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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.
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Table 9.
MR/DD Expenditures in Travis County by CAN Partners, FY 2001
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AGENCIES
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ANNUAL EXPENDITURES
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PERCENT
|
|
Austin Travis County Mental Health Mental Retardation Center1
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$9,501,883
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93%
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United Way
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$350,524
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3.5%
|
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City of Austin and Travis County
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$355,300
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3.5%
|
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TOTAL
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$10,207,707
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100%2
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| 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.
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Table 10.
MR/DD Expenditures by Other Federal, State, and Local Agencies, FY 2001
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AGENCIES
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ANNUAL EXPENDITURES
|
PERCENT
|
|
Federal Investments
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| U.S. Department of Housing and Urban Development |
$1,036,750
|
29.25%
|
| U.S. Department of Education |
$305,178
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8.75%
|
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Other State and Local Investments
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Early Childhood Intervention (ECI)
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$1,982,631
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56%
|
| Capital Metropolitan Transportation Authority |
$65,000
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1.75%
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| Texas Commission for the Blind |
$50,000
|
1.50%
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| Texas Rehabilitation Commission |
$41,380
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1.25%
|
| Texas Department of Human Services, Title XX |
$29,000
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.75%
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| Texas Workforce Commission |
$19,000
|
.50%
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| Texas Commission for the Deaf and Hearing Impaired |
$10,000
|
.25%
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TOTAL
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$3,538,939
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100%3
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| Note: The 2000-2001 period represents varying fiscal calendars that include direct and indirect costs. |
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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.
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Table 9.
MR/DD Expenditures in Travis County by CAN Partners, FY 2001
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AGENCIES
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ANNUAL EXPENDITURES
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PERCENT
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|
Austin Travis County Mental Health Mental Retardation Center1
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$9,501,883
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93%
|
|
United Way
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$350,524
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3.5%
|
|
City of Austin and Travis County
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$355,300
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3.5%
|
|
TOTAL
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$10,207,707
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100%2
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| 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.
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Table 10.
MR/DD Expenditures by Other Federal, State, and Local Agencies, FY 2001
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AGENCIES
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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
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1.25%
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| 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
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$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.
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Table 11.
Institutional and Community Costs - Average Costs Per Person/Year
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NUMBER OF YEARS IN HCS AND ICF/MR PER PERSON
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AVERAGE ANNUAL COST OF MEDICAID FUNDED HOME AND COMMUNITY- BASED SERVICES (HCS) IN TRAVIS COUNTY
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AVERAGE ANNUAL COST OF INTERMEDIATE CARE FACILITIES FOR THE MENTALLY RETARDED (ICF/MR) IN TRAVIS COUNTY
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DIFFERENCE IN HCS AND ICF/MR
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DIFFERENCE IN HCS AND ICF/MR MULTIPLIED BY 100 PEOPLE
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1
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$47,291
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$60,053
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$12,762
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$1,276,200
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2
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$94,582
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$120,106
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$25,524
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$2,552,400
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3
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$141,873
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$180,159
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$38,286
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$3,828,600
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4
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$189,164
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$240,212
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$51,048
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$5,104,800
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5
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$236,455
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$300,265
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$63,810
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$6,381,000
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10
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$472,910
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$600,530
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$127,620
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$12,762,000
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20
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$945,820
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$1,201,060
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$255,240
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$25,524,000
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30
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$1,418,730
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$1,801,590
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$382,860
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$38,286,000
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40
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$1,891,640
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$2,402,120
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$510,480
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$51,048,000
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50
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$2,364,550
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$3,002,650
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$638,100
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$63,810,000
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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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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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