The Department of Intellectual and Developmental Disabilities

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The Department of Intellectual and Developmental Disabilities. Recommended Budget, Fiscal Year 2013-14. DIDD FY2013-14 Budget Hearing. Program Updates Budget by Program Funding Source Estimates Budget Reductions Cost Increases Capital Budget Supplemental Request. Program Updates. - PowerPoint PPT Presentation

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<ul><li><p>The Department of Intellectualand Developmental DisabilitiesRecommended Budget, Fiscal Year 2013-14</p></li><li><p>DIDD FY2013-14 Budget HearingProgram UpdatesBudget by ProgramFunding Source EstimatesBudget ReductionsCost IncreasesCapital BudgetSupplemental Request</p><p>*</p></li><li><p>Program UpdatesHome &amp; Community Based Waivers</p><p>Statewide Waiver Census 6,240FY2012 Average Cost Per Person Per Day $235.33</p><p>Self Determination Waiver Census 1,132FY2012 Average Cost Per Person Per Day $50.91Centers for Medicare &amp; Medicaid Services (CMS) recognized the waiver as a model of best practices.CMS has just approved the renewal of this waiver.</p><p>Arlington Waiver Census 313FY2012 Average Cost Per Person Per Day $396.94</p><p>Waiting list for intellectual disabilities waiver services is 7,264</p><p>*</p></li><li><p>DIDD Waiver Census History *Census is as of June 30th of each year.</p><p>Chart1</p><p>60621116289</p><p>60621223315</p><p>60801175325</p><p>61261166332</p><p>62131143321</p><p>62851123309</p><p>65481119297</p><p>Statewide</p><p>Self Determination</p><p>Arlington</p><p>Sheet1</p><p>StatewideSelf DeterminationArlington</p><p>2008606211162890</p><p>2009606212233150</p><p>2010608011753250</p><p>2011612611663320</p><p>2012621311433210</p><p>2013 (est.)628511233090</p><p>2014 (rec.)654811192970</p></li><li><p>Program UpdatesDevelopmental Centers</p><p>2% of the population served by DIDD is in developmental centers.</p><p>Clover Bottoms census is 41 with planned closure in 2014.</p><p>Greene Valleys census is 136; however, 12 residents will transition to state-operated community homes once constructed. </p><p>Harold Jordan Centers census is 4. The department is making programmatic changes to enable greater use of the facility while also allowing the state to receive federal Medicaid funds. Presently, this center is 100% state funded.*</p></li><li><p>Program UpdatesState Operated Intermediate Care Facility Homes</p><p>West RegionAll 12 homes are operational.Current census is 48.FY2012 actual cost per person per day was $1,092.53</p><p>East RegionTotal of 16 homes are planned.13 are constructed with a current census of 51.Construction will begin soon for the last 3 homes.FY2012 actual cost per person per day was $872.32.</p><p>Middle RegionTotal of 9 homes are planned.Lots have been purchased for 9 homes. Construction has begun on 4 of these homes.</p><p>*</p></li><li><p>Program UpdatesResource Centers</p><p>Current Status:There are three resource centers operating in the three regions and providing the following services: assistive technology, occupational and physical therapy, speech and language pathology, dental, behavior analysis, and physical nutritional management.</p><p>Proposed Changes:</p><p>In the FY2014 budget, 35 positions are moved from the resource centers to the developmental centers where they provide services.</p><p>Another 35 positions will be abolished.</p><p>Middle &amp; east resource centers are restructured leaving only assistive technology and dental services.</p><p>The west resource center will continue to operate with a full array of services.</p><p>*</p></li><li><p>*Budget by Program (includes waiver funding within TennCare)</p><p>Home and Community Based Waiver Services (TennCares budget) $ 653,468,600 Developmental Centers 70,908,900 Administration, QA, Regional Offices 75,152,400Community Homes 35,837,300 Resource Centers 6,256,500 Family Support 7,383,600 Council on Dev Disabilities 2,092,200 $ 851,099,500 </p><p>Chart1</p><p>653468600</p><p>70908900</p><p>75152400</p><p>35837300</p><p>6256500</p><p>7383600</p><p>2092200</p><p>Dev Ctrs.8.3%</p><p>Council on Dev Disabilities0.3%</p><p>Sheet1</p><p>HCBS Waiver Services$653,468,60076.8%</p><p>Dev Ctrs.