Wyoming health officials are preparing a major redesign of a Medicaid program used by thousands of people with developmental disabilities and brain injuries.
The changes are designed to address long waiting lists plaguing the Home and Community-Based Waiver Program. Hundreds of people are now shut out of services that range from job training to around-the-clock supervision.
The Wyoming Legislature’s edict to serve more people without additional spending has caused some concern among families of those with disabilities. They worry the redesign will leave their loved ones with less support.
“There are 500 people waiting for services right now,” said Chris Boston, executive director of NOWCAP Services in Casper, which runs several programs for people with disabilities. “If they are going to serve any of those folks, let alone all of them ... somebody is going to have to give up something.”
The Wyoming Department of Health has planned a series of meetings to discuss the changes. The first is set for Thursday night at the Parkway Plaza Hotel & Convention Centre in Casper.
Feedback at the forums will help officials as they fill in the details of the redesign, said Chris Newman, senior administrator with the Health Department’s Behavioral Health Division.
“Even though we have the framework, we haven’t worked everything out,” she said. “We want to take as much input as we can get from the people who are receiving services and their guardians on how best to do this.”
More than 2,000 people already use waiver services. The program cost the state roughly $120 million in fiscal year 2011, making it the costliest service in the state’s Medicaid program, according to a Health Department study.
Even with that amount of money, people still wait years before receiving assistance. The average wait time for an adult is now 33 months, according to Health Department figures.
The redesign is part of a Medicaid reform package passed by the Legislature earlier this year. It will create two separate waivers. Most people will receive waivers with a hard spending cap that pays for support services. A smaller group, with more intensive needs, will get comprehensive services.
“It’s definitely a whole different approach to what we have now,” Newman said.
Officials haven’t decided how many people will receive comprehensive services. Nor have they set a spending limit for those who receive support waivers.
Before those and other decisions are made, officials want to gather more information about how people use the existing program, Newman said. They also want to know how the state should serve more people within existing spending limits.
“We feel like the people who are impacted by these changes and who are getting these services, or who are on the waiting lists ... are the best people to say how we do this,” she said.
Whatever decisions are made, Boston hopes the state proceeds with caution. He worries about unintended consequences that might come with the redesign.
“Let’s be sure we do the right thing,” he said. “Change for change’s sake is not appropriate in this situation. We have people’s lives in our hands.”