1. Division of Intellectual Disabilities Services Recommended Fiscal Year 2010-2011 Budget

2. Slide 2 2 Change FY 2010 to FY 2011 Pos.StateFederalOtherTotal FY 20103177$69,791,300$2,058,600$763,769,800$835,619,700 FY 2011255530,905,9001,861,100695,309,100728,076,100 Reduction622$38,885,400$197,500$68,460,700$107,543,600 Other represents revenue from TennCare. This includes both the federal Medicaid reimbursements and the required state match. 2

3. Slide 3 3 % of Budget By Type of Program Fiscal Year 2010Fiscal Year 2011 65%16% 8% 7% 4% 72%11% 10% 3% 4%

4. Slide 4 4 $107.5m Reduction by Type of Program Program Funding Change % of Reduction % Reduction to Program Budget Developmental Centers$51.1m reduction47.5%38.5% State Funded Programs$35.5m reduction33.0%60.5% Home & Community Based Waivers $18.0m reduction16.7%3.3% State Community Homes$3.1m reduction2.8%9.4% Other$0.2m increase 4

5. Slide 5 5 Developmental Ctrs - $51.1m Reduction Arlington Closure $1.7m funded in FY10 with non-recurring funds $1.0m for transfer of utilities, court monitor expense, etc to West Regional Office $8.3 for final closure on June 30, 2010 85 Positions Abolished Clover Bottom Downsizing $9.2m funded in FY10 with non-recurring funds for transitions to private ICF/MR (129 Positions) Respites (25 positions previously intended for GVDC) $13.9m associated with downsizing to 32 beds (23 vacant positions abolished. 282 positions & $13.9 million restored with non-recurring funds for 6 months transition) 5

6. Slide 6 6 Developmental Ctrs - $51.1m Reduction Greene Valley – Reduce Census & Daily Cost $3.2m reduction for transitions to private ICF/MR $2.2m reduction for transitions to state-operated community homes $11.4m reduction of operational cost 210 Reduction in Force Major Maintenance - Reduction of $.2m 6

7. Slide 7 7 State Funded Programs $35.5m Reduction ProgramFunding CSN of West Tennessee (targeted to end 6/10) $18.3 million Wrap-around Services - Hospital Attendants, Household Establishment, Housing Subsidies, Some Dental Services, Class Transportation (effective date of 07/01/10) $9.5 million Consumer Directed Supports – (ended 12/31/09 ) $5.0 million State Funded Non-class Members$2.7 million 7

8. Slide 8 8 Home and Community Based Waiver Program $18.0m Reduction Exceeded waiver budget by $41m in FY09 $62.7m increase based on current enrollment and current level of expenditures $36.5m decrease from non-recurring FY10 funding $13.2m increase for growth of 108 people per year $57.4m decrease for targeted reductions 8 65% of Division’s FY10 Budget is waiver funding 72% of Division’s FY11 Budget is waiver funding

9. Slide 9 9 Targeted Waiver Reductions Reduction Waiver Amendment Estimated People Served Savings Dental - cap at $2500 per year Yes640$1.2m Nutrition - limit to 6 visits per year Yes871$0.4m Nursing - limit to 12 hours per day Yes130$14.3m Personal Assistance - limit to 50 hrs per week Yes1760$15.1m Environmental & Vehicle Accessibility Modifications - eliminate service Yes174$1.1m Individual Transportation - eliminate service ( 67% of people who receive PA receive this service) Yes1315$1.2m Remove RN oversight - adjust level 6 rates No1478$7.9m Revise Residential Rates No3344$16.2m 9

10. Slide 10 10 Proposed Waiver Rates Residential Rates range from Level 1thru 6. The higher the level, the more supervision is required. Addressed here are proposed changed to levels 2 thru 4. ServiceCurrent RateProposed RateDifference LON 4 Single Person Placement$484.20$364.65($119.55) SL 4- Two Person Home$294.35$277.75($16.60) SL 4-Three Person Home$247.35$232.60($14.75) Res Hab 4- Four Person Home$189.10$178.25($10.85) SL 3-Two Person Home$241.55$233.90($7.65) SL 3-Three Person Home$169.10$170.60$1.50 Res 3-Four Person Home$95.40$96.90$1.50 LON 2 Single Person Placement$206.95$138.75($68.20) SL 2- Two Person Home$148.75$138.75($10.00) 10

11. Slide 11 11 Proposed Waiver Rates Continued ServiceCurrent Rate Proposed RateDifference LON 1 Companion$176.55$102.55($74.00) LON 1 Single Person Home, Shift Staff$191.00$102.55($88.45) SL 1-Two person home$115.50$102.55($12.95) SL 1-Three person home$80.75$81.25$0.50 Res 1-Four person home$62.25$62.75$0.50 LON 6 Single Person Home$775.25$747.75($27.50) SL 6-Two Person Home$387.65$475.65$88.00 Medical Residential, Two Person Home$546.61$589.60$42.99 Medical Residential Three person$415.13$443.95$28.82 11 Note: Independent Support Coordination - Revising rate for people in ICF/MR’s from $232 to $175, a 25% reduction in rate for this category

12. Slide 12 12 Targeted Waiver Reductions *$205.96 Average Daily Rate FY 09/10 2.8% Over expenditure 7.2% State Revenue Decline *$185.30 Average Daily Rate FY10/11 *Average for all three waivers 12

13. Slide 13 13 State Operated Homes $3.1 Million Reduction East TN Homes $1.8m increase  Operational Funding for 4 additional homes  59 positions from GVDC  Non-recurring start-up funding West TN Homes $4.9m reduction  Abolish 77 positions 13

14. Slide 14 14 DIDS Contact Information James Finch, Ed. D., Deputy Commissioner 615-532-6538 Fred Hix, Assistant Commissioner, Administrative Services 615-253-6710 Debra Payne, Assistant Commissioner, Community Services 615-253-6885 Missy Marshall, Director of Public Affairs 615-253-2236 14