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What would it take to adequately fund high quality services?

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What would it take to adequately fund high quality services?

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Determine the cost of funding what we define as quality.

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Consider what would it cost to contract with an outside vendor to conduct a study. 

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Consider what would it cost to contract with an outside vendor to conduct a study. 

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Q1 - What data has state used to determination cost of EI?

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Q1 - What data has state used to determination cost of EI?

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Known Costs include: Part C Funds, FFS Medicaid (except MCOs which make up 60% of the Medicaid population).

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What data have states used to determine the cost of EI services?

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What data have states used to determine the cost of EI services?

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The cost is calculated using regional salaries and prices where available. The expenses include but are not limited to, personnel, travel, materials, equipment, and facility costs.

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How has your state focused on engaging stakeholders in the conversation about the cost of quality services?

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How has your state focused on engaging stakeholders in the conversation about the cost of quality services?

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A cost study was completed which indicated the annual average per-child cost of providing a full year of high-quality early intervention was $17,949 in Michigan. This cost includes outreach, referral, eligibility determination, IFSP creation, service coordination and provision, transition, and state supports.

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What strategies have been implemented, in the state to engage families and community partners in quality services and fiscal conversations.

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What strategies have been implemented, in the state to engage families and community partners in quality services and fiscal conversations.

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In Michigan, an expert panel was convened to complete a cost study. More than 50 expert practitioners and family members were involved in panel meetings including, EI service providers and administrators, (SLP, OT, service coordinators) and Local ICC members. Additional input on system goals and state supports was gathered from: The Office of Great Start, Staff from the state technical assistance provider, and members of the Michigan ICC.

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There is hesitation to share financial information at ICC.

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Q2 Utilizing the ICC, reviewing the budget. 

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Q2 Utilizing the ICC, reviewing the budget. 

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CIFR- TA resources on sharing with fiscal data 

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CIFR- TA resources on sharing with fiscal data 

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Workforce, child count, outcome data, service data used

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Look at costs or funding amounts for subrecipients who consistently exceed performance and quality metrics.

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Governor’s report (subcommittee within SICC) that includes strategies partners including families and EI providers)

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Like NM, our state is engaging in a Rate Study for Early Intervention. We have been using an Advisory group that includes primarily providers and families to help voice their needs and concerns throughout the study. We could always do better to help families who participate to feel more comfortable to contribute on a topic that is less familiar.

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SICC subcommittee that prepares the report to the Governor includes both families and community partners.

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Important to engage ICC, local program leadership and staff, state leadership, fiscal staff, Lead Agency director

Reviewing cost of the Part C system with the ICC

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AZ just completed a cost study for provider rates, using Dept. of Labor wage data specific to the state with the closest matched positions for each discipline.

Providers were part of the study, filling out extensive surveys with data for their costs and time for each of the required tasks in their contracts.

The final report was published to our website and is a resource for advocating for funding.

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In Nevada, EI Stakeholders, ICC and EI programs were involved in sharing cost concerns with legislators. Our system completed a rate study through Health Management Associates in 2022 through our ARPA funding. With the study data from EI referral to exit, our state approved in 2023 a statewide capitation rate increase for our community programs (from $565 to $794 per IFSP). There was a caveat however, as also starting in 2023 all community programs were required under their service agreements with the state that they must bill through the state billing data system. Therefore all state Medicaid revenue that comes into the community programs is now transparent, and must be returned to the state (so there is no double dipping).