$70,908,9008.3%</p><p>Admin, QA$75,152,4008.8%</p><p>Community Homes$35,837,3004.2%</p><p>Resource Centers$6,256,5000.7%</p><p>Family Support$7,383,6000.9%</p><p>Council on Dev Disabilities$2,092,2000.2%</p><p>$851,099,500100.0%</p></li><li><p>Recommended Budget by Funding Source*TennCare revenue includes $279,555,000 in state matching funds. Direct services receive almost a $2 federal match for every $1 in state funds. Administrative expenses are matched at $1 for $1.*</p><p>DIDD State$28,727,300Federal Revenue1,781,600Current Services Revenue4,712,600TennCare Revenue*146,858,900Other Interdepartmental Revenue15,550,500Total Recommended DIDD Budget (Volume 1, page B-199)$197,630,900</p><p>Waiver funding in TennCare* (not in DIDDs Budget)$653,468,600Total Funding for Programs Administered by DIDD$851,099,500</p></li><li><p>*DIDD Funding By Source</p><p>Chart1</p><p>28727300</p><p>1781600</p><p>4712600</p><p>15550500</p><p>279555000</p><p>520772500</p><p>Column1</p><p>TennCare $800,327,500,94%</p><p>Sheet1</p><p>Column1</p><p>DIDD State$28,727,300</p><p>Federal$1,781,600</p><p>Current Services$4,712,600</p><p>Interdepartmental$15,550,500</p><p>TennCare State$279,555,000</p><p>TennCare Federal$520,772,500</p><p>To resize chart data range, drag lower right corner of range.</p><p>851099500</p></li><li><p>Base Budget Reductions*</p><p>DescriptionPos.Total ReductionBase Budget Reductions (Volume 2, pages 46 - 48)Centralization of Human Resources and Fiscal Services-9-274,700Harold Jordan Center Programmatic Changes Obtain intermediate care facility (ICF) certification for 12 beds (Total state reduction of $1,945,500)-43,400Printing - Utilize copiers instead of printers (Total state reduction $42,300)-64,200Greene Valley Developmental Center Staffing and professional services contracts (Total state reduction $274,800)-15-812,800Central Office - Staffing, contract services and other operating expenses (Total state reduction $497,100)-6-1,112,500Regional Office Staffing, contracts &amp; leased space (Total State reduction $1,541,600)-35-2,739,500Community Services Contract Pre-Admission Screening and Resident Review contract (Total state Reduction $46,100)-184,400Resource Centers Restructure leaving only assistive technology &amp; dental services in middle and east (Total state reduction $424,700)-35-7,215,300Community Homes Staffing, leased space, contracts &amp; supplies (State reduction $171,700)-4-507,700 Total Base Reductions-104-12,954,500</p></li><li><p>DIDD &amp; Total State Position History*</p><p>Chart1</p><p>484354028</p><p>487673904</p><p>498353682</p><p>480973451</p><p>475833177</p><p>461962860</p><p>451502252</p><p>441852248</p><p>438862131</p><p>Total State General Fund Positions</p><p>DIDD Positions</p><p>FY2006 To Recommended FY2014</p><p>Sheet1</p><p>Total State General Fund PositionsDIDD Positions</p><p>200648,4354,028</p><p>200748,7673,904</p><p>200849,8353,682</p><p>200948,0973,451</p><p>201047,5833,177</p><p>201146,1962,860</p><p>201245,1502,252</p><p>201344,1852,248</p><p>201443,8862,131</p></li><li><p>Core Services Continuation and Cost Increases*</p><p>DescriptionPos.Total IncreaseCore Services Continuation (Volume 1, page A-50)Family Support Program Provides non-recurring funds to assist families with a developmentally disabled family member. These funds are in addition to the $4,702,100 in recurring funds within the base budget bringing the total funding for Family Support to $7,383,600.-$2,681,500 Total Core Services Continuation-$2,681,500Cost Increases (Volume 1, page B-162)Clover Bottom Non-recurring funds for the temporary continuation of operations at Clover Bottom until community homes are built. Funded as interdepartmental revenue from TennCare and is comprised of $1,309,200 in state appropriation and $2,306,600 in federal revenue.-$3,615,800Middle TN Homes Certification Non-recurring funds for the first 30 days of operation during which time the department cannot bill TennCare. Increase in state appropriation of $241,200 and decrease in interdepartmental revenue of $241,200.