Presentation to the
Senate Finance Committee
DADS FY2008-09
Legislative Appropriations Request
February 7, 2007
FY2006-07 Issues
 Interest List Reductions
 August 2007 Deferral Payments
 HCSSA Industry Growth
 DADS Infrastructure
FY2008-09 Request
• Caseloads
– Entitlements
– Waivers
– Non-Medicaid
• Staffing
• Provider Rates
FY2008-09 Issues
• Money Follow the Person (MFP)
• Children Aging Out of Services
• Streamlining Regulatory Services
• Medicaid Waiver Optimization
Comparison of Key Caseloads
Program
A.1.1 Mental Retardation Service Coordination
A.2.1 Primary Home Care (PHC)
A.2.2 Community Attendant Services (CAS)
A.2.3 Day Activity and Health Services (DAHS)
A.3.1 Community Based Alternatives (CBA)
A.3.2 Home and Community-based Services (HCS)
A.3.3 Community Living Assistance and Support Services (CLASS)
A.3.4 Deaf-Blind Multiple Disabilities (DBMD)
A.3.5 Medically Dependent Children Program (MDCP)
A.3.6 Consolidated Waiver Program
A.3.7 Texas Home Living Waiver
A.4.1 Non-Medicaid Services
A.4.2 Mental Retardation Community Services
A.4.4 In-Home and Family Support
A.4.5 Mental Retardation In-Home Services
A.5.1 Program of All-Inclusive Care for the Elderly (PACE)
A.6.1 Nursing Facility Payments
A.6.2 Medicare Skilled Nursing Facility
A.6.3 Hospice
A.6.4 Promote Independence Services
A.7.1 Intermediate Care Facilities—Mental Retardation (ICF/MR)
A.8.1 MR State Schools Services
Total
Estimated Budgeted
FY06 Feb
FY07 Feb
Update
Update
7,390
7,390
64,451
58,382
43,819
42,543
18,674
17,097
26,724
26,712
10,147
11,857
2,077
3,159
132
145
957
1,591
167
190
1,417
1,866
13,704
14,432
7,994
8,013
3,944
3,914
2,688
2,674
903
952
57,874
57,769
6,100
6,336
5,197
5,670
4,854
4,799
6,855
6,916
4,932
4,899
291,000
287,306
Recommendations Exceptional Request
FY2008
FY2009
FY2008
7,390
55,502
37,117
17,227
27,138
11,542
3,268
131
1,292
166
1,001
13,414
7,195
3,914
2,674
894
57,361
6,866
6,526
5,101
6,314
4,795
7,390
57,195
37,117
18,072
27,138
11,542
3,268
131
1,292
166
1,001
13,414
7,195
3,914
2,674
894
57,358
7,191
7,128
5,590
6,314
4,795
7,390
52,658
43,502
15,953
25,351
12,432
3,460
156
2,330
199
1,603
14,432
8,013
3,914
2,674
1,066
57,674
6,586
6,091
4,837
7,019
4,869
276,828
280,779
282,209
Summary of Exceptional Items
# Exceptional Items
GR-R
FY 2008
All Funds
GR-R
FY 2009
All Funds
Biennial Total
GR-R
All Funds
SB 1 Recommendations = 2,102,958,105 5,326,002,212 2,136,990,326 5,340,503,141 4,239,948,431 10,666,505,353
1 February Caseload Updates
2 Provider Rate Restorations to FY2003
CLASS Restoration
HCS Restoration
TxHmL Restoration
ICF/MR Restoration
3 Promoting Independence
Large ICF/MRs
Foster Children Aging Out Waiver Slots
Staffing for Regulatory, Intake, &
4 Guardianship
Regulation and Certification Staff
Functional Eligibility Staff
Guardianship Staff
Contract Management Staff
Program Oversight Staff
5 Information Technology Initiatives
Restoration of Base Computer Leases
Websphere Migration
PC Refresh
Enterprise Licensing
6 State School Equipment and Vehicles
Equipment Replacement
Vehicle Replacement (288 Vehicles)
7 State School Utility and Drug Increases
Utility Increase
Drug Increase
8 State School Repairs and Renovation
9 Contract Services for Guardianship
10 MR Equity
