Case Study: Massachusetts Department of Developmental Services

Massachusetts Department of Developmental Services (MA DDS)

Financial management services for a MA DDS Medicaid waiver program that brings individualized services to the homes of families with autistic children.

In most states, the fastest growing group of consumers needing specialized services is children with
autism and their families. MA DDSdeveloped a program to bring individualized services to the homes of these families with the goal of keeping children in their homes. Under a Medicaid waiver, services in the program are provided by local credentialed providers and are delivered on a schedule that supports the families.

Public Partnerships, LLC (PPL) was contracted to provide financial management services.

The program’s benefit package includes behavioral and skilled therapeutic services, as well as
home supports such as respite and homemaking. The maximum spending of $25,000 per year is
based on individualized service plans developed by MA DDS case managers and support brokers.
PPL helps families in the program to purchase the appropriate services. PPL services have included:

Helping families to choose their own providers who meet the credentialing criteria. This includes
establishing providers as employees and managing all federal and state requirements for taxation and reporting.

• Creating a website directory of credentialed providers for use by families and DDS staff.
  
• Processing payments of providers’ timesheets, as well as invoices for other goods and services
  needed to support the child in the home.
  
• Updating service plans and budgets as needed to reflect the changing needs of the child and family.
  
• Performing criminal history screenings on all providers.
  
• Providing secure, web-based and paper expenditure reports for all users.
  
• Providing full reports for the MA Legislature that document expenditures in each service category.

From the outset, this new consumer direction of care program model was extremely popular. Nearly 1,000 families applied for the initial 80 program slots. The State legislature doubled the program to 160 families in the second year. The model has resulted in significant financial and qualitative benefits for all stakeholders. Among these benefits, the program:

• Helps keep children at home with their families, versus expensive residential or institutional care.
  
• Gives families the freedom to choose and manage providers.
  
• Helped MA to quickly ramp up a new autism programs and provider network.
  
• Saves dollars. Benefit programs that enable consumers to use budget-based self-direction models have consistently shown reduced spending when compared to fee-for-service models.