12/01/2015

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.

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.

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.

Actual

Estimated

Requested

DIDD Budget
Administration
Community Services

25,385,500
17,766,700

27,706,500
17,542,900

25,701,000
17,542,900

Protection from Harm

Developmental Centers

5,142,600
61,125,400

4,962,700
46,191,000

4,952,700
22,696,700

Harold Jordan Center

Community Homes
Seating and Positioning Clinics

5,520,700
39,752,300
2,773,400

5,296,500
45,760,600
2,980,400

8,340,400
49,091,000
3,416,500

Regional Offices
Major Maintenance

32,100,600
56,700

33,629,200
130,000

32,083,400
100,000

189,623,900

184,199,800

163,924,600

111,438,500
665,177,700

111,560,200
685,657,800

129,547,000
698,396,200

ECF Choices Waiver Program

TennCare Funding for DIDD Budget

155,128,600

139,308,900

68,958,000
122,526,900

Subtotal - TennCare Budget

931,744,800

936,526,900

1,019,428,100

$ 1,121,368,700

$ 1,120,726,700

$ 1,183,352,700

Subtotal - DIDD Budget

TennCare Budget
Private ICF-IIDs
Current HCBS Waiver Programs

Grand Total

Millions

$350
$300

$289.5

$294.5

FY12

FY13

$315.0

$305.4

FY14

FY15

$319.8

$266.7
$238.1

$250

$200
$150
$100
$50
$0

FY10

FY11

Decrease in FY11 represents multiple

reductions and limits on services and
rates.

Increase in FY12 due to end of

Federal Enhanced FMAP allowed by
ARRA.

FY16
6

3,500

3,177
2,860

3,000
2,500

2,249

2,248

2,150

2,094

2,003

1,976

FY13

FY14

FY15

FY16

FY17

2,000
1,500
1,000
500
0

FY10

FY11

FY12

The downward trend is due to the transition from

developmental centers to community homes.

Increase

Total
19,243,200

State
6,546,300

Federal
Other Staff
11,632,600 1,064,300
452

213,800

74,900

138,900

1.

Greene Valley Developmental Center

Extension - Non-recurring funds for the
6 month court-approved closure
extension.

2.

Aging Caregiver Bill - Annualize the cost

of 21 people enrolling in the waiver
programs.

3.

Waiver Cost Growth - Annualize the

costs people currently enrolled in
waiver programs.

1,681,700

589,000

1,092,700

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

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

40

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

32

7. Waiver 1% Provider Rate Increase for

Benefits Costs- Affordable Care Act

3,475,300

1,216,900

2,258,400

8. Waiver 1% Provider Rate Increase for

Direct Care Hourly Rate

3,475,300

1,216,900

2,258,400

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

398,500

398,500

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

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

12. Positions for Administration

710,200

281,200

271,500

157,500

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

542

Subtotal

10

Increase
1. Employment and Community First
CHOICES Program
2. Aging Caregiver Bill - Annualize the
cost of 21 people enrolling in the
waiver programs.

Subtotal

Total

State

Federal

$ 54,282,200

$ 19,040,400

$ 35,241,800

Other

Staff
$0

434,300

$ 54,950,500 $ 19,274,400 $ 35,676,100

$34,156,500 $58,373,100 $1,221,800

550

668,300

Grand Total DIDD and TennCare

$93,751,400
Programs

234,000

11

Reallocation Plan
State Appropriation Available from Greene Valley

State
$ 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
Remaining Balance

(636,500)
$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.
12

Increase
1.

Clover Bottom Campus

New Middle Tennessee
Regional Office

2.

Capital Maintenance
Clover Bottom Campus
Total Capital

Total

State

Federal

Other

$ 30,000,000

$ 30,000,000

$0

$0

4,670,000

4,670,000

$ 34,670,000

$ 34,670,000

$0

$0

13

Description
1. Eliminate PASS Program - Eliminate the Personal
Assistance Services & Support Program grant that serves
7 people.

State Dollars

Staff

$ 161,700

2. State-Operated ICF-IID Community Homes - Abolish 3

positions and reduce operational and payroll costs.

216,200

3. Regional Offices - Abolish 10 positions, reduce

operational costs, eliminate training grant, reduce payroll
costs, and convert 3 contracted workers to state
employees.
4. Administration - Abolish 8 positions and reduce
professional services from state agencies.

954,300

289,300

59,500

$ 1,681,100

18

5. Seating and Positioning Clinics - Reduce longevity,

supplies, and equipment.
Total Savings
Savings Target

$ 817,600
14

Millions

$400
$350

$351.0
$318.5

$300

$250
$200

$150
$100
$34.2

$50
-$1.7

$0
-$50

Base Budget

Reductions

Increases

Total Request
15

16