2011-08-29T11:34:00.000-07:00

The Intellectual Disabilities/Developmental Disabilities (ID/DD) Work Group met for the first time on Tuesday, August 20. They were one of three groups meeting at the same time - along with the Adult Mental Health Work Group and the Best Practices in Brain Injury Work Group. Since I haven't figured out how to clone myself yet, I stuck to the ID/DD work group (they had chairs remaining in the room - it was standing room only in the adult MH meeting!). I'll be working with other advocates to get reports from the other work groups and will do my best to post reports.

The ID/DD work group reviewed its charge and heard from State Representative Dave Heaton of Mt. Pleasant, one of the legislators that guided the authorizing legislation (SF 525) through the legislature this session.

“We’ve climbed the mountain before and we’ve fallen off,” said Heaton referencing the many past failed redesign efforts. “We’re not going to fall off this time. This (ID/DD Work Group) is the most difficult of all the work groups. The services are complex, the funding is complex, and the system is complex. It is amazing the layers, and it is difficult to know your way around this maze.”

“It’s all about access – equal access,” summed up Rep. Heaton. “And its about a consistent reimbursement rate – (providers) should be paid for their work regardless of the county they are serving. At the same time, it is important to maintain local access – the role of the CPC should not be diminished.”

The work group staff (Technical Assistance Collaborative) presented some very interesting information comparing Iowa to states of similar size and found that (you canread the full report here):

Iowa serves far more people with intellectual disabilities (Iowa serves 533 people per 100,000 population; national average is 212).

More Iowans with Intellectual Disabilities are served by Medicaid waiver services than other comparable states (Iowa provides waiver services to 465 people per 100,000 population; national average is 183).
Iowa uses ICF/MR services much more than other states (68 people per 100,000 population; national average is 29).
Iowa uses larger out-of-home settings to a far greater degree than other states:

o 55.6% of Iowans with Intellectual Disabilities are served in 16-bed or more facilities (national average is 19%) – in fact, Iowa is second in the use of this size of facility.

o 33% of Iowans with Intellectual Disabilities are served in 7-15 bed settings (compared to 18% national average)

o 12% of Iowans with Intellectual Disabilities are served in smaller 1-6 bed homes (compared to 63% national average)

Only 37% of Iowans with Intellectual Disabilities receive services while living in the home of a family member (the national average is 58%).
Despite spending more on larger institutional settings in serving people with Intellectual Disabilities, Iowa spends 44% less per person ($39,220) than the national average ($56,632).
Iowa spends more per person on ICF/MR services ($148,528) than the national average ($138,980) – and less per person on Medicaid waiver services ($23,147) than the national average ($43,495).
The data shows that nearly half of Iowa’s waiver and ICF/MR services are used by 13% of the service population. That means that the remaining half is used by 87% of the population served.

If I were to summarize this data into two sentences: Iowa relies more on large facilities to serve Iowans with Intellectual Disabilities, and spends much less on in-home and small residential setting services. However, Iowa serves more people and uses less money to do that than other states.

The “meat” of this meeting was after lunch, when the work group was tasked with addressing issues related to eligibility for services. There was a lot of discussion about the need to consolidate waivers or at very least equalize services offered under the various waivers and develop a consistent way to assess functional needs (functional assessment). No real decisions were made about eligibility, but the work group did agree on a common set of definitions.

You can read all the work group materials - including information on services provided by the ID waiver, and more Iowa specific data on persons served. Just click here to review.

We'll post again after the next meeting (Tuesday, August 30).

Welcome to ID Advocate!

2011-08-22T22:02:00.000-07:00

Welcome to ID Action's public policy blog - the ID Advocate. Iowans with Disabilities in Action (ID Action) is a non-profit, non-partisan statewide initiative dedicated to generating greater civic and political participation among Iowans with disabilities.

We've started this blog to help you keep up to date on this summer's redesign of the mental health and disability services system - but we'll expand beyond that subject matter once the redesign process ends later this year. We'll post our comments and thoughts after each work group meets (every Tuesday through the end of October) - and then as the legislative interim meets in November and December to craft legislation to be approved in the 2012 legislative session.

In the meantime, you can see the schedules of the redesign meetings, work groups, and materials reviewed by work groups online at: http://www.dhs.state.ia.us/Partners/MHDSRedesign.html.