11 PACE Site Expansion (two new sites)
$ 26,990,040
$ 5,372,371
557,083
2,067,257
52,043
2,695,988
$ 2,043,146
1,374,728
668,418
$ 42,243,400
$ 13,618,177
1,412,123
5,240,196
131,922
6,833,936
$ 5,179,078
3,484,735
1,694,343
$ 32,890,707
$ 5,441,823
564,284
2,093,982
52,716
2,730,841
$ 5,890,285
3,963,270
1,927,015
$ 56,536,287
$ 13,618,177
1,412,123
5,240,196
131,922
6,833,936
$ 14,740,453
9,918,092
4,822,361
$ 59,880,747
$ 10,814,194
1,121,367
4,161,239
104,759
5,426,829
$ 7,933,431
5,337,998
2,595,433
$
$
$ 17,233,603
4,847,585
10,559,001
529,155
790,526
507,336
$ 3,105,855
584,405
1,375,000
315,750
830,700
$ 6,889,000
3,735,000
3,154,000
$ 1,378,485
391,638
986,847
$
150,000
$
534,100
$ 11,000,000
$
825,425
75,522,025
$ 32,848,499
9,695,168
20,028,453
529,155
1,581,051
1,014,672
$ 6,211,709
1,168,809
2,750,000
631,500
1,661,400
$ 6,889,000
3,735,000
3,154,000
$ 4,424,192
951,839
3,472,353
$ 15,044,192
$
534,100
$ 11,000,000
$ 2,092,333
140,084,680
$ 18,564,094
5,528,932
11,067,090
742,210
747,326
478,536
$ 3,421,611
584,405
1,375,000
631,506
830,700
$ 6,831,000
3,735,000
3,096,000
$ 2,982,665
816,493
2,166,172
$
150,000
$
611,498
$ 11,000,000
$ 2,417,175
90,200,858
$ 35,244,000
11,057,864
20,992,204
742,210
1,494,651
957,071
$ 6,843,221
1,168,809
2,750,000
1,263,012
1,661,400
$ 6,831,000
3,735,000
3,096,000
$ 9,310,618
1,960,785
7,349,833
$ 44,832,577
$
611,498
$ 11,000,000
$ 6,048,987
205,616,818
$ 35,797,697
10,376,517
21,626,091
1,271,365
1,537,852
985,872
$ 6,527,465
1,168,809
2,750,000
947,256
1,661,400
$ 13,720,000
7,470,000
6,250,000
$ 4,361,150
1,208,131
3,153,019
$
300,000
$ 1,145,598
$ 22,000,000
$ 3,242,600
165,722,882
$
$
$
$
$
$
$
$
$
98,779,687
27,236,354
2,824,246
10,480,392
263,844
13,667,872
19,919,531
13,402,827
6,516,704
68,092,499
20,753,032
41,020,657
1,271,365
3,075,702
1,971,743
13,054,930
2,337,618
5,500,000
1,894,512
3,322,800
13,720,000
7,470,000
6,250,000
13,734,810
2,912,624
10,822,186
59,876,769
1,145,598
22,000,000
8,141,320
345,701,498
Total, DADS Exceptional Items =
Total, DADS Exceptional Items + SB 1 = 2,178,480,130 5,466,086,892 2,227,191,184 5,546,119,959 4,405,671,313 11,012,206,851
FTEs
FY 2008 FY 2009
14,356
14,356
-
-
599
132
417
10
24
16
599
683
159
469
15
24
16
683
14,955
15,039
Exceptional Item 1
February Caseload Update
• SB 1 Recommendations do not meet HHSC forecasted FY2008-09 Medicaid and
Non-Medicaid caseload growth estimates
•
Funding is needed to serve client caseloads that are currently at or above FY200809 Recommended levels. Many of these programs continue to grow.
•
Programs affected are:
+ Community Attendant Services (CAS)
+ Home & Community Based Services (HCS)
+ Community Living Assistance and Support Services (CLASS)
+ Medically Dependent Children (MDCP)
+ MR Community Services
+ Program for All-Inclusive Care of the Elderly (PACE)
+ Nursing Facility (NF)
+ ICF-MR
+ Primary Home Care (PHC)
+ Community Based Alternatives (CBA)
+ Day Activity & Health Services (DAHS)
•
SB 1 Recommendations do not meet HHSC forecasted FY2008-09 Medicaid and
Non-Medicaid caseload growth estimates
•
Funding is needed to serve client caseloads that are currently at or above FY200809 Recommended levels. Many of these programs continue to grow.
