presented testimony

Testimony by C. Thomas Cook
Provided at the Joint Finance Committee Hearing
Regarding Governor Markell’s Budget Proposal for the
Division of Developmental Disabilities Services
March 26, 2015
Representative George Smith, Senator McDowell, and members of the Joint Finance Committee, my
name is Thomas Cook. I am the Executive Director of the Delaware Association of Rehabilitation
Facilities. DelARF represents organizations that serve people with disabilities in our state, including
individuals with intellectual and developmental disabilities. These providers offer a full array of
community-based services to Delawareans with disabilities.
DelARF strongly supports all of the items listed in the Division of Developmental Disabilities Services
(DDDS) budget that the governor submitted to the General Assembly. We would ask that the
Committee consider appropriating additional funds in three areas:
1) The Direct Support Professional (DSP) rates, aka the ICAP rates. DelARF recognizes that
the Joint Finance Committee has a difficult task in balancing all the competing priorities that you
are facing. If it is at all possible, we are asking that an additional $2.64 million in state funding
be appropriated to bring provider reimbursement to 80% of the benchmark rate identified in the
report Secretary Landgraf submitted to the Office of Management and Budget and the Controller
General on January 17, 20141. When added to the annualization of the FY 15 appropriation, as
recommended in the governor’s budget, and matched with federal funds, this would reduce the
shortfall in the rate setting system to $26.8 million, down from the $37 million shortfall where
we started at this time last year. Until last year’s appropriation by the General Assembly, rates
for service providers in Delaware had not been rebased since they were first put into place in
2004, despite the recommendation from the Mercer consulting team that they be examined and,
if needed, rebased every three years.
2) Staff and consulting resources for DDDS projects. DelARF is eager to see the final report of
the DDDS Quality Working Group. Having an agreed-upon set of quality outcomes upon which
the DDDS service system could be measured would help demonstrate the effect of
appropriations being made to increase the DSP rates and would help self-advocates and families
shop for services. We believe that the General Assembly should make sure that DDDS has the
resources necessary to carry out any initiatives recommended in the report that the Department of
Health and Social Services will issue on April 1.
3) A Family Support waiver. Many Delawareans have saved the state millions of dollars by
continuing to care for their adult family members with intellectual and developmental disabilities
at home instead of asking for out-of-home placements. Eventually, when these good people are
no longer able to care for their family members at home, DDDS will need to find places for them
1
http://delarf.org/wp/wp-content/uploads/2012/04/ICAP_Rebasing_Report_OMB-CGO_012314.pdf
DelARF Testimony on the DDDS Budget
to live. That is why DelARF supports the inclusion of Family Support funding in the FY 16
budget – to give families the help they need, which will extend the amount of time before out-ofhome placements need to be found for hundreds of individuals.
In closing, I want to say a few words about DelARF’s perspective on the HCBS Settings Rule issued by
the Centers for Medicare and Medicaid Services (CMS) in January 2014. This Rule is the most
significant development in the administration of federal Medicaid waivers since their inception in the
1980s and, as such, maintaining the “status quo” is not an option. There is no turning back from the
mandate for people with disabilities to receive services in the most integrated setting appropriate, as
determined by their person-centered planning teams. Consequently, the General Assembly should
expect that these changes will have an impact on the DDDS budget in the years to come as the transition
to more individualized services occurs.
Under Jane Gallivan’s leadership, DDDS ensured that a representative group of stakeholders
participated in the Focus Group that helped design the Transition Plan, which must be completed by
March 17, 2019. This was also the approach that DDDS took with the Quality Working Group. The
only way to ensure that we do not increase the funding gap or produce other unintended consequences
such as diminished access to services is for DDDS to once again engage all the stakeholders in the
system in an open and honest dialogue during the implementation of the Transition Plan, so that we can
reach a consensus about what needs to be changed in the system.
Therefore, DelARF makes two recommendations regarding the implementation of the Transition Plan:
1) The working groups convened by the Advisory Council to DDDS should include representatives
of the provider community who can inform the work by sharing their knowledge about the
opportunities that are afforded individuals in service settings as they exist today, including day
programs like those operated by Easter Seals; center-based work programs like those operated by
Chimes and Elwyn; supported employment programs that help individuals get and keep
community jobs; and residential programs such as group homes and shared living.
2) The Advisory Council’s working groups should also involve legislative participation or some
mechanism for legislative oversight so that realistic budget estimates of proposed changes in the
system can be thoroughly discussed and agreed upon as the transition to more individualized
services occurs.
Thank you for the opportunity to provide testimony on the DDDS budget.
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