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I. Continue to integrate the people DIDD serves into the broader community.

A. Completing the Clover Bottom et al Exit Plan which includes transitioning 100% of the people residing at Greene Valley and Clover Bottom Developmental Centers to community based waiver, ICF homes, or Community Homes.

II. Operate the Home and Community Based Medicaid Wavier Programs (1915c) within recently modified CMS expectations in order to ensure continued federal reimbursements and minimize state liabilities in order to maximize the number of persons receiving services.

A. Ensures the health, safety and wellbeing of people receiving services. When necessary, provides remediation for providers who fail to meet performance. Lower the exposure of state funds if federal reimbursements are not allowed due to ID system performance failures.

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III. Implement the Aging Caregivers law for people on the Waiting List to enroll in the Self Determination Waiver in accordance with T.C.A. Title 33, Public Chapter 5, Part 1.

A. Provide support to families for persons with elderly caregivers (age 80 and above) to help maintain their current living situation.

IV. Continue development and implementation of Project Titan, an integrated Information Management System.

A. Titan will automate and streamline many current business processes allowing resources to be directed to more customer focused tasks.

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1. Complete DIDD commitments made in the Clover Bottom et al Exit Plan, including the closure of Greene Valley Developmental Center.

2. Increase the duration and percentage of people competitively employed. Develop capability to measure progress.

3. Modernize information technology systems that support DIDDs service system, including the potential to support the proposed managed care program called ECF CHOICES.

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Actual Estimated Requested

DIDD Budget

Administration 25,385,500 27,706,500 25,701,000

Community Services 17,766,700 17,542,900 17,542,900

Protection from Harm 5,142,600 4,962,700 4,952,700

Developmental Centers 61,125,400 46,191,000 22,696,700

Harold Jordan Center 5,520,700 5,296,500 8,340,400

Community Homes 39,752,300 45,760,600 49,091,000

Seating and Positioning Clinics 2,773,400 2,980,400 3,416,500

Regional Offices 32,100,600 33,629,200 32,083,400

Major Maintenance 56,700 130,000 100,000

Subtotal - DIDD Budget 189,623,900 184,199,800 163,924,600

TennCare Budget

Private ICF-IIDs 111,438,500 111,560,200 129,547,000

Current HCBS Waiver Programs 665,177,700 685,657,800 698,396,200

ECF Choices Waiver Program - - 68,958,000

TennCare Funding for DIDD Budget 155,128,600 139,308,900 122,526,900

Subtotal - TennCare Budget 931,744,800 936,526,900 1,019,428,100

Grand Total 1,121,368,700$ 1,120,726,700$ 1,183,352,700$

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$266.7

$238.1

$289.5 $294.5 $315.0 $305.4

$319.8

$0

$50

$100

$150

$200

$250

$300

$350

FY10 FY11 FY12 FY13 FY14 FY15 FY16

Mill

ion

s

Increase in FY12 due to end of Federal Enhanced FMAP allowed by ARRA.

Decrease in FY11 represents multiple reductions and limits on services and rates.

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3,177

2,860

2,249 2,248 2,150 2,094 2,003 1,976

0

500

1,000

1,500

2,000

2,500

3,000

3,500

FY10 FY11 FY12 FY13 FY14 FY15 FY16 FY17

The downward trend is due to the transition from developmental centers to community homes.

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Increase Total State Federal Other Staff

1. Greene Valley Developmental Center Extension - Non-recurring funds for the 6 month court-approved closure extension.

19,243,200 6,546,300 11,632,600 1,064,300 452

2. Aging Caregiver Bill - Annualize the cost of 21 people enrolling in the waiver programs.

213,800 74,900 138,900 0 0

3. Waiver Cost Growth - Annualize the costs people currently enrolled in waiver programs.

1,681,700 589,000 1,092,700 0 0

4. Transition to Community-Based Day Services - Federal requirements will shift day services from facilities to community-based day services.

4,766,700 1,669,200 3,097,500 0 0

5. Harold Jordan Center Bed Utilization & Increase - To maximize use of beds and provide services to more people.

2,365,300 1,983,600 381,700 0 40

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Increase Total State Federal Other Staff

6. Conversion of East TN Homes - Six homes will now be able to support people with medically intensive needs.

2,073,400 726,000 1,347,400 0 32

7. Waiver 1% Provider Rate Increase for Benefits Costs- Affordable Care Act

3,475,300 1,216,900 2,258,400 0 0

8. Waiver 1% Provider Rate Increase for Direct Care Hourly Rate

3,475,300 1,216,900 2,258,400 0 0

9. Seating and Positioning Mobile Unit - To provide services to those who have difficulty traveling to the clinics.

398,500 398,500 0 0 1

10. Positions for East Tennessee Community Homes - Establish 4 direct care positions and an assistant director for the homes.

166,000 58,100 107,900 0 5

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Increase Total State Federal Other Staff

11. Security for West and Middle Tennessee Regional Offices - Establish 5 security positions and an after-hours security contract.

231,500 121,500 110,000 0 5

12. Positions for Administration 710,200 281,200 271,500 157,500 7

Subtotal $ 38,800,900 $ 14,882,100 $ 22,697,000 $ 1,221,800 542

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Increase Total State Federal Other Staff

1. Employment and Community First CHOICES Program

$ 54,282,200 $ 19,040,400 $ 35,241,800 $0 8

2. Aging Caregiver Bill - Annualize the cost of 21 people enrolling in the waiver programs.

668,300 234,000 434,300 0 0

Subtotal $ 54,950,500 $ 19,274,400 $ 35,676,100 0 8

Grand Total DIDD and TennCare Programs

$93,751,400 $34,156,500 $58,373,100 $1,221,800 550

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Reallocation Plan State

State Appropriation Available from Greene Valley $ 14,709,800

1. Funds Following GVDC Residents (6,643,100)

2. Funds Available for the new Employment and Community First (ECF) Program *

(5,139,000)

3. Administrative Costs and Revenue Loss (2,291,200)

4. East Regional Office and Community Homes Positions

(636,500)

Remaining Balance $ 0

* The $5.1 million reallocation from Greene Valley and the cost increase request in TennCare of $19 million will provide for a total of $24.1 million in state appropriation for the new Employment and Community First Choices Waiver Program.

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Increase Total State Federal Other

1. Clover Bottom Campus New Middle Tennessee Regional Office

$ 30,000,000 $ 30,000,000 $ 0 $ 0

2. Capital Maintenance Clover Bottom Campus

4,670,000 4,670,000 0 0

Total Capital $ 34,670,000 $ 34,670,000 $ 0 $ 0

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Description State Dollars Staff 1. Eliminate PASS Program - Eliminate the Personal

Assistance Services & Support Program grant that serves 7 people.

$ 161,700 0

2. State-Operated ICF-IID Community Homes - Abolish 3 positions and reduce operational and payroll costs.

216,200 3

3. Regional Offices - Abolish 10 positions, reduce operational costs, eliminate training grant, reduce payroll costs, and convert 3 contracted workers to state employees.

954,300 7

4. Administration - Abolish 8 positions and reduce professional services from state agencies.

289,300 8

5. Seating and Positioning Clinics - Reduce longevity, supplies, and equipment.

59,500 0

Total Savings $ 1,681,100 18

Savings Target $ 817,600

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$318.5

-$1.7

$34.2

$351.0

-$50

$0

$50

$100

$150

$200

$250

$300

$350

$400

Base Budget Reductions Increases Total Request

Mill

ion

s

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