•
Programs affected are:
+ Community Attendant Services (CAS)
+ Home & Community Based Services (HCS)
+ Community Living Assistance and Support Services (CLASS)
+ Medically Dependent Children (MDCP)
+ MR Community Services
+ Program for All-Inclusive Care of the Elderly (PACE)
+ Nursing Facility (NF)
+ ICF-MR
+ Primary Home Care (PHC)
+ Community Based Alternatives (CBA)
+ Day Activity & Health Services (DAHS)
MOF
($ in millions)
FY
2008
General Revenue
All Funds
$ 27.0 $ 32.9 $ 59.9
$ 42.2 $ 56.5 $ 98.8
Program Impact
FY
2008
CAS: caseload/mo +6,385
HCS: caseload/mo +890
CLASS:
+192
caseload/mo
MDCP:
+1,038
caseload/mo
MR Community: +818
caseload/mo
PACE: caseload/mo +172
NF: caseload/mo
+313
ICF-MR:
+705
caseload/mo
PHC: caseload/mo - 2,844
DAHS:
- 1,274
caseload/mo
CBA: caseload /mo - 1,787
FY
2009
FY
2009
+7,537
+890
+192
Totals
Totals
n/a
n/a
n/a
+1,038 n/a
+818
n/a
+176
+263
+705
n/a
n/a
n/a
- 2,366 n/a
- 2,006 n/a
- 1,719 n/a
All Others
TOTAL
+773 +621 n/a
+5,381 +6,149
Exceptional Item 2
FY2003 Rate Restorations
• In the 78th Legislature, provider rates for ICF-MRs were reduced by 3.5% below
FY03 levels, while rates for HCS and CLASS providers were reduced by 2.2%
below FY03 levels.
• The 79th Legislature authorized a Waiver Quality Assurance Fee (QAF) whose
revenues would have restored these rates to FY03 levels
• The approval of the “Waiver” QAF for the HCS and CLASS programs has not
been provided by the Centers for Medicaid and Medicare Services (CMS).
• This request of $10.8 million GR restores these provider rates to their FY03 levels
• Programs Impacted:
– Home and Community Based Services (HCS)
– Community Living Assistance and Support Services (CLASS)
– Texas Home Living Waiver (TxHmL)
– Intermediate Care Facilities for the Mentally Retarded (ICF-MR)
MOF
FY 2008 FY 2009 Totals
($ in millions)
General
Revenue
All Funds
$ 5.4
$ 5.4
$ 13.6
$ 13.6
Program Impact
HCS: costs/mo
CLASS:
costs/mo
TxHmL:
costs/mo
ICF-MR:
costs/mo
FY 2008 FY 2009 Totals
+$35.50 +$35.50 n/a
+ $34.01 + $34.01 n/a
+ $5.00
$
10.8
$
27.2
+ $5.00 n/a
+ $81.14 + $81.14 n/a
Exceptional Item 3
Promoting Independence
•
This exceptional item requests $7.9 million in GR funds for the biennium to
move:
– 240 individuals from large community ICF-MRs and
– 120 children aging out of foster care at DFPS
to the Home and Community-Based Services (HCS) waiver program by
the end of FY09.
•
This item allows the department to meet its commitments to provide mental
retardation services within a twelve-month period under the Promoting
Independence Plan, which is the state’s response to the U.S. Supreme Court
Olmstead Decision
•
Programs Impacted
– Home and Community-Based Services (HCS)
MOF
($ in millions)
FY 2008 FY 2009 Totals
General Revenue $ 2.0
$ 5.9
$
7.9
$
19.9
All Funds
$ 5.2
$ 14.7
Program Impact
HCS (ICF-MR):
caseload/mo
HCS (DFPS):
caseload/mo
HCS:
caseload/mo
HCS: cost/mo
FY 2008 FY 2009 Totals
+65
+185
+240
+33
+93
+120
+98
+278
+360
+ $9.15 + $25.68
Exceptional Item 4
Staffing - Regulatory, Intake, & Guardianship
• This item requests funds for additional staff for the following functions at DADS:
• Regulation and Certification - From FY2001 to FY2006, the number of providers
(facilities and HCSSA agencies) has increased by 38.3% while the number of
Regulatory staff has decreased by 27.2%
• Functional Eligibility – From FY2001 to FY2006, there has been an increase of
30.7% in cases for Long-Term services and supports programs at DADS while
there has been a decrease in the number of Caseworkers by 21.2% .
• Guardianship - APS/CPS reform has increased the number of referrals by 17.1%
during FY2006 and is expected to grow 18% annually.
• Contract Management - DADS received funds to serve an additional 9,360
persons due to interest list reductions. Additional funding is needed to address the
workload related to the increased number of provider contracts.