--Arlington Lawsuit Exit Plans Provides funds that will allow the state to exit the Arlington lawsuit by December 31, 2013. Includes 11 positions for an intermediate care facility (ICF) survey team, 4 positions for an enrollment team and 1 position for lawsuit compliance. Also includes $866,300 in recurring state funded services for the at-risk expansion. 16$1,584,300 Total Cost Increases16$5,200,100</p></li><li><p>Waiver Cost Increases (TennCares Budget)If these cost increases are approved, total funding for the home and community based waivers will be $653,468,600 and will include funding for a 287 person program expansion. All waiver funding resides in TennCares budget.</p><p>*</p><p>DescriptionPos.Total IncreaseCost Increases in TennCares Budget for DIDD Waivers (Volume 1, page B-159)HCBS Waiver Programs Provides recurring funds for growth in enrollment and costs in the home and community based services waiver programs. Allows for 550 enrollments and 454 dis-enrollments for a net growth of 96 people from July 1, 2012 to June 30, 2014. ($4,448,200 state and $8,445,100 federal)-$12,893,300Arlington Lawsuit Exit Plan Provides recurring funds for home and community based wavier services for an additional 182 people who are part of the at-risk expansion and 9 people who will transition from nursing homes to community services. ($10,823,300 state and $20,548,500 federal)-$31,371,800 Total Home and Community Based Services Cost Increases-$44,265,100</p></li><li><p>DIDD History of Expenditures</p><p>Millions*</p><p>Chart1</p><p>865.3</p><p>838</p><p>857.4</p><p>804.7</p><p>803</p><p>834.7</p><p>851.1</p><p>Expenditures</p><p>Actual Expenditures FY2008 to Recommended FY2014</p><p>Sheet1</p><p>Expenditures</p><p>2008$865</p><p>2009$838</p><p>2010$857</p><p>2011$805</p><p>2012$803</p><p>2013 Est$835</p><p>2014 Rec$851</p><p>To resize chart data range, drag lower right corner of range.</p></li><li><p>DIDD History of People Served*</p><p>Chart1</p><p>41451874672008</p><p>373462760012</p><p>362387758023</p><p>166250762466</p><p>140193767797</p><p>1351817717100</p><p>1351857964116</p><p>8,399</p><p>8,399</p><p>8,447</p><p>8,352</p><p>8,106</p><p>8,107</p><p>8,133</p><p>8,400</p><p>State Funded</p><p>Dev Ctrs</p><p>Waivers</p><p>Community Homes</p><p>Sheet1</p><p>State FundedDev CtrsWaiversCommunity HomesTotal</p><p>20084145187,4678,3998399</p><p>20093734627,600128,4478447</p><p>20103623877,580238,3528352</p><p>20111662507,624668,1068106</p><p>20121401937,677978,1078107</p><p>20131351817,7171008,1338133</p><p>20141351857,9641168,4008400</p><p>2013 - actual census</p><p>2014 - actual + HJC budget</p></li><li><p>*Capital Budget</p><p>DescriptionProject CostCapital Maintenance (Volume 1, page A-171)Greene Valley - Upgrade power to two cottages; replace air handling units in the central services building and four cottages; replace the chiller in the resource center building; and replace the roofs on eleven cottages and the gymnasium$3,620,000Arlington Campus - Replace the HVAC systems and demolish the existing cooling tower; replace the current energy management system controls; and convert the air handler system to a variable volume system2,800,000 Total Capital Maintenance$6,420,000Capital Projects (Volume 1, page A-165)Harold Jordan Center Renovations$2,850,000Arlington Developmental Center Cottages Demolition (Exit plan requirement)2,350,000Ruilman Center Renovations720,000 Total Capital Projects$5,920,000Total Capital Outlay$12,340,000</p></li><li><p>Supplemental Appropriations (Volume 1, page A-32)Arlington Lawsuit Exit Plan $569,400 Total Funding$300,000 State in TennCares budget for DIDD</p><p>16 positions11 for an intermediate care facility survey team4 for an enrollment team1 for lawsuit compliance </p><p>FY2013 Supplemental Request*</p></li><li><p>Allows for enrollment growth of 287 people in home and community based services.191 people as part of the Arlington lawsuit exit plan96 people associated with normal growth in the waivers</p><p>Continues funding for the Family Support Program at the FY2013 level of $7.4 million.</p><p>Provides funding for the temporary continuation of operations at the Clover Bottom Developmental Center.</p><p>Reduces 120 authorized positions (54 are estimated to be vacant).