,
38 tweets,
6 min read
Read on Twitter
ADSD budget presentation starting shortly, today's presentation will cover our Regional Centers and related budget accounts. 
Public comment about to start
First comment from a family remarking on the reimbursement rates in Nevada for important services and the need for provider capacity.
SNAP (State of Nevada Association of Providers) representatives and members now commenting regarding supported living arrangement services.
Average turnover rate reported of 75% with an average wage of $9.65 per hour among provider members surveyed. Competing with industries such as fast food for employees to work in supported living fields per commenter from provider Chrysalis. Supportive of the budget.
(You can see the referenced LCB Audit of Supported Living Arrangement settings here: leg.state.nv.us/Division/Audit…)
Opportunity Village commenting from Las Vegas regarding jobs and day training providers. Reference made to advocacy visits to legislators yesterday.
Public comment closed, Administrator Dena Schmidt presenting with Deputy Lisa Sherych and ASO 4 Melissa Laufer-Lewis at the table as well. Starting with the Family Preservation Program. On to Regional Centers.
Three Regional Centers: Desert, Rural, and Sierra. Caseload growth and waitlists covered as well. See meeting agenda here: leg.state.nv.us/App/NELIS/REL/…
(Chair Denis indicated questions will come at the end of the budget presentation, their notes may be in a different order than the budgets in the presentation.)
Disability Services questions starting now with Assemblywoman Benitez-Thompson: there is no increase for jobs and day training, just Supported Living Arrangements? A: we increased both JDT and SLA 5% in the interim, in this budget the additional increase is just for SLA.
Follow-up: does the interim increase for JDT carry forward? A: yes, into the next biennium
Chair Denis: impact of increase on people served? Sherych: expanded service delivery for providers based on increases and benefits to staffing. Follow-up: waitlist to be addressed through this increase? Schmidt: always hopeful rate increases will improve recruitment & retention.
Assm. Benitez-Thompson: if level 4 is highest acuity, is there a need for greater rates at that higher level? Sherych: with the provider rates, it is hourly. While support needs differ, we see the increase allowing additional training for better preparation to support.
Follow-up: so increased training will provide better support but not increase actual staff numbers? A: correct
Q (Sen. Kieckhefer): fiscal impact of carry forward of the 5% carry forward for JDT? A: number not brought, will follow up. Effective date June 1 & universal across all services. Q: why no increase again for JDT this budget?
A: Medicaid waiver sets rate, JDT is already at maximum, SLA is not. CMS approved waiver renewal, but a rate study is ongoing and JDT. Q: is that something that varies state to state? A: rate study is based on cost of living and service needs by area. Expected to be done fall.
Assm. Spiegel: Curious about offices in Mesquite and Pahrump, how eatables l established and when, etc? Sherych: traditionally 74 people served had to travel to Las Vegas for service coordination. One staff now in both locations under Rural Regional Center.
A: Change occurred in June 2018, seeing increased capacity in community. Also Rural Regional instead of Desert Regional are in tune with rural issues. Q: where are the 4 new RRC staff going to be? LL: can expand Mesquite & Pahrump but placement depends on population served.
Q (Chair Denis): surprised by new offices... Sherych: We've worked with partner agencies for space. Q: they were in Las Vegas? Any expenses associated with their office? A: 3600/yr lease in Pahrump, DPBH shared location in Mesquite. Q: where in the budget? A: adjusted base budget
Q(Kieckhefer): how do you calculate increased staffing need by 40? A: current caseload ratio of 1:45, caseload increasing 1,000 across all three Regional Centers in biennium. Need other support staff too.
Follow-up: how often do staff interact with person served? Sherych: can be monthly, more frequent even, depending on need. Quarterly otherwise. Also other waiver requirements for protective oversight, health and safety, respite, emergency needs, etc. Can provide spreadsheet.
Follow-up: do you distribute case load mix based on cases? Sherych: trying in the past year to streamline caseloads - some service coordinators used to have lower loads but all waiver recipients but that was difficult for them. Now mixed SLA, JDT, targeted case management, etc.
Q (Benitez-Thompson): question re JDT waitlist, for 220 individuals, what does it look like as far as capacity to handle the waitlist? Sherych: waitlist is a mix of individuals who may be more behaviorally complex or medically complex and provider network lacks capacity...
... Employee turnover is also an issue for providers contributing to waitlists. Q: is there capacity? A: there is capacity to absorb the waitlist, will follow up if there are needs to expand to meet the need for both JDT and SLA. Follow up questions from Sen. Kieckhefer.
A: other factors can include where people want to live and who they want to live with (for SLAs). Can follow up regarding request about formalized survey about provider capacity.
Questions solicited on Family Preservation Program. Assm. Benitez-Thompson: the rate to families in 2018, $364 (2019 increase to 374) looking to hold rate steady but increase those served? A: were able to reinstate 374 last year, 2018 was lower for budget reasons.
Q: does the monthly money impact their eligibility for other benefits? Schmidt: this income is excluded for eligibility for other programs. Q: is this rate at a good spot? Sherych: in last 12 months only 6 individuals have moved out of family homes, less than one percent.
Q: no waitlist? Sherych: no waitlist at this time.
Sierra Regional Center question from Chair Denis regarding staffing. Sherych: Development Support Technician will transfer when individual will retire this fall, position was holdover from when SRC had an ICF. Custodial employee being talked to about their preferences.
Desert Regional Center questions solicited by the chair. Assm. Benitez-Thompson: discussing new positions, a lot of work done to make sure that ICF is in compliance with CMS and HCQC, question about staffing ratios as recommended by consultants...
Sherych: you're correct, consulting group asked for [38.2] positions, analysis done on the needs of the individuals and based on that and current staffing overage to FTE positions we've been 24.7 positions over. Believe will be sufficient. Chair: maintaining Compliance? A: yes
Chair Denis: van cost doesn't seem enough? A: agency van converting to fleet services van
Rural Regional Center questions solicited by the chair....
Budget hearing complete, final public comment requested. None appearing in North or South. Adjourned.
@threadreaderapp unroll please
*Correction: Sherych indicated later that the position is already vacant
Correction *20.74, my apologies
