By Larry Deal
You might have heard that there are some changes to the way brokerage services are administered and funded. One of the most significant changes is that all brokerage customers must now have a formal functional needs assessment at least once a year.
A functional needs assessment is a series of questions that asks what kinds of living supports a person needs to live independently in the community. Oregon has chosen the Adult Needs Assessment as its current tool. You may view the tool by clicking here. The assessment asks questions about what kinds of independent living supports you need, why you need them, and how often you need them. Once the assessment is completed, it determines certain services you are eligible for and how often you can access those services.
Brokerages have been actively involved in conversations with the state and other stakeholders regarding the implementation of the assessment. Since summer of 2013, brokerages were instructed that we would have a year from the time we received the assessment tool to implement the changes. The state spent several months developing what was to be a brand new needs assessment, but the tool was abandoned for myriad reasons. We received a final tool in November 2013 and immediately began conducting assessments as our customers’ plan years rolled over. Because we typically plan with our customers up to six weeks in advance of a plan’s start date, the first assessments we completed were for customers whose plan years began in January of this year.
Under the original plan, brokerages expected to complete all assessments by October of 2014 for the approximately 7,500 customers receiving our services statewide.
However, we were informed in February 2014 that an agreement between the state and federal oversight entities would force a significant shortening of that timeline. The Centers for Medicare and Medicaid Services (CMS) insisted that all assessments be completed within one year of when Oregon began receiving Community First Choice Option/K Plan dollars (July 1st, 2013.) Leadership in Oregon argued for more time. It wasn’t granted and the deadline was shortened. Instead of October, Oregon was now instructed to have all assessments completed by the end of June 2014 or risk losing its federal funding.
Brokerages expressed ample concern about this change – we would need to complete nearly 2,000 additional assessments in less than five months – and requested additional funding to add staff, hire contractors, or pay overtime to existing staff to meet the charge. Instead of funding brokerages, the state decided to deploy its own staff to complete the additional assessments.
Which brings us to the present.
As a system, we are faced with a June 30, 2014 deadline to complete all assessments. Last week, we sent out letters informing some of our customers that they would be receiving an assessment from a non-Independence Northwest assessor. We have been assigned three state employees (Rachel, Kay and Ana) to complete the assessments in Multnomah and Washington counties. For our Clackamas county customers, Robyn Hoffman (a Clackamas county employee) will be the primary assessor. If you didn’t receive a letter, you won’t be affected.
The staff of INW have met with the assessors and they all carry a great amount of experience working with people with intellectual and developmental disabilities. Independence Northwest is providing designated office space, workstations, and meeting rooms for them and they have begun calling customers and scheduling assessments.
Here at Independence Northwest, we estimate that somewhere around 125 customers will receive their assessments from state or county staff. INW Personal Agents are responsible for conducting the remaining 300+ assessments. Additionally, a plan revision must be completed after each assessment. INW Personal Agents will be completing revisions for all 435 customers in our services, in addition to any necessary job description or contract amendments. The workload for our organization is significant and we are working hard to meet the charge.
Once this implementation phase is completed, your Personal Agent will meet with you at least annually to complete a needs assessment – usually right before your ISP meeting. The state and county involvement is a one-time situation to allow the state to catch up and meet the terms of their agreement with CMS. Moving forward, it becomes a part of our regular service delivery. We’ve posted a set of frequently asked questions. Check them out here.
The functional needs assessment implementation is one of many, many changes occurring in our system right now. Since last August, we have been holding community forums at least twice a month to update the community on what’s changing, why, and how. If you would like to learn more, join us for one of our upcoming sessions.
- INW Frequently Asked Questions on the Needs Assessment (March 2014)
- The Adult Needs Assessment Tool (Excel spreadsheet)
- The Adult Needs Assessment Tool (PDF)
- The Adult Needs Assessment Tool Manual (Released March 2014)
- The State of Oregon Developmental Disabilities Facebook page
- INW Blog Post: Big Changes in Oregon’s I/DD Service System Part One: The Functional Needs Assessment Tool (August 2013)