Strategies To Ensure Quality of Client Services Within A Finite Budget

Statewide Managers’ Meeting November 5-6, 2014

Sandy WilliamsBarbara Burkett

Objectives of This Session

I. Overview of Critical IssuesA. SFY15 Budget-Williams

1. SFY15 Basic VR Budget 2. Carry Over SFY14 Budget 3. Monthly Distribution

4. Spending Goals Versus Actual Spending SFY15 Year to Date 5. SFY15 Predictions

B. Supported Employment Expenditures-Burkett

1. Supported Employment SFY15 Expenditures Year to Date2. Subcategories of Supported Employment Expenditures3. Situational Assessment4. Job Development5. Placement and Training

C. Over Authorizations-Burkett

II. Strategies to Implement to Control Expenditures and Provide Quality Services -Discussion

SFY 15 Basic VR Budget

FY 15 Basic VR Budget $ 18.2M

Carryover from FY 14 - $ 4.1M

Distribution FY 15 to date - $ 12.2M

Remaining Distribution available = $ 1.8M

Carryover from SFY 14FY 15 Basic VR Budget $ 18.2MCarryover from FY 14 - $ 4.1M

Distribution FY 15 to date - $ 12.2MRemaining Distribution available = $ 1.8M

Highest since 2008 (between 1.1M – 1.85)

Breakout of Monthly Distributions

FY 15 Basic VR Budget $ 18.2MCarryover from FY 14 - $ 4.1M

Distribution FY 15 to date - $ 12.2MRemaining Distribution available = $ 1.8M

Jul-14 Aug-14 Sep-14 Oct-14 Nov-14Statewide Distribution 3.4 M 3.1 M 2.3 M 1.9 M 1.3 M

SFY 15 Expenditures Goals vs. Actual

Jul-14 Aug-14 Sep-14 Oct-14Goals 1.5M 1.5M 1.5M 1.5M

Expenditures 2.6M 2.3M 2.2M 2.7MDifference -1.1M -800K -700K -1.2M

Over goal Under goal

SFY15 Budget Predictions

The budget for case services for SFY15 is 18.2M

If we continue to spend at the rate we have for the 1st quarter, we predict we would need 30M for SFY15

Clients Currently Open As of November 3, 2014 = 19,983Compares to 18,331 Clients November 2013

Comparison of Clients by Status November 2013 and November 2014

Average Cost Per Client In FFY14 and Estimated Cost if System Were to Remain Static as of November 2014

Status Average Cost per client in 2014

Median Cost per Client in 2014

Clients As of November 2014

Estimated Cost for FFY15 With System Static

In employment $2,072.14 $1,131.21 1333 $2,762,162.62

Receiving Services $1,855.94 $ 990.97 10538 $19,557,895.72

Ready for employment $1,768.45 $1,149.48 995 $1,759,607.75

Post Employment Svcs $1,371.91 $ 750.00 162 $222,249.42

Extended eligibility $1,144.99 $ 901.25 207 $237,012.93

Trial work $1,076.55 $ 777.62 211 $227,152.05

Extended eval $879.13 $ 425.50 86 $75,605.18

Eligible $500.51 $ 168.00 6201 $3,103,662.51

Application $180.87 $ 29.00 250 $45,217.50

Wait-listed $109.61 $ 20.00 207 $22,689.27

Predicted Expenditures if System remains Static $28,013,254.95

Supported Employment and Job Coach Training Account for 65.3% of All Expenditures Statewide With 4.5

Million Spent SFY15

Expenditures SFY 2015 July 1 - Oct. 21, 2014

Northern Central Eastern Southwest Total

Supported Employment and Job Coach Training Expenditures SFY15 ytd

$1,759,401.0871.8%

$1,082,254.1565.4%

$1,290,692.3670.8%

$411,737.1440.0%

$4,544,084.73

65.3%

Total Expenditures SFY15 ytd $2,451,167.80 $1,655,621.08 $1,823,968.40 $1,030,200.79 $6,960,958.07

Subcategories for Supported Employment SFY15 By Region

Northern % of All Expenditures Central

% of All Expenditures Eastern

% of All Expenditures Southwest

% of All Expenditur

esState Total

% of All Expenditures

Individual JCTS

Placement and Training

$93,830.08 3.8% $117,158.31 7.1% $23,169.50 1.3% $60,998.80 5.9% $295,156.69 4.2%

