Workforce Challenges & DDS Waiver Services Analysis
Cost Considerations for HCBS Waiver Redesign.
A variety of costs would potentially be included in the proposed HCBS Waiver redesign/expansion, depending on State decisions
Common Cost Elements
HCBS Waiver-specific services (see appendix for
examples of common DD Waiver services)
Medicaid State Plan spending
Potential for rate changes / inflation of all Medicaid-
related costs over time
Case management staff / family navigators.
Administrative staffing at DHS
One-time investment in additional FTEs/contractor
support to design and implement new system
General I/DD Waiver Revision
Changes to service array may result in minimal cost added,
with emphasis on cost-effective services
Changes to LOC may result in more individuals with ASD
qualifying for the I/DD Waiver - the new LOC would need to
be selected to identify this cost
Service Expansion for Ages 3-5
If LOC fully opened to match the under three eligibility, the
State would spend $8-$12 million on Medicaid-related costs
LOC for this group could be more narrowly targeted than the
under three group to reduce this cost
New IFS Waiver
If the new IFS Waiver is designed to meet the full
demonstrated need of the ASD and MF waitlists, then the
State will need to spend an additional $100-$600 thousand
based on waitlists
ALVAREZ & MARSAL
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