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VIII. CURRENT SPENDING
EXPENDITURES
Funding for persons with MR/DD in Travis County is provided through
federal, state, and local sources. However, these funding streams are
often embedded within other services (e.g., mental health, education,
criminal justice, etc.) and other populations. In addition, prevention
dollars are included in these funding streams as well as other federal,
state, and local resources. This fragmented system creates a complex
financial labyrinth to navigate through. Currently, there is no comprehensive
assessment of the community's investment in the area of MR/DD. However,
efforts have been initiated to inventory resources (Table 5) with the
goal of creating a comprehensive resource map that includes capacity,
waiting lists, costs of services, and funding streams.
Table 9 simply provides a sample of public sector expenditures by
CAN Partners. These funds provide a range of public services and supports,
including assistive technology, adaptive aides, case management, employment,
supported employment, respite, family support, medical services, prescriptions,
offender programs, guardianship, individual support, rehabilitation,
psychosocial rehabilitation, residential services, personal safety,
awareness, self-advocacy, community advocacy, and transportation. Each
of these services and supports reflect the characteristics of best
practices as described in the previous section and is an indicator
of improvement of the quality of life for persons with MR/DD in Travis
County. However, these services and supports are not available to all
Travis County residents.
|
Table 9.
MR/DD Expenditures in Travis County by CAN Partners, FY 2001
|
|
AGENCIES
|
ANNUAL EXPENDITURES
|
PERCENT
|
|
Austin Travis County Mental Health Mental Retardation
Center1
|
$9,501,883
|
93%
|
|
United Way
|
$350,524
|
3.5%
|
|
City of Austin and Travis County
|
$355,300
|
3.5%
|
|
TOTAL
|
$10,207,707
|
100%2
|
| Note: The 2000-2001
period represents varying fiscal calendars that include direct
and indirect costs. |
In addition to spending by CAN partners, federal, state, and other
local agencies spend millions of dollars on MR/DD services and supports
for Travis County (Table 10). When added together, over $ 13.5 million
is being spent. Chart 17 shows that 94 percent of the expenditures
spent on MR/DD service in Travis County were funded by federal and
state sources, while 6 percent was from local sources.
|
Table 10.
MR/DD Expenditures by Other Federal, State, and Local Agencies, FY 2001
|
|
AGENCIES
|
ANNUAL EXPENDITURES
|
PERCENT
|
|
Federal Investments
|
| U.S. Department of Housing and Urban Development |
$1,036,750
|
29.25%
|
| U.S. Department of Education |
$305,178
|
8.75%
|
|
Other State and Local Investments
|
Early Childhood Intervention (ECI)
|
$1,982,631
|
56%
|
| Capital Metropolitan Transportation Authority |
$65,000
|
1.75%
|
| Texas Commission for the Blind |
$50,000
|
1.50%
|
| Texas Rehabilitation Commission |
$41,380
|
1.25%
|
| Texas Department of Human Services, Title XX |
$29,000
|
.75%
|
| Texas Workforce Commission |
$19,000
|
.50%
|
| Texas Commission for the Deaf and Hearing Impaired |
$10,000
|
.25%
|
|
TOTAL
|
$3,538,939
|
100%3
|
| Note: The 2000-2001 period represents
varying fiscal calendars that include direct and indirect costs. |
Top Of Page
MEDICAID COSTS
The average annual cost per person of Intermediate Care Facilities
for the Mentally Retarded (ICF/MR) is $60,053 (Chart 18). ICF/MR is
the Medicaid funded institutional model, which includes State Schools
as well as other smaller institutions. The average annual cost of Medicaid
funded Home and Community-Based Services (HCS) in Travis County is
$47,291. This average is based on a range between $13,125 to $123,577
per person (L. Shelby, personal communication, August 22, 2001). Non-inclusive
Medicaid costs for comprehensive outpatient rehabilitation services
average $4,000-$4,200 per client, per year.
EXPENDITURES
Funding for persons with MR/DD in Travis County is provided through
federal, state, and local sources. However, these funding streams
are often embedded within other services (e.g., mental health,
education, criminal justice, etc.) and other populations. In addition,
prevention dollars are included in these funding streams as well
as other federal, state, and local resources. This fragmented
system creates a complex financial labyrinth to navigate through.
Currently, there is no comprehensive assessment of the community's
investment in the area of MR/DD. However, efforts have been initiated
to inventory resources (Table 5) with the goal of creating a comprehensive
resource map that includes capacity, waiting lists, costs of services,
and funding streams.
Table 9 simply provides a sample of public sector expenditures
by CAN Partners. These funds provide a range of public services
and supports, including assistive technology, adaptive aides,
case management, employment, supported employment, respite, family
support, medical services, prescriptions, offender programs, guardianship,
individual support, rehabilitation, psychosocial rehabilitation,
residential services, personal safety, awareness, self-advocacy,
community advocacy, and transportation. Each of these services
and supports reflect the characteristics of best practices as
described in the previous section and is an indicator of improvement
of the quality of life for persons with MR/DD in Travis County.
However, these services and supports are not available to all
Travis County residents.
|
Table 9.
