The Developmental Disability trade group the Alliance for the Betterment of Citizens with Disabilities (ABCD) formed the Support Coordination Alliance (SCA) in January 2014 at a time when the Department of Human Services initiated the fee for service system.
The SCA member agencies employ over 250 professionals, represent 25% of people eligible for DDD services and are responsible for managing $180,625,013 budget dollars for those enrolled in DDD’s Program Waivers.
We believe there are two fundamental flaws in the current reimbursement rate for Support Coordination services:
·The initial BLS code used to set the Support Coordination reimbursement rate was not reflective of the bachelor’s degree required by DDD and one year ID/DD work experience requirement and was therefore substandard to the actual cost and responsibilities that exceeded the high school rate used for the position.
·We are entering the 6th year of the program and there has been no cost of living adjustment to the rate.
DDD’s New Fee For Service System
In 2013 DDD embarked on a new fee for service system that empowers the DDD participant and their families with choice and control over the services that they choose to support them and the providers that will deliver the services. A Support Coordinator is the linchpin in educating and guiding families in navigating the system and in creating the initial, renewal and revision plans while also providing ongoing monthly monitoring of the plan implementation and the health and safety of the participant.
Initial Rate Setting
The Final Report on Rates by Johnston, Villegas-Grubbs and Associates LLC (JVGA) to DDD on July 18, 2014 established the following rates:
·Support Coordination Services: $239.81 per month based on a 25 person caseload and the BLS code for Social and Human Service Assistants; a category not requiring a Bachelor’s degree while DDD’s rules require a Bachelor’s degree
·The current calculation hourly rate for a Support Coordinator with a bachelor’s degree is: $17.50 per hour.
·The BLS has a category called “Social Worker” that requires a college degree and currently pays $23.79 per hour. This payment level will result in a Support Coordinator agency compensation of $325.84 per month.
Implications of Inadequate Support Coordinator Reimbursement Rates
·Inadequate rates do not allow SC agencies to offer competitive wages and benefits to attract and maintain the small pool of qualified staff available in the labor market. Increased turnover affects quality services.
·Inadequate rates do not allow for the Managerial/Administrative staff needed to maintain quality.
·Inadequate rates make it difficult to invest in technology and oversight systems needed to ensure quality.
Recommendations
To increase the compensation rate for an SC to that of a BLS “Social Worker” category - $23.79 per hour and a SC agency payment rate of $325.84 per month. This reflects: the education skill required for this position, the current market cost for this type of position, and the benefit, administrative and managerial costs to a Support Coordination agency. This will require an additional funding cost to DDD of $13,200,000 along with a $6,600,000 match from Medicaid.
Broad Based Support for a Support Coordination Rate Increase
There is broad based support for a Support Coordination rate increase as evidenced by the preliminary recommendations of the Developmental Disability Fee for Service Advisory Board that Support Coordination agencies receive the rate increase reflected in this proposal. It is important to note the advisory board is made up various DDD constituencies including: consumers, guardians, family members, service providers, trade group representatives, and testimony from the NJ Disability Ombudsman, Paul Aronsohn.
See the attached document for the full text of the rate request.