Examples of Needs Based Changes

Correct Use of Needs Based Changes

1. Permanent reduction of one service is used to fund a permanent increase in another.

Example:  The person no longer needs respite.  However, they do need an increase in support living.  So, the units prescribed for RP2 are permanently reduced (or eliminated) and used to fund a permanent increase in SLN.

2. Temporary reduction of one service is used to fund a temporary increase in another.

Example:  The person needs a temporary increase in DSG worth two units because two extra week days fall in the plan cycle that year than normally do.  Conversely, the person does not need to use any respite in the twelfth month of the plan.  So, the RP2 money originally intended for use in the twelfth month is moved to fund two extra days of DSG in the current plan cycle.  Then, when the next plan cycle begins, the support coordinator plans to restore the prescriptions for both DSG and RP2 at their original levels (i.e. before the change was made in the old plan).

Incorrect Use of Needs Based Changes

1. The reduction of one service (temporary or ongoing) is used to fund a permanent increase in another.

Example:  The person needs more ongoing units of supported living.  They also need respite to be funded at its current level.  Even so, the support coordinator moves money from RP2 to fund the increase in SLH.  Now, the person has insufficient funds to cover their ongoing need for RP2.

2. The permanent reduction of one service and increase in another are sufficient to cover the person's needs in the Active plan.  But, the change does not represent a full twelve months of the person's need for either or both services.  Consequently, the reduced service does not have enough units to cover the person's need in the next plan cycle.

Example:  The person needs more ongoing units of supporting living.  They also have not used all of the units prescribed for RP2 in the Active plan like they usually do.  The unused RP2 units are enough to cover the ongoing increase for SLN in the Active plan.  But, the person is expected to need RP2 at it's historic level in the next plan cycle instead of the lesser amount used in the Active plan.  Nevertheless, the support coordinator moves the units from RP2 to SLN in the Active plan and expects to keep funding SLN at its new level in the next plan cycle.  The change means that insufficient funds exist to fund either or both RP2 and SLN at their new amounts in the next plan cycle.