Developmental disability waivers; reallocation of unassigned and unused waiver slots.
Summary
HB2714 would authorize the Department of Behavioral Health and Developmental Services to reallocate unused developmental disability waiver slots among community services boards or regions for the Community Living, Family and Individual Support, and Building Independence waivers. A slot could be moved only after it has remained unused for at least 30 days and only if no eligible individual on the Priority One waitlist is identified within the relevant catchment area during that period. The bill is aimed at improving use of available waiver capacity and reducing the number of unused slots in the developmental disability waiver system.
The bill also conditions its effectiveness on federal approval from the Centers for Medicare and Medicaid Services, reflecting that the waiver program operates within Medicaid rules. In addition, the Department of Behavioral Health and Developmental Services and the Department of Medical Assistance Services would be required to adopt implementing regulations within 280 days of enactment. The measure would therefore affect state administrative practice and waiver allocation procedures, but only after the necessary federal approvals are secured.
Impact
If enacted and federally approved, the bill would add a new section to Title 37.2 governing how unused developmental disability waiver slots may be reassigned across local service areas or regions. It would give the Department of Behavioral Health and Developmental Services more flexibility to move unused waiver capacity to where it can be used, while preserving priority for individuals on the Priority One waitlist in the applicable area. The bill would also require regulatory action by DBHDS and DMAS and would operate within Medicaid waiver requirements, making CMS approval a prerequisite to implementation.
Sentiment
The bill appears to have been generally well received in the legislative process. It advanced unanimously through subcommittee, full committee, and the House, indicating broad support for the goal of reducing unused waiver slots and improving access to developmental disability services. However, it was later amended in the Senate committee process and ultimately passed by indefinitely in Senate Finance and Appropriations, suggesting that while the policy concept was acceptable, there may have been concerns about fiscal impact, implementation, or broader budget priorities.
Contention
The main policy issue is how unused waiver slots should be allocated: the bill allows reallocation beyond the original community services board or region only after a 30-day unused period and only if no Priority One individual in the local catchment area can be identified. That structure balances efficiency with local access, but it may still raise concerns among advocates or local providers about whether slots should remain reserved locally longer. The Senate referral to Finance and Appropriations and the final disposition by indefinitely suggest possible concern about cost, administrative complexity, or the need to align the measure with federal Medicaid approval and state budget considerations.