Testimony Before The House Human Services Committee
Clara Sue Price, Chairman
Rate setting processes for treatment and care centers for people with developmental disabilities
January 12, 2005
Chairman Price, members of the Committee, I am Gene Hysjulien of the Department of Human Services. I am here today testifying in support of House Bill 1146.
The 2003 Legislative Assembly passed legislation (Senate Bill 2086) relating to implementation of a fee for service ratesetting system for payment to treatment or care centers for individuals with developmental disabilities. SB 2086 created a workgroup composed of one voting member appointed by the governor, three voting members from the department and three voting members from the North Dakota Association of Community Facilities, required all meetings of the workgroup to be open to the public, addressed definitions, fee determination, extraordinary client needs, trust fund, transition, rulemaking and reporting to the legislative council during the 2003 – 2004 interim regarding progress. By October 1, 2004, the department was to certify to the legislative council whether the department and the service providers reached an agreement on a new fee-for-service system.
On June 23, 2004, Jon Larson, one of three representatives from the North Dakota Association of Community Facilities and co-chairperson for the workgroup, testified before the Budget Committee on Human Services regarding the workgroup's activities. Mr. Larson stated in his testimony that after thoroughly analyzing the current system and making recommendations for changes to the existing system, the workgroup was not recommending a change to a fee-for-service payment system at this time. It was determined by the workgroup that a major change like what would be needed for a new reimbursement system should be researched carefully to analyze its impact on the lives of the people we serve as well as its impact on providers. That was not going to be possible by July 1, 2005. Mr. Larson further testified the recommendations made by the workgroup have the support of the provider association, and they feel that issues that may arise in the future should be dealt with through the positive, constructive dialogue the workgroup employed.
House Bill 1146 repeals some of the provisions that were enacted with the passage of SB 2086 and does away with references to a fee-for-service payment system for DD providers. In summary, it:
- Revives the budget flexibility that DD providers have under NDCC 50-06-18 by incorporating it into chapter 25-18
- Revives the return on investment for for-profit providers under NDCC 25-16-10.1 by incorporating it into chapter 25-18
- Removes two definitions from NDCC 25-18-01 (fee-for-service and historical operating costs)
- Amends NDCC 25-18-05 regarding limitation on owner compensation to take out references to “fee” and would consistently refer to DD providers as “treatment or care centers”
- Repeals NDCC 25-18-02, which required a workgroup to be appointed to discuss a fee-for-service payment system
- Repeals NDCC 25-18-04, which required the department to implement a fee-for-service payment system by July 1, 2005
- Repeals NDCC 25-18-06, regarding workgroup development of criteria identifying extraordinary needs of individuals with developmental disabilities
- Repeals NDCC 25-18-07, regarding establishment of a trust fund
- Repeals NDCC 25-18-08, regarding establishment of protocols and methodologies for transitioning to a fee-for-service payment system
- Repeals NDCC 25-18-11, regarding authority of the department to adopt rules for a fee-for-service payment system
- Repeals NDCC 25-18-12, regarding the department's duty to report to the Legislative Council during the 2003 – 2004 interim regarding progress in developing a fee-for-service payment system
- Would be effective on July 1, 2005.
This concludes my testimony. I would be happy to try to answer any questions the committee members may have. Thank you.