“Half Sheets” Are Out – Not Many Surprises

February 22, 2022

Let’s start with rates generally:

• Increases in DD rates which include in addition to the services listed in the Governor’s Budget, Group Day, all Group Home, Group Supported Employment  (a few additional services, eg Workplace Assistance , Community Guide and Benefits Management, in the Senate version) to correspond with the rates proposed in the Burns study with the slight wrinkle that the Senate version limits the increase for Group Homes to 97.25% of the established rate and nursing services to 80% of the established rate in accordance with provision in the Budget.
• Both include a continuation of the 12.5% for behavioral health until June 2023 and the Senate adds services not otherwise included in other measures
• The Senate also includes a 30% increase in Dental rates; the Governor’s budget only increased those rates by 5%
• And the Senate increases Peer Recovery Specialists rates by 300% and Personal Care, Respite and Companion by an additional 10%
• The House increases Adult Day Health by 12.5% – making that a permanent increase.

In other news:

• Both require DMAS to take needed action to allow families to provide personal care to minor children (small restrictions)
• Both remove the funding for a study of BH services which was in the Governor’s budget and direct the effort to the new Behavioral Health Commission
• Both remove funding due to the delay in the FY22 slot distribution and the Senate also removes the 600 slots which were budgeted for FY23, the Senate also has specific language to direct DBHDS in how they are to manage slot distribution in the future
• Both have some funding either for salary increases for CSB direct care staff or for recruitment and retention bonuses, saving will accrue for reducing the allocations for state direct care staff to be paid at the 75 percentile of the average to the more reasonable 50 percentile.
• And the Senate included funding to support Pact C services by adding the equivalent to the 12.5% for non-Medicaid children

On the broader policy side:

• The House included deferring the funding for additional licensing specialists until a full study of the office of licensing could be completed; the Senate removed the automatic carry-forward for unspent DOJ funds and will require a quarterly report on the progress to meeting the DOJ requirements
• the Senate also moves the rate setting process and oversight including the processing of customized rate requests to DMAS.
• The Senate also requests a study of the potential of a new Waiver to serve those who may not be eligible for the existing DD Waivers by level of disability.
• The Senate also included our requested language on removing the 6 bed limit on Group Home size until June of 2024.
• The House added language to make the telehealth/virtual options which were available under Appendix K permanent
• Lastly, the Senate asked the Secretary of HHR to study “restructuring DBHDS” including: “(i) whether responsibility for developmental disability services is more appropriate in another state agency; (ii) whether community-based behavioral health services and the operations of the state mental health hospitals should be divided split into separate entities; (iii) whether a different structure or model, such as public-private partnerships, is appropriate for the operation of state mental health hospitals; and (iv) whether the current structure for community-based services can be enhanced to better deliver services.”