B&A staff have been providing continuous monitoring for the Division of Developmental Disabilities (DDD) program to support operational performance. This has included developing prospective annual services forecasts, developing and maintaining ongoing monitoring reports for service utilization, and members’ access to services.
Prior to B&A’s formation, Peter Burns and Steven Abele designed and conducted the readiness review of the DDD’s FI selection. In addition to conducting the review and writing up findings, our team worked with the FI and DDD to ensure that the proper systems implementations were in place before the FI went live.
Prior to B&A’s formation and continuing in recent years, current B&A staff assisted the DES/DDD develop its Requests for Qualified Vendor Application (RFQVA) process, an online procurement system that enables open procurement for specific services. B&A staff assisted in writing the original RFQVA template documents, the specific requirements for indvidual services, and amendments to previously-released RFQVA documents.
B&A assisted the DES/DDD in redesign of the Early Intervention Program. The focus of the redesign was to increase provider capacity and to build a team model for early intervention services. Tasks included conducting focus groups with therapists, rate-setting for the team based model, targeted rate increases by zip codes/regions, and calculation of the fiscal impact.
Prior to B&A’s formation, Gretchen Engquist of B&A designed a rate assessment tool for the DDD to use in determining the rate paid on a statewide basis to independent providers. The rate assessment tool evaluates environmental factors, distance, safety, behaviors, medical needs, activities of daily living (ADLs) and the availability of nonpaid caregivers that can assist the paid independent provider. An automated scoring system and database was also developed as part of this process. B&A staff is currently responsible for the maintenance of the rate assessment tool.
Prior to B&A’s formation, current B&A staff assisted the DES/DDD implement a fiscal intermediary that enables persons with developmental disabilities to select individuals or agencies to provide services to them in their home. B&A staff assisted in writing the Request for Proposal, conducting the readiness review of the awarded FI, and develop operational flows for the DDD to implement the FI. Arizona was unique in that its FI program was a “turn-key” implementation of over 2,000 at the outset.
B&A staff assisted DES/DDD in the conversion to a consumer-directed individualized budget system. Stages in the movement to consumer direction that have been implemented include (a) establishing a rate structure for HCBS providers, (b) streamlining the procurement process, (c) enhancing management information systems, (d) developing consumer assessment tools and (e) retaining a fiscal intermediary.
Peter Burns supervised the development of reporting systems to score clinical/environmental assessments and transform scores into unique consumer rates reflecting each individual’s need. B&A staff maintain the rate assessment tool that is used to tie service needs to rates to set the individual budgets.
B&A staff have been assisting the DES/DDD in setting HCBS rates since 2000. Originally, we were involved in the formulation and adoption of a legislatively mandated rate structure for both agency and independent providers. Responsibilities included developing the methodology and performing the financial analysis of the implementation costs of the rate structure and developing strategies for implementation of the rate structure within budget constraints. Included in the financial estimates were two-year projections of caseload and utilization. The rates were developed using cost information collected from providers in conjunction with the collection of market-based, Arizona-specific costs.
Recently, B&A participated in the rebasing of all HCBS rates (with two other consulting firms). This required detailed, web-available provider cost survey tools and instructions, publication of frequently asked questions, extensive provider briefings on rebasing results and methodology, and fiscal impact analysis.