MINUTES OF THE MEETING OF THE JOINT APPROPRIATIONS SUBCOMMITTEE ON HUMAN RESOURCES January 15, 1981

The meeting was called to order at 7:15 a.m. by Chairman Hurwitz. All subcommittee members were present except Senator Story who was excused.

DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES (SHS)

vocational Rehabilitation Program

John LaFaver, Director of SRS, told the subcommittee the major concern with this program is the decrease in SociaL Security federal funding which wiLl cause a significant decrease ln the services now being provided by this program.

Bob Donaldson, Administrator of the Rehabilitative Services Division, told the subcommittee there are two programs within this division. They are the Vocational Rehabilitation Program and the Disability Determination Program. (EXHIBIT 1)

The Vocational Rehabilitation Program (VR Program) is funded with 80% tederal funds and 20% state funds. Subcommittee mem­bers received copies of the proposed budgets made by the LFA and Executive for the VR Program. (EXHIBITS 2 and 3) He also gave out copies of the general agency accomplishments of the program. (EXHIBIT 4)

Mr. Donaldson went over the handouts with the subcommittee mem­bers. He explained the Section 110 funding is the 80%-~0% monies he had mentioned earlier. He handed out copies of the VR Program's list of offices which will be closed and the sav­ings realized by those closures. (EXHIBIT 5) The program's FTE count will be lowered by nine and the savings realized will be $9,240 in operating expenses and $118,000 in personnel costs.

Judy Rippingale, acting legislative fiscaL analyst, was asked how the LFA figured personal services amounts for FY'8l. She told them the figure is 19% higher than personal services for Fy'80. The LFA took money out in proportion to the way the federal funds are dropping off.

Representative WaLdron asked what the cost per client was in each program. Mr. DonaLdson told him the tederal report shows that breakdown and he wouLd get Representative Waldron a copy.

Representative WaLdron stated there was a 67% increase in cost per client in the SSI funds from FY'79 to FY'80. He asked why there was such a large increase. Mr. Donaldson told him one or two very expensive cases can throw those figures off.

Minutes of the Meeting of the Joint Appropriations Subcommittee on Human Resources January 15, 19H1

John Harp spoke in support of the Flathead Industries in Kalispell. He thinks it is a very worthwhile industry. people he has hired from there do better than the people used to hire.

Page 2

The he

Senator Aklestad asked how many psychologists were gram. Mr. Donaldson told him the program does not psychologists as full-time employees of the state. contracts out for them.

in this pro­employ any

'l'he program

Judy Rippingale asked why the federal funding is falling off. Mr. Donaldson told her the federal government feels they are no longer getting the number of clients they used to have and therefore not justifying the amount of money they used to put in. She also asked if they spent money for the SSI and if so, was more money spent per client because the number of clients dropped off and money needed to be spent. Mr. Donaldson told her the bulk of people who need vocational rehabilitation were SSI cllents and S5I is an expensive service.

Senator Regan said the office at Crow Agency averaged $16,000 per client which she feels is very high. She asked why that amount was so high. Mr. Donaldson told her the clients (22 served) were coming into the program and staying because they were difficult to rehabilitate. Senator Aklestad asked if the federal government has a program similar to this that would be a duplicate service on the Indian reservations. Mr. Donaldson told him no.

Bill Vollmer, Administrator of the Disabiiity Determination Bureau, gave subcommittee members copies of the proposed budget for FY'H2 and FY'83 and information sheets on the Bureau. (EXHIBITS 6 and 7) He went over EXHIBIT 7 with the subcommittee.

Judy said she had one concern and that was the anticipation of more federal funds. She said if the agency wants more spending authority, they should line-item that program in their budget.

Bili Crlveilo, representing the Montana Association of Rehabili­tation Facilities, said the rehabilitation facilities in Montana provide community services for mentaily retarded, emotionally disturbed, etc. He read a prepared statement to the subcommittee. (EXHIBIT 8)

Chairman Hurwitz asked Mr. Crivello what the rate of pay was for the people who work through the rehabilitation facility. Mr. Crivello told him they are paid either minimum wage or are paid on a piece-rate basis. That is, if the client is 50% of

Minutes of the Meeting of the Joint Approprlations Subcommittee on Human Resources January 15, 1981

Page 3

productive, then he gets SO% of what a non-disabled person would get for the same jon. He said if correctLy placed, the people in this program are very consistent and hard working.

Senator Aklestad said in 1979-80, placement for clients in the VR Programs was down, yet the number of clients was up. Mr. Crivello told him they began serving more severely impaired clients so the success rate would not be as high.

