HHS outlines DD services growth, waiver changes and budget requests including host-home pilot

Tina Bay, director of the Developmental Disability Section at the Department of Health and Human Services, told the Appropriations committee the section serves about 8,410 people and operates a range of services including early intervention, program management, intermediate care facilities and a 1915(c) home- and community-based services (HCBS) waiver.

The department emphasized that eligibility and service delivery have shifted over time and requested funding in the executive budget for assessment-tool replacement, a host-home service for youth and planning for a cross-disability children's waiver.

Why it matters: Committee members were shown utilization trends and policy changes that affect how many people qualify for services, what services are available and how the state budgets for them. Several of the department's requests would change service access or payment arrangements and could increase ongoing costs if enacted.

Bay described the Developmental Disability (DD) Section's core functions: provider licensing and enrollment, waiver administration, service authorization, guardianship services and program-integrity work including quality reviews and provider audits. "The developmental disability section is dedicated to ensuring that individuals with developmental and intellectual disabilities have access to comprehensive person centered services that promote independence, inclusion and quality of life," Bay said.

Officials told the committee the DD program currently employs 117 program managers, conducts an average of 240 new referrals and 191 new eligibility determinations monthly, and serves about 8,410 people with DD case management supports. Bay showed a 7.8% increase in eligibility determinations since 2019 and said self-directed services and family-home supports are among the fastest-growing delivery modes.

Program and policy changes highlighted

- Waiver renewal changes effective April 2024: Bay said in-home supports may now be provided by a mix of provider-managed and self-directed services; allowable equipment-and-supplies limits increased from $4,000 to $5,000 per waiver year; environmental-modification…