• Program Oversight - Staff for utilization review, utilization management, and
technical assistance staff to improve quality of client services.
•
Currently, less than 5% of DADS FTEs are administrative.
MOF
($ in millions)
FY
FY
Totals
2008 2009
General Revenue $ 17.2 $ 18.6 $
35.8
All Funds
$ 32.8 $ 35.2 $
68.1
FTEs
Regulatory
Access & Intake
Guardianship
Contract Mgmt
Prog Oversight
599.4
132.0
417.4
10.0
24.0
16.0
Program Impact FY
2008
Inspections
+66
Completed
Investigations
+71
Completed
HCSSA
+270
Inspections
HCSSA
+194
Complaints
Investigated onsite
Caseload per
- 87.1
Caseworker
682.8
159.0
468.8
15.0
24.0
16.0
N/A
n/a
n/a
n/a
n/a
n/a
FY
Totals
2009
+130 n/a
+144 n/a
+580 n/a
+418 n/a
- 98.5
Regulatory Workload and FTEs
REGULATORY WORKLOAD / FTEs
8,000
600.0
7,787
568.3
7,313
558.8
550.0
7,000
6,713
500.0
6,500
476.1
6,000
5,500
480.2
5,962
5,631
450.0
5,720
Surveyors
Facilities & Agencies
7,500
413.8
414.0
400.0
5,000
4,500
350.0
2001
2002
2003
2004
2005
2006
Fiscal Year
Facilities & Agencies
Surveyors
Access & Intake Cases and FTEs
ACCESS & INTAKE CASES / FTEs
310,000
1,000
922
923
Weighted Cases
292,786
900
265,167
270,000
800
250,000
255,303
727
240,028
230,000
210,000
278,689
912
707
224,072
700
686
600
190,000
500
170,000
150,000
400
FY01
FY02
FY03
FY04
Fiscal Year
Weighted Cases
Intake Workers
FY05
FY06
Intake Workers
290,000
Exceptional Item 5
Information Technologies Initiatives
• This item requests several critical automation infrastructure needs at DADS:
• DADS is requesting funding for 2,570 PCs of the 6,450 PCs that were leased
during the FY06-07 biennium
• Continuation of the PC Refresh project to replace the remaining 2,780 outdated
PCs.
• Upgrade of software licenses for Microsoft Office and Microsoft operating
systems, which will ensure that DADS IT will use the latest security patches and
service releases
• The retirement of the old SAVERR mainframe and the move to HHS standards
for data and applications will require that old
mainframe applications and
databases be migrated to newer technologies
•
Programs Impacted
– Entire Agency
•
DADS also will be included in a number of HHS Enterprise technology requests,
primarily the messaging/collaboration and HHS telecommunications projects
MOF
($ in millions)
FY
FY
Totals
2008 2009
General Revenue $ 3.1 $ 3.4 $ 6.5
All Funds
$ 6.2 $ 6.8 $
13.1
Program Impact
FY
2008
FY2006-07 PCs 2,570
FY2008-09 PCs 1,370
Software Licenses 7,820
FY
2009
2,570
2,780
9,230
Totals
n/a
n/a
n/a
Exceptional Item 6
State School Equipment and Vehicles
• DADS is a provider of services for persons with mental retardation, through the
operation of the State Schools
•
We are obligated to provide these services in such a manner that meets the needs,
safety, and well being of the residents, and ensures maintaining Medicaid
certification
•
This item requests funding to replace old and damaged vehicles ($6.2 million) and
equipment and furniture ($7.5 million) at State Schools
•
•
Programs Impacted
– State Schools
MOF
FY 2008 FY 2009 Totals
($ in millions)
General
Revenue
All Funds
$ 6.9
$ 6.8
$
13.7
$ 6.9
$ 6.8
$
13.7
Program
FY 2008 FY 2009 Totals
Impact
Vehicles
+144
+144
+288
State School: +$116.91 +$116.91 n/a
costs/mo
Exceptional Item 7
State School Utility and Drug Increases
• Inflationary cost pressures at State Schools are not covered as an “entitlement”
program.
•
Rising energy costs are affecting utility costs (electricity, oil, and natural gas) at
all State Schools, increasing by 30 percent over the FY2006-07 biennium and by
an estimated 12 percent for FY2008-09.
