COBI 2015 - Utah State Developmental Center

Overview
Issues
Performance
Background
Financials

Sources Uses

FY 2016 Appropriation

The Utah State Developmental Center (USDC), formerly known as the Utah State Training School, is a publicly funded and managed Intermediate Care Facility for Individuals with an Intellectual Disability (ICF/ID). The center provides 24-hour residential and active treatment services. Specialized services include: medical and dental services; physical, occupational, speech, and recreational therapy; psychological services; social work; and day training.

Additional information regarding the Utah State Developmental Center can be found on its official website found at: Utah State Developmental Center

Funding History

Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $37,788,400 from all sources for Utah State Developmental Center. This is a 4.3 percent increase from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $10,850,200 from the General/Education Funds, an increase of 6.7 percent from revised Fiscal Year 2015 estimates.

Appropriation Adjustments

In addition to statewide compensation and internal service fund cost increases, the following appropriation adjustments were made during the 2015 General Session:

DescriptionOngoingOne-Time Disabilities Dental Program$0$200,000

OngoingOne-TimeFinancing Source

$0$200,000General Fund, One-time

Funding is meant to help provide specialized dental services statewide to individuals with disabilities.

Staff Analysis

For the most recent completed fiscal year, the following information represents the purposes for which the money was used:

Utah State Developmental Center Detailed Purposes

The Utah State Developmental Center is considered a statewide program including all rural areas and is open to all residents of Utah with intellectual disabilities eligible for care as determined by an intensive screening and governed by UCA 62A-5-3. For FY 2014, the daily cost of services for residents of the USDC was $491.51 per person ($179,400 annually). There is no statutory requirement for distribution of funds or allocation of slots by geographic region.

Percent of maladaptive behavior reduced from time of admission to discharge

Percent of direct care staff who have received outcome measures training within the last 3 years

Regarding the positive trend greater than 5% in the maladaptive behavior reduced from the Utah State Developmental Center (USDC) performance measures, the agency states, "During 2014 a crisis admission from the community to USDC occurred once a month, sometimes more often. These people came from a jail, an acute care hospital psych unit or directly from home. All these individuals were involved in some sort of violent behavior and most had assault charges pending. None of the forty plus community waiver providers in the community was capable or willing to care for these individuals. There was nowhere else for these violent people to go. USDC has seen an increase of very aggressive disabled individuals. The population mix at USDC is changing. The facilities in which these individuals go to in USDC are older and slated for replacement. Staff turnover in these areas is high. Regardless, teams at USDC provide early intervention, behavior support plans, medical support and psychiatric intervention. This early transition prevents a continuation of behaviors seen in the community. In other words, the team at USDC works very well right at the time of admission and even before to provide interventions that mitigate and reduce behaviors from the beginning. Individuals are helped at the onset and result in fewer behaviors needing reduction. If the plan works at admission and there are very few behaviors then there will be a negligible reduction in this number. This positive result reflects upon DSPD as a whole in the actions to control some very aggressive and assaultive individuals and the willingness of providers in the community to take them back once they have been stabilized. A community provider will now accept a transfer from USDC without a blemish free record. In the past an individual had to go years without a behavior before a waiver provider would accept their care. The number no longer needs to be zero so that percentage measure has increased.

Regarding the negative trend greater than 5% in the percent of direct care staff who have received outcome measures training from the Utah State Developmental Center (USDC) performance measures, the agency states, "Turnover rates in the direct care staff at USDC is high, 75%, making it difficult to get staff into Outcome training once they are hired and then retain them once they are trained. Outcome training involves a full week of training outside the direct care arena. There have been few weeks when the luxury of pulling staff out of direct care for a week at a time was possible. Reporting in FY 2013 was reported incorrectly initially but was corrected with a response similar to this year. The correct percentage for FY 2013 was 81%, 2014 65%."

In December of 1989, a class action lawsuit, known by the title of Lisa P., was filed against the state by the Disability Law Center and the Association of Retarded Citizens (ARC) of Utah on behalf of all residents of the USDC. A settlement agreement was entered into in October of 1993 that required an evaluation of each resident to determine appropriate placement. Due in large measure to the terms of the settlement agreement, USDC has seen its population decrease from about 425 in 1991 to 203 today.

The Developmental Center has restructured its delivery system. This has involved remodeling many of its dormitory-type housing units into apartments with one to three bedrooms which has provided more independence and privacy for its residents. This has altered the Center's care delivery system, requiring a greater staff-to-client ratio. This has served to decrease the behavior problems of residents and improve their quality of life.

Intent Language

SB0002: Item 83

The Legislature intends the Division of Services for People with Disabilities (DSPD) in the Department of Human Services provide to the Office of the Legislative Fiscal Analyst no later than September 1, 2015 a report that includes a(n): 1) response to each specific audit recommendation found in A Performance Audit of the Division of Services for People with Disabilities (October 2014 - Audit No. 2014 - 10), 2) identification of specific efficiencies gained by DSPD through implementing the audit's recommendations, 3) estimate of savings, if any, achieved through implementation of each recommendation, and 4) measures that demonstrate effective implementation of each recommendation. The Legislature further intends the Office of the Legislative Fiscal Analyst provide the report to the Office of the Legislative Auditor General (OLAG) and that OLAG review the report in order to assess: 1) if the measures accurately demonstrate effective implementation of the recommendations and 2) the accuracy of the savings estimates, if any. The Legislature further intends OLAG report its review of the DSPD report to the Social Services Appropriations Subcommittee.

