Ligas Data Report as of 12-31-11

Ligas Data Report as of 12-13-11 (pdf)

March 27, 2012

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 first 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. As this is the first of the reports, and per agreement among the Parties and Intervenors, the report is being released as a draft for review by the Parties and Intervenors and the due date has been delayed in order to incorporate information regarding the Administration's Introduced Budget for FY13. Unless otherwise specified in the body of this report, the data collected represents a time frame of June 15, 2011 through December 31, 2011.

Class Member List

The DDD has developed 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 February 28, 2012.

Summary of Class List Movement

Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
Living at Home 10870
ICF/DD after 6/15/11 5
ICF/DD on 6/15/11 with an Affirmative Statement To Move (2a) Total 552
DD PAS 10 9
DHS 1243/1238 83
Class Request Form 453
OSG Request 6
Other Guardian Request 1
# At End of Fiscal Year 11427

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 Date Data from Consent Decree

Category 12/30/13 12/30/15 6/30/17 Cumulative
Total to Date
# of Class Members With Waiver Capacity Award Letters 30
*Total Class Members Who Have Moved to Waiver Services (per billing data) 17
Subtotal Approved for CILA Services 30
Subtotal Approved for HBS Services 0
Subtotal Approved for CLF Services 0

Note:  The above data includes individuals who are moving due to ICF/DD downsizing and closure agreements.

Services for Class Members from the Waiting List

The first 800 class members have been selected from the waiting list using the criteria specified in the Ligas Implementation Plan. The DDD prepared letters dated February 24, 2012, inviting the individuals to apply for services. The PAS/ISC agencies received lists of the selections on February 24, 2012 and were instructed to complete eligibility determinations and facilitate the choice and selection process.

Although 800 individuals were originally selected, 65 names were removed from the selection for various reasons through working with the PAS/ISC agencies. These reasons include now deceased, moved out of state, etc.

A set of tables is attached to this report that provides summary information regarding the results of the selection process.

Summary of Results of Selection Process

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) 800
Total Class Members With Waiver Capacity Award Letters
Total Class Members Who Have Received Waiver Services (per billing data)
Subtotal Approved for CILA Services
Subtotal Approved for HBS Services

ICFs/DD Resident Outreach

A Request for Proposals (RFP) has been drafted. This RFP will seek a contractor(s) to conduct the outreach efforts required by the consent decree. An RFP development and review team has been formed. The draft RFP is being distributed to the team for review and comment as this draft data report is being written. Until such time as a contractor(s) is selected and in place, there will not be any data to report under this section.

Category 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

An advisory work group is scheduled to meet on April 2, 2012 to begin development of the Transition Service Plan policies and protocol. In the meantime, there is not any data to report under this section. 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.

Summary of Services

Category 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.

Summary of Crisis Services

Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
Total # of Crisis Requests Received 197
Total # of Class Members Approved 167
# of Class Members Approved for CILA 120
# of Class Members Approved for HBS 47
Total # of Class Members Who Received Services 145
# of Class Members Who Received CILA Services 99
# of Class Members Who Received HBS Services 46
Total # of Class Members Denied Crisis Approvals 30

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.

Summary of Downsizing Activity

Category FY12 FY13 FY14 FY15 FY16 FY17 Cumulative
Total to Date
# of Agreements Initiated 8
Total # Licensed Capacity 128
Total # of People to Move 104
*Moved to CILAs 26
*Moved to HBS 0
*Transferred to Other ICFs/DD 1
*Moved to Other Settings 0
*No Selection Yet Made 77

Eligibility Appeals

The DDD and Department of Healthcare and Family Services (HFS) are working together to identify and address issues that will streamline processing of appeals. HFS has obtained the services of additional hearing officers. As a result, the DDD is seeing a decrease in the number of pending appeals. At HFS's request, the DDD is providing the opportunity for the hearing officers to visit providers of developmental disabilities services in order to learn more about the programs. A meeting has been scheduled in April for DDD and HFS staff to continue discussions of additional possibilities for streamlining the process.

Summary of Eligibility Appeals

Category FY12 FY13 FY14 FY15 FY16 FY16 Cumulative
Total to Date
Total Class Members Submitting Appeals 30
Subtotal Appeals Upheld 5
Subtotal Appeals Denied 13
Subtotal Appeals Pending 10
Subtotal Appeals Withdrawn 2

Budget for Ligas

The Governor's introduced budget for FY13 includes $38.9 million in increased funding to the Division of Developmental Disabilities for items related to Ligas Consent Decree implementation. This $38.9 million includes:

Summary of Budget for Ligas

Description of Expense FY13 Proposed Amount Comments
Contractual Agreements
RFP ICF/DD Outreach $200,000
Eligibility Determinations $450,000
Increased PUNS Enrollment Processing $16,000
Transition Service Plans Development $160,000
New ISSA Services $679,000
Person-Centered Planning Training $200,000
Transition Service Plan Reviews & Consult $110,000
Family Liaison $90,000
Total Contractual $1,905,000
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 $26,401,140 1,000 additional individuals; 300 annualized from FY12 and 700 phased in during FY13; 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 $8,873,310 400 individuals; 200 annualized from FY12 and 200 phased in during FY13; average annual cost for CILA $49,429, plus $2,500 one-time start-up
Total Direct Services $35,274,450
Total Estimated Budget $38,861,259

Spending for the ICF/DD program remains constant. In FY11 ICF/DD spending totaled $392.8 million. Year-to-date spending in FY12 is $242.8 million. The FY13 introduced budget includes $390 million for an estimated 6,300 individuals in ICFs/DD. (This last amount includes the addition of $133 million to prevent the current payment cycle from lengthening.)

Future reports will include spending information regarding the Home and Community-Based Waiver services as well as numbers of individuals served.

Implementation Plan Updates and Amendments

There have not been any amendments or updates to the Implementation Plan since its submission to the Court on December 15, 2011.

The DDD has received a request to reconsider the issue of including the concept of geographic distribution in the PUNS selection process. The DDD plans to discuss the matter with the Parties and Monitor.