– This also affects the transportation and food costs at State Schools
•
Cost of drugs for State School residents has grown 13% annually since FY2003;
increasing from $2,645 per resident per year in FY2003 to a forecasted $5,746 per
resident in FY2009
– Rising pharmaceutical costs
– Increasing number of Dual Diagnosis consumers (MR & MI)
•
Programs Impacted
– State Schools
MOF
FY
($ in millions) 2008
FY 2009 Totals
General
Revenue
All Funds
$ 1.4
$ 3.0
$
$ 4.4
$ 9.3
$ 13.7
Program Impact FY
2008
State School:
costs/mo
4.4
FY 2009 Totals
+$75.72 +$159.35 n/a
Exceptional Item 8
State School Repairs and Renovations
• The physical infrastructure at State Schools needs to be addressed to ensure ICFMR certification (and thus Medicaid funding) This would include:
– Life-safety code requirements
– Roofs
– Heating, Ventilation, and A/C (HVAC)
– Plumbing
– Electrical
•
DADS is requesting almost $60 million in general obligation bonds to address
these infrastructure issues
•
Programs Impacted
– State Schools
– State-Owned Bond Homes
MOF
($ in millions)
FY
FY
Totals
2008 2009
General Revenue
$
0.2
$
15.0
All Funds
$
0.2
$
44.8
$
0.3
$ 59.9
Exceptional Item 9
Contract Services for Guardianship
• To meet 50 percent of the projected caseload increases for Guardianship services
with community contractors (the other 50 percent increase in caseloads is
addressed in exceptional item # 4)
•
As a result of the APS/CPS reform at DFPS last session, the number of intakes for
statewide abuse and neglect hotline has increased during the last year, and the
number of cases opened for investigation has increased accordingly. DFPS-APS
estimates that their caseloads will increase by at least ten percent through the next
biennium.
•
For the DADS Guardianship program, there is a direct correlation between the
size and growth of the APS/CPS caseload and the size and growth of the
guardianship program caseload.
•
Programs Impacted
– Guardianship Program
MOF
($ in millions)
FY
FY
Totals
2008 2009
General Revenue
All Funds
$ 0.5 $ 0.6 $
$ 0.5 $ 0.6 $
1.1
1.1
Program Impact
FY
FY
Totals
2008 2009
Guardianship clients +288 +330 n/a
served through
Contract Services
Exceptional Item 10
MR Equity
• Requests $22 million in GR funds over the biennium to increase allocations to
Mental Retardation Community Centers that are currently funded below the
statewide average as compared to all MRAs operating across the State
•
Historically, the funding provided to the Community Centers has not been
proportional to the number of individuals living in their catchment areas
•
These funds would bring the Centers that are funded below the mean, up to the
average statewide per capita allocation -- $2.39
•
Programs Impacted
– Mental Retardation Community Centers
MOF
($ in millions)
FY
2008
FY
2009
Totals
General Revenue $ 11.0
$ 11.0
All Funds
$ 11.0
$ 11.0
$
22.0
$
22.0
Program Impact
FY
2008
FY
2009
Totals
MR Community
Services
consumers
+988
+988
n/a
Exceptional Item 11
PACE Site Expansion
• This item requests funds to add two additional Program of All-Inclusive Care for
the Elderly (PACE) sites
•
DADS currently operates two PACE sites, in El Paso and Amarillo, with a third
site (Lubbock) anticipated to come on-line during FY2006-07
•
DADS has received interest in additional sites
•
These two additional sites would serve an additional 226 individuals in this
program by the end of FY2009
•
Programs Impacted
– Program of All-Inclusive Care for the Elderly (PACE)
MOF
($ in millions)
FY
FY
Totals
2008 2009
General Revenue $ 0.8 $ 2.4 $
All Funds
$ 2.1 $ 6.0 $
Program Impact
3.2
8.1
FY
FY
Totals
2008 2009
+78 +226 n/a
PACE:
caseload/mo
PACE: costs/mo n/a
$3.37 $8.64
DADS Exceptional Items
in HHSC’s LAR
HHSC Exceptional Item
Provider Rate Increases – 1%
• For FY2008-09, the DADS provider rate increases are included in the HHS
Consolidated Budget, published in October 2006. These numbers have been
updated for the HHSC February Caseload Update.
•
This analysis initially determines what a 1% rate increase would cost for each
DADS Program, based upon its rate methodology (generally Cost Reports prospective and interim with settle-ups) . Some rates are based on other
programs' rates.
•
These cost reports (primarily from FY2005) can then updated for the known
inflation that took place in FY2006 and FY2007, and then further adjusted for the
anticipated inflation for FY2008 and FY2009.
•
The provider rates for most programs (except NF, Hospice, and State Schools)
have not been increased since either FY2000 or FY2002.