SB0002: Item 83

The Legislature intends that for the building block titled "DSPD - Direct Care Staff Salary Increase," the Division of Services for People with Disabilities (DSPD) shall: 1) Direct funds to increase the salaries of direct care workers; 2) Increase only those rates which include a direct care service component, including respite; 3) Monitor providers to ensure that all funds appropriated are applied to direct care worker wages and that none of the funding goes to administrative functions or provider profits; 4) In conjunction with DSPD community providers, report to the Office of the Legislature Fiscal Analyst no later than September 1, 2015 regarding: 1) the implementation and status of increasing salaries for direct care workers, 2) a detailed explanation with supporting documentation of how DSPD providers are reimbursed, including all accounting codes used and the previous and current rates for each accounting code, and 3) a conceptual explanation of how DSPD community providers realize profit within the closed market of providing DSPD community services.

SB0003: Item 134

The Legislature intends that the $400,000 in Beginning Nonlapsing provided to respite care for individuals with disabilities in the Division of Services for People with Disabilities is dependent upon up to $400,000 funds not otherwise designated as nonlapsing to the Department of Human Services - Division of Substance Abuse and Mental Health line item being retained as nonlapsing in FY 2015.

SB0003: Item 134

The Legislature intends that the $75,000 in Beginning Nonlapsing provided to respite care for individuals with disabilities in the Division of Services for People with Disabilities is dependent upon up to $75,000 funds not otherwise designated as nonlapsing to the Department of Human Services - Executive Director Operations line item being retained as nonlapsing in FY 2015.

SB0007S01: Item 28

The Legislature intends that the Division of Services for People with Disabilities (DSPD) use Fiscal Year 2016 beginning non-lapsing funds to provide services for individuals needing emergency services, individuals needing additional waiver services, individuals who turn 18 years old and leave state custody from the Divisions of Child and Family services and Juvenile Justice Services, individuals court ordered into DSPD services and to provide increases to providers for direct care staff salaries. The legislature further intends DSPD report to the Office of Legislative Fiscal Analyst on the use of these non-lapsing funds.

SB0007S01: Item 28

The Legislature intends that the Department of Human Services report on the following performance measures for the Services for People with Disabilities line item: (1) Community Supports, Brain Injury, Physical Disability Waivers, Non-waiver Services - % providers meeting fiscal requirements of contract (Target = 100%), (2) Community Supports, Brain Injury, Physical Disability Waivers, Non-waiver Services - % providers meeting non-fiscal requirements of contracts (Target = 100%), and (3) People receive supports in employment settings rather than day programs (National ranking) (Target = #1 nationally) by January 1, 2016 to the Social Services Appropriations Subcommittee.

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Expenditure Category

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Appropriation History by

Sources of Finance	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
General Fund	6,579,300	9,106,000	10,808,400	12,554,000	10,135,300	0	10,135,300	469,600	10,604,900
General Fund, One-time	(884,400)	0	0	16,900	34,200	0	34,200	211,100	245,300
American Recovery and Reinvestment Act	2,129,600	(2,000)	0	0	0	0	0	0	0
Dedicated Credits Revenue	2,623,100	2,083,600	1,665,000	1,870,900	1,709,300	0	1,709,300	70,200	1,779,500
Transfers	0	0	0	0	0	0	0	932,300	932,300
Transfers - Medicaid	21,620,100	21,376,500	21,721,900	23,724,200	24,337,400	0	24,337,400	(111,000)	24,226,400
Transfers - Within Agency	(21,800)	0	0	0	0	0	0	0	0
Closing Nonlapsing	(30,300)	(254,200)	(240,900)	(2,030,700)	0	0	0	0	0
Lapsing Balance	0	0	(100)	0	0	0	0	0	0
Total	$32,015,600	$32,309,900	$33,954,300	$36,135,300	$36,216,200	$0	$36,216,200	$1,572,200	$37,788,400

Categories of Expenditure	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Change	FY16 Approp
Personnel Services	25,611,400	25,469,100	26,435,700	26,886,400	29,285,000	22,000	29,307,000	1,427,300	30,734,300
In-state Travel	100	300	800	300	3,000	0	3,000	0	3,000
Out-of-state Travel	0	0	800	0	3,000	0	3,000	0	3,000
Current Expense	5,758,900	5,360,400	4,922,200	6,438,300	5,527,500	3,700	5,531,200	119,000	5,650,200
DP Current Expense	645,200	868,500	910,500	1,022,700	945,700	(25,700)	920,000	25,900	945,900
DP Capital Outlay	0	0	105,500	21,800	0	0	0	0	0
Capital Outlay	0	385,100	1,345,300	1,569,700	452,000	0	452,000	0	452,000
Other Charges/Pass Thru	0	226,500	233,500	196,100	0	0	0	0	0
Total	$32,015,600	$32,309,900	$33,954,300	$36,135,300	$36,216,200	$0	$36,216,200	$1,572,200	$37,788,400

Show Table | Show Additional Information

Other Indicators	FY11 Actual	FY12 Actual	FY13 Actual	FY14 Actual	FY15 Approp	FY15 Change	FY15 Revised	FY16 Approp
Budgeted FTE	591.20	597.50	604.50	601	604.50	(1)	603.50	603.50
Actual FTE	533.47	546.10	567	563.60	0	0	0	0
Vehicles	46	47	47	42	47	(5)	42	42

COBI contains unaudited data as presented to the Legislature by state agencies at the time of publication. For audited financial data see the State of Utah's Comprehensive Annual Financial Reports.