TASK FORCE TO STUDY THE COST-EFFECTIVENESS OF
THE CHILD DEVELOPMENT SERVICES SYSTEM
Minutes from November 21, 1997 meeting

Members present: Barbara Brown (clinical professional/service provider); Ellen Courtney (CDS site director); Luanne Crinion (Maine State Nurses Association); Angela Faherty (CDS board member); Jaci Holmes (Commissioner of Education’s designee), Sen. James Libby, Rep. Rodney McElroy; Mary Anne Miosan (development therapist/service provider); Joan Nason (Maine Association of Directors of Services for Children with Exceptionalities); Rachel Olney (Commissioner of Mental Health; Mental Retardation & Substance Abuse Services’ designee); Sen. Peggy Pendleton; Leslie Steltzer (parent receiving services); and Rep. Elizabeth Watson

Others present: David Elliott (Office of Policy & Legal Analysis); Rep. Richard Farnsworth; Jeffrey Hubert (Macdonald Page); Dawna Lopatosky (Bureau of the Budget); Joseph Mayo (Clerk of the House); Phillip McCarthy (Office of Policy and Legal Analysis); Greg Scott, (Dept. of Education); and David Stockford (Dept. of Education)


Convening of the Task Force

¨ Joseph Mayo, Clerk of the House, presided over the convening of the task force on behalf of Rep. Elizabeth Mitchell, Chair of the Legislative Council. Having ascertained that a quorum was present, Mr. Mayo asked task force members to introduce themselves before he presided over the election of the Chairperson for the task force.

¨ Rep. Watson nominated Sen. Pendleton to serve as task force chair; the nomination was seconded by Ms. Olney, and the task force members unanimously approved the motion to elect Senator Pendleton as chairperson (13-0).


Overview of legislative history of CDS

¨ David Elliott reviewed the legislative history related to the governance of the CDS System; and Phil McCarthy reviewed the authorizing legislation that established the task force and the duties charged to the task force.


Briefing / discussion of financial aspects of CDS

¨ Jeffrey Hubert, CPA at Macdonald Page, presented an overview of the financial structure of the CDS System (copies of overheads are enclosed). The presentation included a financial profile of revenues and expenditures based on 1996 audited financial data for the State CDS Office (or Intermediate Educational Unit, IEU), and 5 CDS regional sites.

¨ Discussion centered on the following issues:

• The various sources of revenues that flow through the CDS State IEU and the regional CDS Sites. In the regional CDS site example, 49% of resources are Medicaid funds paid directly to contracted service providers, (and are outside of the CDS fiscal records), while 51% of the funds represent State General Funds, Federal Part H (birth through 2 years old), Federal Section 619 (three through five years old), Medicaid, and Other sources of revenues;

• The impact of using Medicaid funds as program income (e.g., would increasing the level of Medicaid funds -- as reimbursement for the provision of direct services -- result in a decrease in other State or Federal resources?); and

• The impact of managed care on the level of Medicaid funding available for CDS?

Discussion of cost effectiveness of contracting for services versus hiring professional staff

¨ Jaci Holmes presented data from a 1996 Cost Review Study based on the cost methodologies established (examples of how cost components were determined are enclosed); and

¨ Phil McCarthy presented a brief summary of effectiveness and cost-effectiveness research related to early intervention programs.


Recap discussion, identify issues for discussion at next meeting

¨ David Elliott reviewed the substantive issues discussed and task force members identified the following issues as those which should be addressed at the next task force meeting:

• Further review of the components included in the two cost methodologies that were established to determine the annual cost to a CDS regional site to employ a professional therapist as compared to contracting with a service provider;

• An examination of the policies and regulations related to Medicaid program income and direct service reimbursement; and

• A presentation of the mission and scope of CDS regional site operations (Ellen Courtney will present some materials).

Adjournment and meeting schedule

¨ The task force members agreed to the following schedule for the next two meetings:

Thursday, December 4, 9:30 am - 3:00 pm in the State Office Building, Rm. 113
Wednesday, December 17, 9:30 am - 3:00 pm in the State House, Rm. 334

¨ The meeting adjourned at 3:00 p.m.



Respectfully submitted,

Phillip D. McCarthy, Ed.D.

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