Quarterly BDS wait‑list report: department funded all current developmental disability requests; Medicaid eligibility delays slowed starts

The Division of Long‑Term Supports and Services briefed the House Health and Human Services Oversight Committee on April 25 about second‑quarter fiscal year 2025 wait‑list activity for developmental and related waivers. Melissa Hardy, Division Director, said the department allocated funding for all requests submitted in the quarter but that eligibility and family decisions delayed some service starts.

Hardy said 75 individuals requested services under the Developmental Disabilities (DD) waiver in the quarter and the department funded all 75 allocations; 29 people later withdrew their requests. “Out of that, the remaining 46 individuals that were funded, 42 of them projected to start their services. … Out of those 42, 30 individuals started services, and 12 did not start services in quarter 2,” Hardy said, adding that eight non‑starts were due to incomplete Medicaid eligibility and others were family requests to delay.

The nut graf: DHHS reported full funding of quarter‑2 requests but noted that Medicaid enrollment and administrative steps — not funding availability — were primary causes of service start delays. The agency said provider capacity remains a concern even when funding is in place.

Hardy described how the wait‑list registry is managed through area agencies that work with families to predict service needs and put individuals into an online registry. For the DD waiver, Hardy explained the program uses two intake categories: “A” for people exiting school and “B” for individuals newly eligible or moving into the state.

On the children’s In‑Home Supports (IHS) waiver, Hardy said 11 requests were funded in the quarter; two withdrew and nine received allocations and started at least partial services. For the Acquired Brain Disorder (ABD) waiver she reported four requests, three withdrawals and one funded individual who had not started services because Medicaid enrollment was not yet complete.

Members asked whether workforce shortages prevented service starts despite funding. Hardy acknowledged statewide provider capacity issues, but said the specific non‑starts documented in the quarter were mostly due to Medicaid eligibility and family choice. Representative McDonald sought historical context and Hardy said there is no current wait list for DD services; the last time a wait list existed was 2020.

Hardy also clarified the difference between eligibility under RSA 171‑A (determining developmental disability service eligibility) and subsequent Medicaid eligibility required for waiver payment. She said area agencies confirm DD eligibility first, then families apply for Medicaid when waiver payments are needed, and that processing or paperwork can delay service starts.

Ending: Hardy said the quarter‑by‑quarter report helps the department and Legislature anticipate needs over five years and that the department will continue to monitor Medicaid eligibility processing and provider capacity to reduce start delays.