Oklahoma Department of Human Services Developmental Disabilities Service Waiver Waiting List

Policy Considerations and Agency Recommendations

Policy Considerations

The Legislature may consider the following:

• For improved transparency, repurpose an existing fund or create a program stabilization fund. Identified underutilized funds or realized programs savings could be deposited for targeted reinvestments.
• Requiring a more transparent process to establish provider incentive payments, with an emphasis on paying incentives based on performance or metrics the state wishes to achieve, such as adding specific vendors to allow for higher utilization of waivers.
• Requiring annual updates be provided to the Legislature regarding a strategic plan to increase the number of people served from the Community and In-Home Services Waiver Program Waiting List. Updates should reflect progress made toward milestone objectives.
• Requiring publicly available monthly data updates reflecting current cost expenditures and number of waivers being utilized by month and year to date.
• Dedicating funds for a third-party operational audit to identify inefficiencies and duplication of services within the Developmental Disabilities Services division and its partners, which could create internal savings to be reinvested into the program.
• Requiring that data collected by Liberty Healthcare of Oklahoma (Liberty) and reported to the Department of Human Services be made publicly available online and updated regularly to provide, at minimum, the number of people on the Waiting List.

Agency Recommendations

DHS should:

• Create a strategic plan with goals and milestone objectives for how the Developmental Disabilities Services Waiver Program will be enhanced. Goals should be fully achievable two years before the State’s renewal deadline for the current program.
• Conduct a cost analysis of its waiver structure to identify opportunities for adding or adjusting waiver services to improve cost effectiveness and to enable more people to be moved onto waivers.
• Revise management of the Waiting List so that only those who need immediate services are shown on the public-facing Waiting List. The agency should maintain a separate list of those who anticipate needs in the future.
• Make the data reporting required in the Liberty contract publicly available, including data on the cost of the waiver program and the number of waivers being utilized.
• Enhance communications with the people on the Waiting List, including communication of any program changes and potential impact, as well as estimates for wait times.
• Deposit any one-time funds, such as service costs of an individual plan being less than budgeted, or other cost savings generated through the program into the program stabilization fund. Funds should be reinvested into the programs to achieve goals listed within a strategic plan.