Department of Disabilities and Special Needs seeks $9.3M for 48 non‑Medicaid placements and $17.5M for capital to open settings

CONSTANCE HOLLOWAY, director of the Department of Disabilities and Special Needs, told the Senate Finance Committee Health and Human Services Subcommittee on March 19 that DDSN is requesting $9,275,380 to fund 48 individuals whose care cannot be reimbursed by Medicaid and $17.5 million in nonrecurring capital funds to help providers open new residential settings.

Holloway said Medicaid does not cover every placement scenario—examples named in testimony included people judicially admitted to DDSN after a finding of incompetence to stand trial and some children needing intensive out‑of‑home treatment. The department calculated a $529 per‑day cost per bed to arrive at the $9,275,380 figure for 48 beds, which the director said is needed because the agency’s residential wait list continues to grow.

DDSN reported 281 people on the residential services wait list, with an average lead time of 12.6 months; 19 people on the list have waited longer than 12 months. Holloway said 24 people are currently supported in institutional respite settings designed for short stays but often used longer because of placement shortages; she testified that the typical stay in a respite unit has been about six months, while an appropriate stay would be about 60 days.

To address placement capacity, DDSN asked for $17.5 million in nonrecurring capital that would be available to providers—both DSN boards and private entities—to build residential settings. Holloway said past capital solicitations produced openings (one solicitation yielded 24 beds through several providers) and described a typical contract mechanism that would include a revert clause so funds revert to the state if the provider later stops operating the facility.

Holloway also presented two Greenwood Genetics requests the department supports: a $500,000 recurring request to expand genomic testing access for adults and underfunded medical conditions, and a $1,000,000 nonrecurring request to support Greenwood Genetics’ efforts to expand and sustain genomic testing capacity statewide. Greenwood Genetics’ Dr. Skinner was not present; Holloway said Greenwood works statewide though its home base is in Greenwood.

Committee members asked about provider interest and capacity to open new settings; Holloway said DDSN conducts monthly provider outreach and would solicit interest before issuing funding solicitations. She noted that requests for additional Medicaid waiver slots have been made to HHS but that waiver approval does not solve the immediate problem without physical settings to place people.

Holloway concluded by saying DDSN needs capital and placement funding to reduce reliance on inappropriate, long‑term use of respite settings and to move people from institutional respite into community settings.