ARTICLE
Presentation (PDF) Open in new window Goals of the Work Group • Ensure the VR Services are truly Person-Centered • Add Flexibility to allow for changing client needs • Increase/Improve the discovery Process • Allow longer-term supports prior to closure • Reform rate structure to appropriately reimburse CRPs The Team Patrick Cockrum, Chair Bitta DeWees Teresa Grossi Kelley Land Suzi Rinne Carla Orr Patrick Sandy Kelly Hartman Steve Cook Christian Campbell Kylee Hope, BRS Theresa Koleszar, BRS Systemic Values and Principles • Serves persons with varying disabilities, including those with the most significant disabilities • Focuses on career pathways and development • Designed to be individualized, strength-based, and flexible • Responsive at the point of service delivery • An unsuccessful outcome does not necessarily result in elimination from services • Discovery process directs the employment path/plan/outcome • Promotes economic self-sufficiency • Emphasizes participation of the individual’s support network • Recognizes the need to support long-term employment outcomes The Need for Change • The process for determining the Tier is subjective and difficult to meet • The need for long term supports without a means to pay for them leads to avoidance of Tier 1 • People with the most significant disabilities are underserved VR Hourly Reimbursement Versus estimated Cost per Hour • 1999 • Expense per hour: $30.60 • VR Reimbursement: $36.96 • 2001 • Expense per hour: $39.16 • VR Reimbursement: $36.96 • 2003 • Expense per hour: $37.51 • VR Reimbursement: $36.96 • 2005 • Expense per hour: $40.18 • VR Reimbursement: $36.96 • 2007 • Expense per hour: $39.32 • VR Reimbursement: $36.96 • 2009 • Expense per hour: $40.48 • VR Reimbursement: $36.96 • 2011 • Expense per hour: $44.86 • VR Reimbursement: $34.00 • 2013 • Expense per hour: $47.39 • VR Reimbursement: $34.00 • 2014(est) • Expense per hour: $49.56 • VR Reimbursement: $34.00 Work Group Proposal - Single Tier • Hybrid of RBF and Hourly Services • ALL consumers enter at the same level of service (tier) • Core Services follow RBF, 5 Milestones • Enhanced Services are paid hourly • Team decides when enhanced services are needed throughout time of service • Milestone 1: Planning and Discovery • Milestone 2: Placement and Matching • Milestone 3: Support and Training • Milestone 4: Retention • Milestone 5: Stabilization and Closure ENHANCED SERVICES • Benefit Information Network (BIN) • Community-Based Evaluation • Internships • Hourly Enhanced Services Hourly Enhanced Services Examples • In Depth Discovery • Social Skills Development • Natural Supports • Enhanced Job Readiness • Professionalism • Job Coaching • Other Services as necessary BRS Proposal - Hybrid Model • ALL consumers enter at the same level of service (tier) • RBF Model; 3 Milestones • Discovery is a separate, flexible service • Ongoing Support paid outside of RBF • VRC and Team determine amount of discovery and ongoing support needed • Discovery - Hourly • MS1 – Placement • MS2 – 30 Days • Ongoing Support - Flexible • MS3 - Retention Ongoing Support is authorized using BDDS model: • 1-5 SE Hours per Month • 6-10 SE Hours per Month • 11-15 SE Hours per Month • 16-20 SE Hours per Month • 21-25 SE Hours per Month • 26+ SE Hours per Month Comparison Work Group Model • Single Tier - no pigeonholing • 5 Milestones (RBF) • Enhanced Services add flexibility, based on need • Ongoing support is paid hourly • Requires team decision-making to determine need BRS Model • Single Tier - no pigeonholing • 3 Milestones (RBF) • Discovery process is flexible, based on need • Ongoing support is paid by range of hours • Requires team decision-making to determine need Potential Concerns (both models) • Decision to authorize services lies with VRC • Most time is spent in placement; reimbursement is shifted toward closure • Is the model Future-Proof? • Will BRS and CRPs adjust to the new model easily? Next Steps • Obtain feedback from ES Section • Identify best model (or combine features) • Determine appropriate reimbursement • Design training, pilot, and roll-out plan