Class Member List

The DDD is maintaining a centralized, master class list as described in the Ligas Implementation Plan. Individual records are categorized into three separate areas: individuals living at home in the community, individuals living in an ICF/DD who were admitted after June 15, 2011, and individuals living in an ICF/DD who were there on June 15, 2011 (the date of the Court's approval of the consent decree). Written statements documenting a desire to be a part of the class are obtained for each individual in the latter category. Individuals are added to or removed from the class list as appropriate. The table below provides a summary of the class list as of January 15, 2013.

FY12* FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
Living at Home 10694 10439
ICF/DD after 6/15/11 21 27
ICF/DD on 6/15/11 with an Affirmative Statement To Move (2a) Total 668 770
DD PAS 10 12 10
DHS 1243/1238 186 334
EFE Form 448 403
OSG Request 8 8
Other Guardian Request 14 15
# At End of Fiscal Year 11383 11236

*The numbers for FY12 were incorrect in the last Ligas Data Report issued in August of 2012. In developing this current report, it was discovered that the Division's reporting mechanism for some of the data in this section was counting the number of electronic records as opposed to the number of individuals. The FY12 numbers are corrected here.

Removals Number
Individual Moved Out of State 23
Determined Clinically Ineligible 12
Determined Financially Ineligible 6
Withdrew-Reason Not Given 88
Individual Deceased 20
Objector 1
Other 5
Incorrect SSN (Duplicate Record) 10
Ineligible Setting 23
Unable to Locate Individual 108
Stay in ICF/DD 50
Total Removals 346

Services for Class Members in ICFs/DD

The DDD informed PAS/ISC agencies of the confirmed class members residing in ICFs/DD as of June 15, 2011, and instructed the agencies to complete eligibility determinations and facilitate the choice and selection process. PAS/ISC agencies are now reporting to the DDD on a monthly basis progress made in assisting the individuals with their options. The DDD continues to inform the PAS/ISC agencies of new class members as they are identified.

Target Dates from Consent Decree: 12/30/13 12/30/15 6/30/17 Cumulative Total to Date
# of Class Members With Waiver Capacity Award Letters 216
Total Class Members Who Have Moved to Waiver Services (per billing data) 157
Subtotal Who Received CILA Services 151
Subtotal Who Received HBS Services 4
Subtotal Who Received CLF Services 2

Please note that the above data includes individuals who are moving due to ICF/DD downsizing and closure agreements.

Services for Class Members from the Waiting List

Three selections have been completed from the PUNS database (the Division's waiting list) since the approval of the Consent Decree using the criteria specified in the Ligas Implementation Plan. The Class Members selected have been notified and the PAS/ISC agencies have been instructed to complete eligibility determinations and facilitate the choice and provider selection process. A set of tables is maintained that provides summary information regarding the results of the selections.  Please see PUNS Selection Data Tables for this information.

Ligas Benchmarks 1,000 6/30/13 500 6/30/14 500 6/30/15 500 6/30/16 500 6/30/17 Cumulative Total to Date
# of Class Members Selected From The Waiting List (PUNS) 3112
Total Class Members With Waiver Capacity Award Letters 514
Total Class Members Who Have Received Waiver Services (as reported by the PAS agencies and providers) 328
Total Class Members Who Have Received Waiver Services (per billing data) 268
Subtotal Who Received CILA Services 28
Subtotal Who Received HBS Services 240

ICFs/DD Resident Outreach

With input from the Monitor, Class Counsel, and Intervenors, the DDD issued a Request for Proposals (RFP) to secure the services of a contractor or multiple contractors to contact all Potential Class Members residing in ICFs/DD; however, the DDD did not receive any bids in response to the RFP. After consultation with the State's procurement staff to ensure all regulations are appropriately followed, the DDD is now in discussions with a potential vendor. Until such time as a contractor is selected and in place, there will not be any data to report under this section.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
# of Adults in ICFs/DD
# of Individuals who Excluded Themselves from the Class by Having Objected to the Decree Prior to its Approval or by Submitting a Written Request to be Excluded Prior to Compilation of the Initial Class List
Total Class Members (2a)
Total Potential Class Members
# with Initial Phone Contact
# Choosing Not to Meet w/Outreach Contractor
# Choosing not to Meet but Want Info Sent
Total # Choosing to Meet w/Outreach Contractor
# Persons Completed Written Request for Community Services Through Outreach
# Undecided
# Pending
# Choosing ICF/DD

Transition Service Plans

The DDD is finalizing the development of its process for completion of a Transition Service Plan for each class member seeking services in a Community-Based Setting. An initial version of a standardized format and accompanying instructions was developed with input from the Monitor, Plaintiffs Counsel, PAS/ISC agencies, and other advocates throughout the system. Two PAS/ISC agencies are piloting the draft process and materials with Class Members and providers in their areas. These two PAS/ISC agencies participated in a planning/training meeting with the Monitor and DDD staff on August 23, 2012 in order to begin the pilot.

As the Implementation Plan is being revised, 41 Transition Service Plans have been developed and submitted for review by the DDD and Monitor. Monthly conference calls have been held among the two PAS/ISC agencies, Monitor, and DDD staff throughout the pilot. The standardized format and accompanying instructions are now undergoing final revisions, based on the experience of the pilot, for Statewide implementation.

