P007: Percent of developmental disabilities waiver applicants who have a service plan in place within 90 days of income and clinical eligibility
Story Behind the Curve
- This performance measure is in response to Lewis v. New Mexico Department of Health. The Developmental Disabilities Supports Division (DDSD) Intake and Eligibility Bureau (IEB) works closely with internal and external partners to make sure that individuals with disabilities receive waiver services in a timely manner by completing the necessary application requirements.
- This performance measure is important in making sure allocated individuals have a service plan in place within 90 days of income and clinical eligibility.
- During FY17, 73.6% (14 of 19) of individuals had a service plan in place within 90 days of income and clinical eligibility. Six of those individuals were recipients of expedited allocations and all had an individual service plan (ISP) in place. The remaining 13 individuals were part of prior allocation groups, which had been experiencing delays from previous quarters.
- The IEB collaborates with other bureaus in DDSD to coordinate efforts in getting accurate and timely documentation from provider agencies.
- The Central Registry Unit (CRU) staff will continue to collaborate with case managers and consultants to track the progress of newly allocated individuals in starting to receive waiver services. DDSD anticipates that the development of the Client Data Management System (CDMS) (in process) will help alleviate the tracking issues.
- Human Services Department (HSD) Medical Assistance Division (MAD)
- Human Services Department (HSD) Income Support Division (ISD)
- Qualis (HSD's contracted Third Party Assessor)
- UNM Center for Development and Disability (CDD)
- New Mexico Department of Health's (NMDOH) Outside Review
- Advisory and Support groups
- NMDOH DDSD Mi Via Program
- Community Providers, Case Management, and Consultant Agencies
- Managed Care Organizations
- Micro and macro level review of allocation status reports by CRU staff to determine if systemic or case-specific problems exist during the allocation process.
- Providing training on the allocation process and deadlines to case managers, Mi Via Consultants, and DDSD staff.
- Continued collaboration with case managers and Mi Via Consultants regarding time frame expectations.
- On-going focus on communication with applicants to maintain current contact information and to make sure they are familiar with eligibility criteria and available services.
- Regularly review status reports to determine if systemic or case-specific problems are encountered during the allocation process.
- Provide training and collaborate with providers, partners, and DDSD staff regarding the allocation process and deadlines.
- Improve and maintain current contact information for applicants.
- Increase applicant awareness of Medicaid, State General Fund, and community-based service options.
- Q1-Q4: Provide regional Allocation Fairs to new allocation groups to educate applicants on the allocation process. Completed.
- Q1-Q4: Increase direct contact with applicants who have not completed income and clinical eligibility; troubleshoot issues that are keeping the applicant from completing the allocation process. Completed and on-going.
- Q2-Q4: Track all expedited allocations to ensure the small percentage of individuals who were allocated proceed through the income and clinical eligibility process in a timely manner. Completed and on-going.
- Q4: The CRU Eligibility Caseworker will receive additional guidance on the tracking and documenting of allocation timelines and clarification of acceptable and unacceptable delays. In process.
- Q4: Research individuals in the last three quarters who have not received services within the 90-day timeline. Completed.
FY17 Annual Progress Summary
- At the end of FY17, 14 of 19 (73.6%) individuals had a service plan in place within 90 days of income and clinical eligibility. Six of those individuals were recipients of expedited allocations and all six had the ISP in place within 90 days. The remaining 13 individuals were part of prior allocation groups, which had been experiencing delays from prior quarters. This result reflects a considerable improvement over FY16 (54.0%). The success can be connected to increasing direct contact with applicants and having case managers troubleshoot issues that keep applicants from completing the allocation process in a timely manner.