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Developing and Sustaining a Part C Finance System:

Developing and Sustaining a Part C Finance System:. Connecticut. Ongoing Monitoring of:. Demographics. Expenditures. State Economics. Political Context. Demographic Information Trends in Children Served. Fiscal Year 2003. Demographic Information Eligibility.

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Developing and Sustaining a Part C Finance System:

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  1. Developing and Sustaining a Part C Finance System: Connecticut

  2. Ongoing Monitoring of: • Demographics • Expenditures • State Economics • Political Context

  3. Demographic InformationTrends in Children Served Fiscal Year 2003

  4. Demographic InformationEligibility Moderate eligibility criteria (-2SD in one area, -1.5 SD in two areas) List of diagnosed conditions with high probability of resulting in a developmental delay Children with other diagnosed conditions plus mild delays are also eligible Children with -2SD in speech only plus a biological factor are eligible

  5. = 2% level Massachusetts 5.29 Hawaii 3.64 Indiana 3.42 Delaware 2.93 Wyoming 2.86 New Hampshire 2.63 Florida 2.57 Wisconsin 2.56 Arkansas 2.56 Rhode Island 2.51 Kansas 2.41 Pennsylvania 2.38 Vermont 2.38 Maryland 2.34 Maine 2.28 South Dakota 2.15 West Virginia 2.26 Colorado 2.26 Virginia 2.07 Michigan 1.78 Ohio 1.70 Mississippi 1.65 Minnesota 1.56 North Carolina 1.51 Iowa 1.46 New Mexico 1.41 Washington 1.32 Louisiana 1.21 Alabama 1.18 IDEA Part C Percentage of children under the age of 3 receiving services as of 12/1/2001 (excludes at-risk) New York 4.15 Connecticut 2.97 Kentucky 2.39 Idaho 2.15 Tennessee 2.09 Illinois 1.93 Utah 1.93 New Jersey 1.92 Texas 1.86 Puerto Rico 1.71 California 1.67 Oregon 1.42 Nebraska 1.36 South Carolina 1.31 Georgia 0.98 Alaska 2.21 Montana 1.84 Oklahoma 1.83 North Dakota 1.59 D.C. 1.45 Missouri 1.28 Arizona 1.27 Nevada 1.03 Moderate Eligibility Narrow Eligibility Broad Eligibility Data Source: Westat

  6. Funding Sources Direct Services

  7. Expenditures Funding deficits in each of previous three years covered by transfers from other department accounts Data Source: Monthly Invoices

  8. State Economics Budget Surpluses & Deficits Fiscal Years 1985 - 2002 Data Source: Legislative Office of Fiscal Analysis

  9. Political & Economic Context Republican Governor - proposes to end entitlement Democratic majorities in House & Senate but not veto-proof. No obvious champions. • The state’s worst budget crisis since 1991 = chaos • layoffs - January • early retirements - June • lead agency reorganizes to 3 regions - June • no budget agreement until August Strong provider trade association. Birth to Three providers function as part of a much larger group

  10. Redesign the Finance System Demographics Decrease number of eligible children (or at least prevent further increases) Funding Sources Increase revenue for direct services 1. Family cost participation 2. Shift in Part C allocation 3. Increase in insurance revenue Decrease expenditures for direct services by modifying some payment rules for programs

  11. Change demographics through small, measurable eligibility changes Review diagnosed conditions list Revise modifications that expanded eligibility Provide safety net of enhanced developmental monitoring

  12. Expand Funding Sources Reallocate admin costs saved by reorganization Expand coverage to include all services Charge families on sliding scale 

  13. Change payment policieswithin Connecticut political and economic context Make small changes that do not affect larger overall provider community • Change policy on continuing to pay programs for up to 8 consecutive weeks of “no service” to no payment for any month of no service (cancellations by family less than 24-hours in advance excluded) • Change payment of additional fee-for-service rates for children needing intensive services. Pay for those hours over 15 instead of 13.

  14. Infrastructure Changes Statutes - family fees, insurance coverage Regulations - family fees, credentialing Provider Contracts - modifications to payments Procedures - eligibility, family fees, provider payments, insurance Data System - eligibility, provider payments, family fees Billing contractor - for family fees

  15. Guidance and ongoing support New materials for primary referral sources & families Two forums for program directors with follow-up New procedures - hard copies, cds, website Letter to families, phone calls from families Questions and answers - hard copies, posted on data network

  16. OngoingMonitoring

  17. Families Declining InitialEvaluation Percent of all eligibility determinations

  18. Percentage of children exiting due to withdrawal by their parents Letter announcing fees sent to all families Percent of all withdrawals

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