Workforce Challenges & DDS Waiver Services Analysis
Person-Centered Planning & Case Management
Person-centered planning and case management is a critical part of providing supports for people with disabilities and their families and is required by the Centers for
Medicare and Medicaid Services. Expansion will require shoring up the current system and seeking innovative solutions to meet the need.
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Current State
At the core of home and community-based supports is a case manager (also called a program manager or service
coordinator) who supports the person and their family to set goals, get connected with services in the community and
through the waiver to help them achieve those goals, stay healthy and safe, and understand and mitigate risks.
The case manager works with the person to develop and implement an individualized person-centered plan, at least
annually, and more frequently based upon changes in the person's needs and preferences. They connect the person
with providers, monitor to assure quality supports, and do annual assessments for level of care. A case manager is also
the person many people call when they have questions and need help navigating the system.
Currently, by regulation, North Dakota has a 1:60 ratio for developmental disabilities case management, and services
are provided by state staff, called Program Managers. To meet the required ratio, the Department is using temporary
employees. This creates risk of overturn, disrupting continuity of relationships and knowledge-base for people and their
families. For employees, there is an inequity in that temporary employees are doing the same job as their peers with less
benefits.
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ALVAREZ & MARSAL
LEADERSHIP ACTION. RESULTS.View entire presentation