The IDD Summit Part 1: Strategic Planning and Legislative Updates

As we gear up for the second annual IDD Summit, I want to touch on some key points from our first-ever Summit in 2023. With IDD and particularly autism services growing at a fast pace, we felt it was important to give direct support professionals (DSPs) an insight into advancing technologies, expert thought leadership, legislative developments and key strategies for sustainability and growth.

Our agenda consisted of a state-of-the-industry overview, the latest federal and state legislative activity, a provider panel discussion and demonstrations of two technology solutions to help with the number one challenge in IDD care: recruiting and retaining DSPs. Joining me was an all-star lineup of industry experts including:

·      Virginia Gabby, Executive Director for IDD Program Development at Merakey

·      Erin McCloskey, CIO and Co-Leader of Operations at Youth Consultation Service

·      Jamie Pagliaro, Executive Vice President and Chief Learning Officer at RethinkFirst

·      Donna Wilson, Senior Director for State Partnership and Innovation at ANCOR

·      Ken Winston, Director of IDD Service at Integral Care

·      Jen Gray, Director of Solution Consulting at Netsmart and Former IDD Clinician

·      Alan Ortego, Vice President of Engineering for Bells at Netsmart

·      David Strocchia, Senior Vice President for Human Services at Netsmart

In this blog series, I’ll detail what each of these experts had to share, and hope you’ll join us for our 2024 IDD Summit.

First up: Strategic Planning and Legislative Updates

Windshield, Landscape, Horizon: What’s in Your Future?

According to Dave Strocchia, it’s important to think about human services technology in terms of immediate needs, short-term needs and long-term needs––what he calls “windshield, landscape and horizon.” We’re seeing numerous changes in the industry, with immediate trends including:

·      Leveraging data for a whole-person view of your population, including social, mental and physical health

·      The far-reaching impact of automation on the global workforce

·      A change in the flow of funds from Medicaid to Medicaid managed care, and from fee-for-service to value-based

·      More grant funding available to organizations

·      Greater emphasis on community care models

·      Increased focus on data

The number one market issue that IDD providers face is nearly universal: workforce challenges. Fortunately, there are organizational and advanced technology solutions to help address these dynamics––from user experience design to Artificial Intelligence (AI) and advanced automations. Automating workflows reduces the need for manual work and repetitive tasks leading to incredible benefits. For example, AI documentation assistants decrease notetaking burden by 50%, eliminate common errors, reduce multiple rounds of reviews, decrease time from session to claim to payments, reduce staff turnover and increase revenue.  Automation also means predictive analytics to improve decision-making and processes that drive efficiencies for your revenue cycle team and back office. According to a recent McKinsey study, 50 percent of work activities can be automated––so imagine giving your DSPs back 50 percent of their week so they can see more individuals. In addition, the study found that automation and analytics could eliminate $200-360B in annual healthcare spending in the United States. So it’s going to help your bottom line, as well.

 According to Dave, automation can “improve the outcomes for the individuals that you serve, help recruit and retain your staff, and maximize your reimbursement so you can continue to invest back into your organization.” IDD organizations have been generating data for years, going back to Meaningful Use in 2011. But with automation and analytics, that data is now actionable. Predictive models can never replace the critical thinking of a professional, of course––but like all advanced automation, it can give them the tools to act efficiently and make more informed decisions.

Updates from Capitol Hill

ANCOR is the leading association for IDD providers. Their mission is to advance support for individuals to fully participate in their communities. Donna Wilson shared updates from the association, including the State of America's direct support workforce crisis study. Conducted I 2022, this research found that:

·       83 percent of providers said they were turning away new referrals, up 26 percent since the pandemic.

·       63 percent of providers are discontinuing programs and services, up 85 percent since the pandemic

·       55 percent of providers are considering additional service discounts

·       55 percent of providers are having trouble finding other providers to refer people

·       Workforce insufficiency was cited as the main reason for all of the above

According to these statistics and a 2023 DSP report, it’s clear that workforce challenges are the number one challenge in our industry. So, what’s happening at the policy level that might offer IDD organizations some relief?

First, IDD services are being included in more managed care plans. Both Kansas and Iowa have implemented a full, managed care plan for LTSS. Other states are implementing this in pockets, including Florida, where Miami-Dade and seven surrounding counties have just passed a law requiring a managed KTSS system. Tennessee has managed care embedded in one of their waivers for IDD.

Alternative Payment Models (APMs) are a strategy that changes the way Medicaid providers are paid, moving away from fee for service payments, which reward providers for the volume of service they offer, and moving toward payments that incentivize value. According to Donna, this is a growing trend in IDD that will greatly assist providers from a financial and operational perspective. ANCOR has published three papers on this type of value-based care and its benefit for the IDD sector.

Currently, ANCOR's number one legislative focus is the Direct Support Professionals Act. This bill would create a standard occupational code within the Bureau of Labor Statistics to capture the direct support professional specifically. This would significantly help in benchmarking DSP turnover issues, funding rates for DSPs, and pay rates for DSPs. This bill is up for vote in the Senate and has also been introduced in the House. Other legislation includes:

·      The Supporting our Direct Care Workforce and Family Caregivers Act, which is part of the Primary Care and Workforce Expansion Act. This would create a one-time grant program through the Department of Health and Human Services to carry out projects for the purpose of recruiting, retaining, and providing advancement opportunities for direct care professionals, managers and staff. The bill would also provide additional funding for new technical assistance centers as part of the administration for community living.

·      The Support Act, which is aimed at addressing the opioid crisis, but also contains a provision to require additional reporting if antipsychotic drugs are used by people with IDD. This is a bipartisan bill with some good support behind it.

·      The Heads-Up Act, which seeks to improve access to behavioral health, medical care and dental care for people with IDD. This bill would help classify and address people with IDD as a medically underserved population, which creates access to funding and grants.  

·       The Direct Care Opportunity Act, which provides funding to states and other entities to invest in strategies to recruit, retain, and advance the workforce pipeline and implements models and strategies to make the field of direct care more attractive.

What’s Next?

Our industry experts can’t wait for you to join us at the next IDD Summit.  Until then, here are a few recommended next steps:

·      Create an automation roadmap for your organization

·      Stay up to date on industry trends

·      Become a member of ANCOR by visiting their website, or sign up for ANCOR notifications and alerts

·      Expand your competitive strategy for employee recruitment, faster onboarding and retention

·      Reach out to Netsmart if you’re interested in any of the technology discussed here

Our first IDD Summit was a resounding success. We look forward to your participation in future education and advocacy for the IDD community.