MR/DD Expenditures in Travis County by CAN Partners, FY 2001
|
|
AGENCIES
|
ANNUAL EXPENDITURES
|
PERCENT
|
|
Austin Travis County Mental Health Mental
Retardation Center1
|
$9,501,883
|
93%
|
|
United Way
|
$350,524
|
3.5%
|
|
City of Austin and Travis County
|
$355,300
|
3.5%
|
|
TOTAL
|
$10,207,707
|
100%2
|
| Note: The
2000-2001 period represents varying fiscal calendars that include
direct and indirect costs. |
In addition to spending by CAN partners, federal, state, and
other local agencies spend millions of dollars on MR/DD services
and supports for Travis County (Table 10). When added together,
over $ 13.5 million is being spent. Chart 17 shows that 94 percent
of the expenditures spent on MR/DD service in Travis County were
funded by federal and state sources, while 6 percent was from
local sources.
|
Table 10.
MR/DD Expenditures by Other Federal, State, and Local Agencies,
FY 2001
|
|
AGENCIES
|
ANNUAL EXPENDITURES
|
PERCENT
|
|
Federal Investments
|
| U.S. Department of Housing and Urban Development |
$1,036,750
|
29.25%
|
| U.S. Department of Education |
$305,178
|
8.75%
|
|
Other State and Local Investments
|
Early Childhood Intervention (ECI)
|
$1,982,631
|
56%
|
| Capital Metropolitan Transportation Authority |
$65,000
|
1.75%
|
| Texas Commission for the Blind |
$50,000
|
1.50%
|
| Texas Rehabilitation Commission |
$41,380
|
1.25%
|
| Texas Department of Human Services, Title XX
|
$29,000
|
.75%
|
| Texas Workforce Commission |
$19,000
|
.50%
|
| Texas Commission for the Deaf and Hearing Impaired |
$10,000
|
.25%
|
|
TOTAL
|
$3,538,939
|
100%3
|
| Note: The 2000-2001 period
represents varying fiscal calendars that include direct and
indirect costs. |
Top Of Page
MEDICAID COSTS
The average annual cost per person of Intermediate Care Facilities
for the Mentally Retarded (ICF/MR) is $60,053 (Chart 18). ICF/MR
is the Medicaid funded institutional model, which includes State
Schools as well as other smaller institutions. The average annual
cost of Medicaid funded Home and Community-Based Services (HCS)
in Travis County is $47,291. This average is based on a range
between $13,125 to $123,577 per person (L. Shelby, personal communication,
August 22, 2001). Non-inclusive Medicaid costs for comprehensive
outpatient rehabilitation services average $4,000-$4,200 per client,
per year.
As the datum in Table 11 show, institutionalization
of persons with mental retardation is not as cost effective
as services provided in the community, and often reduces
the quality of life for each individual. In one year,
the community can save over $1.25 million by providing
community services to 100 persons with mental retardation
instead of institutional care. Another example is that
in 10 years, the community could save over $12.5 million
and allow almost 270 additional persons to be served.
|
|
|
Table 11.
Institutional and Community Costs - Average Costs Per Person/Year
|
|
NUMBER OF YEARS
IN HCS AND ICF/MR PER PERSON
|
AVERAGE ANNUAL
COST OF MEDICAID FUNDED HOME AND COMMUNITY- BASED SERVICES
(HCS) IN TRAVIS COUNTY
|
AVERAGE ANNUAL
COST OF INTERMEDIATE CARE FACILITIES FOR THE MENTALLY
RETARDED (ICF/MR) IN TRAVIS COUNTY
|
DIFFERENCE IN
HCS AND ICF/MR
|
DIFFERENCE IN
HCS AND ICF/MR MULTIPLIED BY 100 PEOPLE
|
|
1
|
$47,291
|
$60,053
|
$12,762
|
$1,276,200
|
|
2
|
$94,582
|
$120,106
|
$25,524
|
$2,552,400
|
|
3
|
$141,873
|
$180,159
|
$38,286
|
$3,828,600
|
|
4
|
$189,164
|
$240,212
|
$51,048
|
$5,104,800
|
|
5
|
$236,455
|
$300,265
|
$63,810
|
$6,381,000
|
|
10
|
$472,910
|
$600,530
|
$127,620
|
$12,762,000
|
|
20
|
$945,820
|
$1,201,060
|
$255,240
|
$25,524,000
|
|
30
|
$1,418,730
|
$1,801,590
|
$382,860
|
$38,286,000
|
|
40
|
$1,891,640
|
$2,402,120
|
$510,480
|
$51,048,000
|
|
50
|
$2,364,550
|
$3,002,650
|
$638,100
|
$63,810,000
|
In the spring of 1995, the Texas Department of Criminal
Justice (TDCJ) became the largest prison system in the
world with 117,000 men and women incarcerated. The total
does not include people on parole, probation, in state
jails, boot camps or private prisons. In 1995, the number
was projected to increase to 156,000 inmates by 1996
with a minimum representation of 15,600 people with mental
retardation incarcerated. As a result, the cost to taxpayers
would be a minimum of $468,000,000 (Chart 19) as opposed
to $140,400,000 if appropriate diversion and community
supports had been utilized (ARCIL, In., 1996).
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Top Of Page
THE NEED
As reported in Section III, it is projected that approximately
1,000 people with mental retardation and developmental disabilities
are currently awaiting services in Travis County. It is estimated
that in order to address the number of people on the waiting list,
annual funding totaling an average of $47,291 per person or a
total of $47,291,000 would be needed. In addition, Section IX
outlines specific strategies, actions, and estimated costs to
address current issues and needs.
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Assessment Home
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