Topics to review today:
- DSP Funded Hours Pause
- Zero-Hour Model
- Preview Scenario 4
- ICAP Data
- 5- to 7-Bed Staffing Tables
- Rate Summary Sheets
DSP Funded Hours Pause
DDD will be announcing the extension of the pause on the implementation of the full rate calculator through the end of FY24 in order to give providers time to prepare for implementation.
Zero-Hour Model
What is the Zero-Hour Model?
- Zero Hour Model funds CILA providers at 24 hours/day, as opposed to the 5-Hour Model that is currently funding 19 hours/day. The Model assumes minimum staffing requirements are met throughout the day to allow more flexibility for CILA residents to promote choice in their day-to-day activities.
What would happen if a Zero-Hour Model is implemented?
- DDD guidance would provide that in-person staffing would only be required if an individual needs or wants to be home during their regular day programming hours.
- With the implementation of Zero-Hour, Enhanced Residential (37U) would no longer be available.
- Additionally, there are expectations if multiple individuals/all individuals are home as it relates to staffing requirements.*
- This more flexible model is subject to change and DDD could require minimum staffing at all times, but at implementation, DDD would not require minimum staffing if no residents are in the home.
*See Tables 26 to 29 of the Rate Study with staffing requirements based on RUL, the number of people in the home, and on the time of day (non-prime for day programming hours).
Preview Scenario 4
What would Scenario 4 include?
- Scenario 4 results in a net neutral to the system meaning the overall hours to the system remain at 28.6M.
- Scenario 4 utilizes the rate calculator with the ICAP+HRST translating to Resource Use Level (RUL) but adds an adjustment factor.
The adjustment factor is a set number of hours that would be added to the Guidehouse staffing tables that, when applied to each of the 9,777 individuals in 24-hour CILAs equates to the 28.6M hours currently funded.
- This scenario is a "point in time scenario" in that the adjustment factor is calculated using the DSP funded hours resulting from the Guidehouse 5-Hour Model prior to implementation.
ICAP Update
- In Fall 2023, DDD requested data from all ISC agencies on the ICAPs submitted via the Medicaid Redetermination process.
- DDD have reviewed ICAPs received, comparing them to the ICAPs on file with the CILA Rates Unit (ICAP that directly impacts an individual's current rate).
- Effective July 1, 2024, DDD will utilize the ICAPs collected via the Redetermination process for purposes of an individual's rate.
- DDD will also be creating a process whereby ICAPs collected via the Redetermination process are shared with the CILA Rates Unit with regular updates (potentially biannually to match HRST updates) to be used to update an individual's rate (if there is a change).
5- to 7-Bed Staffing Tables
- Out of the 9,777 people in 24-hour CILA, there are only 15 people who have an ICAP of 85 or greater, have a current HCL of 1 or 2, and live in a 5-7 bed CILA home (i.e., are in the category of a staffing ratio below 1 for Non-Prime Hours).
- 5 Bed: 6 People, 10 Hours Annually below full staff funding
- 6 Bed: 8 People, 8 Hours Annually below full staff funding
- 7 Bed: 1 Person, 1 Hour Annually below full staff funding
Rate Summary Sheets
Open for questions on rate summary sheets.
