Caseload Forecasting for Disabilities

Silhouette of people with sunset.

Senator Emily Randall (D- 26th Leg. District, WA) has introduced SB 6056 – Concerning the budgeting process for services for individuals with developmental disabilities

This is a hopeful beginning to the generation of appropriate funding for the needed supports to allow the people in this vulnerable population to be included in their communities as they would desire, improve their quality of life and help provide a more meaningful life as they would choose.

In our opinion, this means more choices and less restrictions, appropriate assessments of needs and supports and increased stability in all areas of life – home, work and community.

This bill will help address the issue of the mysterious people who live in the world of “the  no-paid services caseload” withing DDA.  No one knows who these people are, if they are even in our state or alive or what their support needs may be.  It will at least provide case managers for this population in hopes of being able to provide supports if these people are in need.

But, caseload forecasting is not just counting heads.  We need to understand what the range of support needs is and how many people are in each acuity level in each setting to better assess appropriate funding for these supports.

The Joint Legislative Executive Committee on Planning for Aging and Disability Issues (JLEC) had a work session on January 9, 2020.  A link to the session is highlighted.

 

JLEC – January 9, 2020   (Olympic Neighbors presentation begins at 48.00)

Olympic Neighbors, Father’s Group of Jefferson County, Developmental Disabilities Funding Crisis Task Force (DDFTF) members provided much information to the committee.  The chart below is taken from their information.

State Funding for Supports - Jefferson County Father's Group

Regarding residential supports – in theory the SOLA and Supported Living are essentially the same supports – the difference is that the SOLA is state operated and Supported Living is typically private-non-profit/profit agencies providing the support.

There is a significant difference in the wages for the caregivers in these residential settings – that of the state employee versus agency employees – but does that alone account for the difference in cost for these residential settings?

I think there may also be differences in acuity levels of the residents in these settings.  There may be higher percentage of higher acuity residents in the SOLAS which also could be reflected in the higher cost.

This is an issue that hopefully can be addressed in Caseload Forecasting.  We cannot base our funding on the “Average” for the whole population.  We must break out acuity levels and look at the average for that level.  This method will provide a much better understanding of the necessary funds for appropriate supports.

 

Cognitive Bias

As the legislative session is fast approaching we need to be aware of cognitive bias – a phenomenon that we have witnessed many time over the past years.  Cognitive bias is especially prevalent with issues related to care, supports and cost of that care for people with intellectual/developmental disabilities.

Take a peek at this site to read about the following 10 Cognitive Biases that distort our thinking – remember this is only a list of 10 of these biases – there are many more that have been identified.

Confirmation Bias

Hindsight Bias

Anchoring Bias

Misinformation Effect

The Actor-Observer Bias

The False Consensus Effect

The Halo Effect

The Self-Serving Bias

The Availability Heuristic

The Optimism Bias

Let’s plan for more conversation and collaboration with regards to caseload forecasting.  Keep in mind the issue of cognitive bias and how these biases have affected discussions in the past.

Have people been heard and questions answered?

Have concerns been addressed?

Let’s listen to each other and collaborate.

 

18-cognitive-bias-examples

Cognitive bias illustration from https://www.visualcapitalist.com/wp-content/uploads/2018/03/18-cognitive-bias-examples.html