P007: Number of individuals on the developmental disabilities waiver waiting list
Story Behind the Curve
- The wait time for home and community-based Intellectual/Developmental Disabilities (I/DD) waiver services varies widely. In New Mexico, registrants are offered waiver services as allocation slots become available. The current average wait time is 10.7 years. Eligible persons can receive standard Medicaid benefits while on the waiting list.
- The Developmental Disabilities Waiver (DDW) Program is designed to provide services to allow individuals with intellectual and developmental disabilities to live as independently as possible. The capacity of the program depends on combined state and Medicaid funding. This measure is important in gauging and responding to the need for services.
- At the end of FY17, 6,602 people were on the Central Registry (i.e., the waiting list), which is an increase of 76 people as compared to FY16.
- The New Mexico Department of Health (NMDOH) Developmental Disabilities and Supports Division (DDSD) Central Registry Unit will continue to address the backlog of applications by prioritizing both current and outstanding applications with the oldest registration dates. These are the applications without an eligibility determination and are either in the “start” or “pending” status.
- Health care providers
- Community providers
- Advisory and support groups
- Case management and consultant agencies
- Managed care organizations
- Statewide pre-k through 12 educational institutions
- NMDOH Family, Infant, Toddler (FIT) Program
- FIT Program provider agencies
- Continuous review of waiting list status reports to determine if systemic or case-specific problems exist during the eligibility determination process.
- Maintaining current contact information for registrants.
- Regular outreach to and communication with registrants, families, community providers, and others to ensure they know about DD Waiver eligibility and documentation that assists in the determination process.
- Continuous evaluation of the methods utilized in processing applications and allocations.
- Reallocation of unit resources to allow eligibility caseworkers to focus on backlogged applications.
- Maintain focus on reducing the backlog and completing current applications.
- Increase applicant awareness of other Medicaid, State General Fund, and community-based service options.
- Increase applicant and community provider awareness of DD Waiver eligibility by doing outreach to community agencies in each DDSD region.
- Q1-Q4: Conduct training for Case Managers, Consultants, and DDSD staff on the allocation process as well as DD Waiver eligibility criteria. Completed and on-going.
- Q1-Q4: Establish monthly meetings with the Medical Assistance Division, Income Support Division, Qualis Healthcare, and other agencies involved in the allocation process. Completed. Meetings have happened as needed.
- Q3 to Q4: Refer individuals with mental and behavioral health issues to the appropriate behavioral health system. Completed and on-going.
- Q3: Develop a written plan to systemically address the backlog of applications. Completed and implemented on April 1, 2017.
- Q3: Reorganize Intake & Eligibility Bureau to direct more managerial support to the Central Registry Unit. Second Central Registry Unit Manager started 4/10/2017. Completed.
- Q4: Implement the backlog plan, which should reduce the backlog by approximately 5% per quarter. In Process.
FY17 Annual Progress Summary
- Over the course of FY17, the waiting list grew by 76 individuals (FY16-Q4: 6526, FY17-Q4: 6602).
- Significant efforts were undertaken to work on cleaning up the Central Registry that resulted in 381 applications being closed for reasons other than allocation.
- Although the target of 6,300 was not met, any reduction without a large allocation group is progress on this goal of decreasing the number of individuals on the DD Waiver waiting list.