Training for all PAS/ISC agencies is scheduled for April 16, 2013. Local training sessions for small groups of PAS/ISC agencies will be held throughout the rest of April and May. A webinar session will also be made available. These training opportunities are being conducted by DDD staff and the Monitor. The DDD will begin reporting data in this section after the statewide implementation targeted for July 1, 2013. In the meantime, per the Ligas Implementation Plan, PAS/ISC agencies are following the processes described in the DD PAS manual to assist individuals in obtaining needed services.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
# with Services Implemented Prior to Transition Plan Completion
# with Transition Service Plan Completed
# with Transition Service Plan Under Development
Total to Date

Crisis Services

The DDD continues to process service requests for individuals in crisis situations. Below is summary data regarding the requests processed during this reporting period.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total to Date
Total # of Crisis Requests Received 343 153 496
Total # of Class Members Approved 290 136 426
# of Class Members Approved for CILA 205 92 297
# of Class Members Approved for HBS 85 44 129
Total # of Class Members Who Received Services 247 132 379
# of Class Members Who Received CILA Services 173 89 262
# of Class Members Who Received HBS Services 74 43 117
Total # of Class Members Denied Crisis Approvals 53 17 70

Voluntary ICFs/DD Closure/Downsizing Agreements

The DDD continues to work with ICF/DD providers that wish to downsize or close their facilities on a voluntary basis. The information below summarizes the agreements underway during this reporting period. Please take note of the following issues involving the data in the table below:

  • Included in the FY12 numbers are persons who were part of closure/downsizing agreements that were in process at the time of the approval of the Consent Decree on June 15, 2011. Therefore some individuals may have moved prior to that date and were not included in the Class as they already had community-based services prior to the approval of the Consent Decree.
  • It is a rare occurrence, but it is possible that some individuals who are part of closure/downsizing agreements are determined to be ineligible for the Adult Developmental Disabilities Medicaid Waiver. In such instances, the individuals are funded in community-based services with only State funding and are not eligible for membership in the Ligas Class.
  • In comparing this data with that in the section entitled "Services for Class Members in ICFs/DD", note that the data source for whether an individual has moved is different between the two sections. This section uses self-reported information from the ICF/DD providers regarding the status of their closure/downsizing agreements; the section entitled "Services for Class Members in ICFs/DD" uses billing data. Typically, there is a greater lag time in the billing data.
FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total
to Date
# of Agreements Initiated 9 3 12
Total # Licensed Capacity 144 287 431
Total # of People to Move 117 232 349
*Moved to CILAs 82 20 102
*Moved to HBS 0 0 0
*Transferred to Other ICFs/DD 3 1 4
*Moved to Other Settings 0 0 0
*No Selection Yet Made 32 211 243

Eligibility Appeals

The DDD continues to process appeals of eligibility. Below is summary data regarding the appeals processed during this reporting period.

FY12 FY13 FY14 FY15 FY16 FY17 Cumulative Total
to Date
Total Class Members Submitting Appeals 57 25 82
Subtotal Appeals Upheld 9 11 20
Subtotal Appeals Denied 29 8 37
Subtotal Appeals Pending 17 4 21
Subtotal Appeals Withdrawn 2 2 4

Budget for Ligas

The Governor's introduced budget for FY14 included $32.5 million in increased funding to the Division of Developmental Disabilities for items related to Ligas Consent Decree implementation for an FY14 Total of $68.1 million. This $68.1 million includes:

Budget Category and Description of Expense FY14 Proposed
Contractual Agreements
RFP ICF/DD Outreach $700,000
Eligibility Determinations and TSPs $500,000
Increased PUNS Enrollment Processing $500,000
New ISSA Services $592,000
Training,Consultation & Family Support $400,000
Total Contractual $2,692,000
DDD Additional Staffing
Strategic Planning - Ligas Compliance Coordinator $108,277
Data Support $93,408
Quality Management - clinical reviews $653,856
Transition Services - facilitate and monitor $373,632
Appeals $79,004
Rate Setting $93,408
Medicaid Waiver - post payment reviews $280,224
Total Staffing $1,681,809
Direct Services
PUNS Selection $49,772,300 500 individuals, 1,000 annualized from FY12
and FY13.  500 phased in during FY14;
one-half CILA and one-half HBS; average
annual cost for CILA $49,429, plus $2,500
one-time start-up; average cost for HBS $25,740
ICF/DD Transitions $13,925,100 600 individuals; 400 annualized from FY12
and FY13 and 200 phased in during FY14;
average annual cost for CILA $49,429, plus $2,500 one-time start-up
Total Direct Services $63,697,400
Total Estimated Budget $68,071,209

The funding for Ligas Consent Decree Implementation in the Governor's FY14 budget released on March 6, 2013 included an increase of $32.5 million, for an FY14 total of $68.1 million. The FY14 budget still needs to be passed by the General Assembly and signed by the Governor.

Spending for the ICF/DD program remains constant. In FY11 ICF/DD spending totaled $392.8 million, with 6,427 individuals being served at the end of that fiscal year. In FY12, spending for ICF/DDs in FY12 was $404.4 million, with a projected 6,350 being served at the end of the fiscal year. The FY13 introduced budget included $390.0 million for an estimated 6,300 individuals in ICFs/DD. ICF/DD spending is projected at $390.0 million for FY14.

Spending for the Waiver program in FY12 is estimated to be $652.2 million. 18,710 individuals were served in FY11; 20,000 are projected to be served by the end of FY12; 20,500 are estimated to be served in FY13; and 21,300 are estimated to be served in FY14.

As a subset of the Waiver program, the total DDD funding for the CILA program, including day program services, for FY11 was $422.5 million, with 9,567 persons served throughout the year. In FY12, spending was $430.6 million, with 9,678 being served throughout the year. Spending for FY13 is projected to be $444.3 million with 9,356 persons served year-to-date.

Implementation Plan Updates and Amendments

The first annual update of the Ligas Implementation Plan has been completed with input from the Monitor, Plaintiffs, and Intervenors.