The past six months have shown a very promising shift in how the Area Agencies (AA), the Department of Health and Human Services (DHHS) and the Bureau of Developmental Services (BDS) are working together.

Good progress has been made in working together to finalize budget numbers, allocations, and reallocations. The Budget Advisory Committee, a working group comprised of AA representatives and key members of DHHS executive management, have worked together over this period, and spent several intense weeks in June and July sifting through, evaluating, and coming to agreement on actual dollar figures available for the end-of-budget-year reconciliation. The AA forecast held true to what had been projected in January of this year, and provided reassurance to DHHS of the Area Agencies’ ability to accurately forecast spending needs. Finalizing these numbers as a group is critical to closing out our fiscal year, and will ensure that we don’t operate at a loss or allow needed money to go unspent. It also sets the stage for more effective future budget planning.

Significant progress has been made in inter-organizational relationships as well. DHHS Commissioner Jeffrey Meyers and his team are having regular conversations with Area Agencies. They have engaged in dialogue and have been very open to listening to what the Area Agencies have to say. Sandy Hunt is now serving as Interim Director of BDS, following Lorene Regan’s move to the Office of Medicaid Policy in early June. Although new to this job, Sandy has a wealth of experience with both Provider Agencies and Managed Care. She has already reached out to each AA to get a better understanding of how things work and has joined the Budget Advisory Committee. The Department is also contracting with former BDS Director Matthew Ertas to help sort through and reshape BDS policies and finances – his long-time experience will be invaluable moving forward.

Legislative Update

We have also seen forward movement at the Legislative level. In late April, HB 1394 was passed by both the House and Senate. This bill was introduced in early March following the Legislative Budget Assistant’s February report on $40 million in lapsed dollars from the last biennium. This bill allows a one-time carryover of unused BDS appropriations – millions of dollars – for developmental services, giving DHHS and the AAs more time and flexibility in this upcoming fiscal year to get budgeted dollars to people who depend on community supports.

In early June, Governor Hassan signed into law SB 553, instructing the DHHS to develop an implementation plan for the remaining unimplemented phases of the Medicaid managed care program. This means that Step 2 of Medicaid Care Management (MCM), covering many of the services provided by MDS and other AAs, must be comprehensively outlined in a specific plan before any shifts of these services to managed care are made. The implementation plan must specifically address nursing services; services provided under the Choice for Independence (CFI) waiver; and services provided under the developmental disability (DD), acquired brain disorder (ABD), and in-home support (IHS) waivers. The plans for implementation of nursing home and home care services provided under the Choices for Independence Waiver into managed care will be prepared prior to the plan for any other services.

It has been a roller coaster ride these past few months and years. A spirit of collaboration and trust is being forged on many levels. We look forward to this new era.

This article appeared in the Summer 2016 edition of The Clipboard.