MOF
FY
($ in millions) 2008
General
Revenue
All Funds
FY
2009
Totals
$ 19.3 $ 19.7 $ 38.9
$ 28.4 $ 28.4 $ 56.8
Program Impact FY
FY
Totals
2008 2009
PHC: costs/mo + $6.20 + $6.21 n/a
CAS: costs/mo + $6.19 + $6.24 n/a
DAHS:
+ $4.82 + $4.85 n/a
costs/mo
CBA: costs/mo +$12.61 +$12.61 n/a
HCS: costs/mo +$32.29 +$32.29 n/a
CLASS:
+$28.67 +$28.67 n/a
costs/mo
PACE: costs/mo +$22.85 +$22.85 n/a
NF: costs/mo
+$32.15 +$32.15 n/a
Hospice:
+$22.34 +$22.34 n/a
costs/mo
ICF-MR:
+$40.97 +$40.97 n/a
costs/mo
There are numerous other Programs with
rate changes
HHSC Exceptional Item 4
Interest List Reduction – Demographic Growth
• One of two options that are presented in HHSC’s LAR as Exceptional Items to
reduce Interest Lists at DADS:
•
Keep pace with Demographic Growth:
– Serves 4,751 consumers
– Costs $32.2 million GR
•
DADS IL Request represents 77.3% of HHS Enterprise request
MOF
FY
($ in millions) 2008
$
FY
2009
8.1 $ 24.1
Totals
General
Revenue
All Funds
$ 32.2
$ 18.2
$ 53.7
$ 72.0
FTEs
23.1
46.9
n/a
Program Impact FY
2008
FY
2009
Totals
CBA:
caseload/mo
+327
+981
+1,308
HCS: caseload +149
/mo
+446
+595
CLASS:
caseload /mo
+41
+124
+165
DBMD:
caseload /mo
+2
+5
+7
MDCP:
caseload /mo
+28
+83
+111
CWP: caseload +3
/mo
+8
+11
Non-Medicaid: +557
caseload /mo
+1,671 +2,228
IHFS: caseload +47
+140
+187
/mo
STAR+Plus:
caseload /mo
+35
+104
+139
TOTALS
+1,189 +3,562 +4,751
HHSC Exceptional Item 8
Interest List Reduction – 20% Reduction
• One of two options that are presented in HHSC’s LAR as Exceptional Items to
reduce Interest Lists at DADS:
•
Reduce current interest lists by 20 percent:
– Serves 13,308 consumers
– Costs $168.7 million in GR
•
DADS IL Request represents 93.3% of HHS Enterprise request
MOF
($ in millions)
FY 2008 FY 2009 Totals
General Revenue $ 42.2 $ 126.5 $ 168.7
All Funds
$ 104.3 $ 310.1 $ 414.4
FTEs
70.1
139.9
n/a
Program Impact
CBA:
caseload/mo
HCS: caseload
/mo
CLASS: caseload
/mo
DBMD: caseload
/mo
MDCP: caseload
/mo
Non-Medicaid:
caseload /mo
IHFS: caseload
/mo
STAR+Plus:
caseload /mo
TOTALS
FY 2008 FY 2009 Totals
+671
+2,014 +2,685
+1,382 +4,147 +5,529
+303
+908
+1,211
+1
+2
+3
+214
+643
+857
+221
+662
+883
+377
+1,130 +1,507
+158
+475
+633
+3,327 +9,981 +13,308
HHSC Exceptional Item 16
Nurse Retention and Recruitment
• Based on the recommendation of the HHS Nurse Compensation Workgroup this
exceptional item requests funds to increase salaries for Registered Nurses (RN)
and Licensed Vocational Nurses (LVN) by an average of 15%. Approximately
1,110 nurses working at DADS would receive this salary increase. During FY
2005 the turnover rate at the Department of Aging and Disability Services was
24.9% for RNs and 28.0% for LVNs, the current turnover rates in FY 2006 are
29.5% for RNs and 31.0% for LVNs.
•
This request also funds a nurse stipend program for 58 RN's and 50 LVN's by the
end of FY 2009 as well as reimbursement for continuing education classes and
license renewals.
MOF
FY 2008 FY 2009 Totals
($ in millions)
General
Revenue
All Funds
$ 3.7
$ 5.0
$
8.7
$ 8.3
$ 9.6
$ 17.9
FTEs
54.0
108.0
n/a
Program Impact FY 2008 FY 2009 Totals
State School:
$77.56 $77.56 n/a
costs/mo