JCTS Job Development

Services$145,132.05 5.9% $146,241.03 8.8% $24,155.59 1.3% $123,084.36 11.9% $438,613.03 6.3%

Individual SE Placement

and Training$604,669.53 24.7% $400,719.02 24.2% $655,491.46 35.9% $65,040.67 6.3% $1,725,920.68 24.8%

SE Job Development

Services$471,599.67 19.2% $264,960.46 16.0% $434,303.18 23.8% $107,274.27 10.4% $1,278,137.58 18.4%

Situational assessment

for SE$387,512.33 15.8% $111,719.53 6.7% $118,615.63 6.5% $27,551.04 2.7% $645,398.53 9.3%

All Other SE Services

$56,177.42 2.3% $37,855.80 2.3% $34,957.00 1.9% $27,788.00 2.7% $156,778.22 2.3%

Vocational Eval and Non-SE Situational Assessment

$480.00 0.0% $3,600.00 0.2%         $4,080.00 0.1%

Total $1,759,401.08 71.8% $1,082,254.15 65.4% $1,290,692.36 70.8% $411,737.14 40.0% $4,544,084.73 65.3%

Currently there are 197 clients who have been in situational assessment 40 or more days at a cost of $811,867.59

Case Master ID Counselor Office

Days in Situational

Assessment

Amount spent on Situational Assessment

Most Recent Situational

Assessment Current Status

432527 104 Danville 66 $4,064.58 07/18/2014Receiving Services

421599 104 Danville 67 $4,042.28 10/11/2011Receiving Services

1,057 Clients Currently Open Have Been In Job Development for 60 Days or More at a Cost of $2,723,581.42

Case Master ID Counselor Office Days In Job Dev.

Amount Spent on Job

Development

Most Recent Job Development

Service Current Status

419203 104 Danville 1219 $219.38 06/20/2011Receiving Services

445481 104 Danville 715 $617.11 11/05/2012Receiving Services

445419 104 Danville 740 $569.60 11/07/2012Ready for

Employment

464138 104 Danville 196 $1,963.00 07/10/2014Ready for

Employment

Currently 104 clients have been in SE Placement and Training for Over 100 Days

Total Cost of $962,761.72 (Max = $21,875.84)

Example:

Case Master ID Counselor Office

Days of SE Placement

and Training

Amount Spent on SE Placement

and Training

Most Recent SE

Placement and Training

ServiceCurrent Status

431130105

Martinsville105 $6,953.57 09/11/2014

In Employment

423137 109 Farmville 131 $8,573.95 01/10/2014Receiving Services

Tools to Assist You In Decision Making

Vendor score card shows you average cost and time to successful closure for each vendor along with type of jobs clients receive.

75% of our successful clients move from a supported employment service to “in employment status” within 4 months.

Strategies To Keep In Mind

Should there be a maximum number of hours before case is flagged for some type of action?

If so when?

Strategies

Would an AWARE alert/flag be of benefit?

A checkbox could be added

here

JCTS/SE Services Interrupted

Authorization V. Paid Amount SFY15

State Fiscal Year Originally Authorized Amount Paid DifferenceSFY 2011 $28,203,724.88 $18,663,643.88 $9,540,081.00SFY 2012 $20,905,376.91 $14,117,916.22 $6,787,460.69SFY 2013 $27,664,041.56 $18,960,858.57 $8,703,182.99SFY 2014 $37,465,520.90 $23,170,007.75 $14,295,513.15SFY 2015 $12,083,688.52 $6,371,671.86 $5,712,016.66Total $126,322,352.77 $81,284,098.28 $45,038,254.49

Over-authorizing in Group Auth

July 2014$801K

Over-authorizing in Individual Auths

July 2014$170K

Over-authorizing in Group Auth

August 2014$783K

Over-authorizing in Individual

August 2014$154K

Over-authorizing in Group Auth

September 2014$811K

Over-authorizing in Individual

September 2014

$195K

1st Quarter Over Authorizing

Jul-14 Aug-14 Sep-14Group 801K 783K 811K

Individual 170K 154K 195KTOTAL 971K 937K 1.006M

Exercise

What are some strategies to reduce spending for supported employment?

What are some strategies to reduce over authorizations?

Other thoughts?