The Department of Human Services is drafting a plan it says would reduce costs and lessen the number of individuals with intellectual and developmental disabilities waiting for home and community services by 1,100-1,200.
A 21-page bill has been drafted and was circulated Thursday (Feb. 9) to medical and specialty Medicaid providers, with whom DHS plans to meet on Friday. Feedback from the meeting will be used to modify the bill before it is introduced in the Legislature, said Amy Webb, Department of Human Services spokesperson. The bill does not yet have a legislative sponsor.
The plan relies on the creation of risk-based provider organizations, otherwise known as Provider-owned Arkansas Shared Savings Entities, or PASSEs. The PASSEs would be composed of providers of developmental disabilities services, behavioral health service providers, hospitals or hospital services organizations, physician practices, and pharmacists or pharmacy benefit organizations.
The PASSEs would integrate care among those providers with the goal of increasing proper use of medications, hospital follow-up care and well-child checkups while decreasing hospital re-admissions and the use of high-cost services. They would receive lump sum payments to be distributed among the participating providers.
The state provides services for 30,000 individuals with behavioral health needs and/or intellectual or developmental disabilities. It spends more than $1 billion annually on this population, not counting costs for human development centers, nursing homes and assisted living facilities.
An incentive payment structure would be created to reward PASSEs that meet desired outcomes.
The PASSEs, which are funded by state and federal Medicaid dollars, would be subject to an existing premium tax currently paid by insurance companies. Proceeds from the tax would reduce a list of 3,000 individuals with significant disabilities who have been waiting for home- and community-based services, some as long as since 2007.
In January, legislators passed into law a measure that would reduce the waiting list by about 700 individuals by using tobacco settlement money that is earmarked for a program that no longer exists.
Webb said DHS hopes to continue to reduce the list.