</p><p>Facilitates programmatic changes at the Harold Jordan Center which allows for the collection of Medicaid funding.</p><p>Provides for capital project maintenance and improvements.FY2014 Budget Highlights*</p><p>*DIDD FY2013-14 Budget HearingProgram Updates</p><p>Budget by Program</p><p>Funding Source Estimates</p><p>Budget Reductions</p><p>Cost Increases</p><p>Capital Budget</p><p>Supplemental Request*Program UpdatesHome &amp; Community Based Waivers</p><p>Statewide Waiver Census 6,240FY2012 Average Cost per Person Per Day $235.33</p><p>Self Determination Waiver Census 1,132FY2012 Average Cost Per Person Per Day $50.91CMS recognized the waiver as a model of best practicesCMS has just approved the renewal of this waiver.</p><p>Arlington Waiver Census 313FY2012 Average Cost Per Person Per Day $396.94</p><p>Waiting list for intellectual disabilities waiver services is 7,264 (This number just represents those with an intellectual disability who have requested services. Actual number of people with an intellectual disability in Tennessee is much higher. Approximately 2% of the population has an intellectual disability ; and this does not include those with a developmental disability such as autism.)</p><p>**DIDD Waiver Census HistoryProgram UpdatesDevelopmental Centers</p><p>2% of the population served by DIDD is in developmental centers.</p><p>Clover Bottoms census is 41 with planned closure in 2014.</p><p>Greene Valleys census is 136; however, 12 residents will transition to state-operated community homes once constructed. (We plan no closure of Greene Valley but recognize there is choice with incoming persons served. I have asked Regional Director John Craven and Supt. Dianne Brightwell to look at how we will operate this facility as the census continues to decline.) </p><p>Harold Jordan Centers census is 4. The department is making programmatic changes to enable greater use of the facility while also allowing the state to receive federal Medicaid funds. Presently, this center is 100% state funded at $5.8 million dollars.*State Operated Intermediate Care Facility HomesWest RegionAll 12 homes are operational.Current census is 48.FY2012 actual cost per person per day was $1,092.53. (We are expecting to reduce this cost . Similar homes operated by the private sector are in the $750 per person per day range; however, the people in the west homes are more medically fragile.)</p><p>East Region Total of 16 homes are planned.13 are constructed with a current census of 51.Construction will begin soon for the last 3 homes. (estimate construction will begin in April)FY2012 actual cost per person per day was $872.32.</p><p>Middle RegionTotal of 9 homes are planned.Lots have been purchased for 9 homes.Construction has begun on 4 of these homes. (The budget assumes full occupancy in January 2014. The homes may be constructed as early as October 2013. The remaining 5 homes will be ready for occupancy by June 30, 2014)</p><p>*Resource Centers</p><p>Current Status:There are three resource centers operating in the three regions and providing the following services: assistive technology, occupational and physical therapy, speech and language pathology, dental, behavior analysis, and physical nutritional management.</p><p>Proposed Changes:In the FY2014 budget, 35 positions are moved from the resource centers to the developmental centers where they provide services.</p><p>Another 35 positions will be abolished. (of which 11 are vacant)</p><p>Middle and east resource centers are restructured leaving only assistive technology and dental services. (Other services can be purchased in the open market).</p><p>The west resource center will continue to operate with a full array of services. (Generally, the people in the west region tend to have more medical needs. Therefore we decided to keep all the services in the west resource center to act as a safety net.)*Budget By Program (includes waiver funding within TennCare) </p><p>Home and Community Based Waiver Services (76.8%) $653,468,600 (Represents payments to a network of private providers that employ 26,000 people)</p><p>Developmental Centers (8.3%) 70,908,900</p><p>Admin/QA/Regional Offices (8.8%)...</p></li></ul>

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