Senator Regan asked if there were other sources of funding other than contracts from within the community. Mr. Crivello told her the facilities derive their income from the Disability Deter­mination Bureau and the VR Program for contracted services and they procure work in the communities. The money derived from these contracts is used to pay for the cost of production and time for the clients. Because of the non-profit status, the facilities must put the money back into the facilities.

Senator Aklestad asked why there are such varlances between the LFA and Executive budgets in the travel category. John LaFaver told him the LFA used a much smaller inflation factor than the ~xecutive and the LFA recommended 18 fewer FTEs.

Senator Regan asked about the Renal Disease Treatment Program. Now that there are federal dollars available for that program, .she asked if the state should be involved. Mr. Donaldson told her there were 100 clients being served in that program at an average cost of $1,500 per client. Only one person out of the 100 does not qualify for Medicaid or Medicare. Senator Regan said we have to make a decision on making our state dOllars go as far as they can and should we continue funding this program or not. She said if there is a real need for this program, then the state should help wlth the funding but if the program could be terminated without harming the people served, then we Should stop funding the program. Mr. Donaldson said it was his opinion that the people now being served will continue to be served under some other program should state funding be discontinued. Mr. LaFaver said it is clear that if faced with cut backs, this would be the one area SRS would want to look at being cut.

Senator Aklestad asked what the savings would be if the Renal Pro­gram was dropped. Mr. Donaldson told him there are no FTEs involved with the Renal Program but there is a $150,000 state appropriation for service that would be saved.

Representative Waldron said if clients would get service whether we have the Renal Program or not, this subcommittee should make the recommendation to the Appropriations Committee to drop the program. Senator Regan suggested having some sort of gUideline that said these funds are to be used only when there is no other

,

Minutes of the Meeting of the Joint Appropriations Subcommittee on Human Resources January 15, 1981

Page 4

funding available for that client. If that couid be done, then the amount being appropriated could be quite a bit lower. She asked the people from the VR Program to look at the Renal Pro­gram again and come up with a figure that would be appropriate to serve clients who do not have any other funding available to them.

Ron Weiss, Office of Budget and Program Planning, suggested putting wording in the proposal to the effect that funds would be used in a life-saving situation. Mr. LaFaver asked when this subcomnittee would like to have thlS information. Judy asked to have it by Friday, January 16, 1981.

Senator Regan asked how many rehabilitation facilities would receive money from the contracted services category of this budget. Mr. Donaldson told her the VR Program contracts out to five facilities. Mr. Crivello told the subcommittee each facility is responsible for developing the potential for placement of severely handicapped clients and the $108,000 WOUld be used for people who work as placement officers. Mr. Donaldson told the subcommittee the $108,000 is a 80%-20% match. Judy broke down the $109,554 expenditure in FY80 for vocational rehabilita­tion placement. Forty-six tnousand dollars of the money was matched 80%-20%; $32,000 was for a special project that was' 100% third party funded; and $31,321 of Section 110 money was used ana the match was put up by a third party so no state funds were actually used. The LFA put all the Section 110 money in the budget but did not divide it up between the different programs.

Senator Regan said if all the Section 110 money is in the budget, then there is enough to continue the contracts already being served.

Senator Regan asked again if the $2,620,361 is all the Section 110 money but just not distributed out among the programs. Judy told her that was correct.

Senator Regan told Mr. Crivello that the Section 110 money is available to continue his facility's contract if it is a priority with the SRS VR Program.

The meeting was adjourned at 10:00 a.m. /'

J ~/ I • .,,; 1 /" ~ ..-..~

, -" I -/ 1 I -; /":'-~""t/' _~ -- ... .(.1 [L' / ',;,/ mURT HURWITZ, Chairman' .

vrnl

Exhibit 1 1/15/81

DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES

Rehabilitative Services Division

A. REHABILITATIVE SERVICES BUREAU:

This is the principal state program to provide needed services to voca­tionally handicapped people, of employable age, to restore them to gain­ful employment. Program emphasis is on serving first the severely disabled. Required Vocational Rehabilitation Services will be furnished an individual if found by diagnostic study to require such services.

Eligibility for Vocational Rehabilitation will be determined upon the basis of these established criteria: 1) the presence of a physical or mental disability, which for the individual constitutes or results in a substantial handicap to employment; and 2) a reasonable expectation that vocational rehabilitation services may benefit the individual in terms of employability.

Vocational Rehabilitation Services means any goods and services necessary to render a handicapped individual fit to engage in a gainful occupation. These include: evaluation of rehabilitation potential; counseling, guidance, and referral; physical and mental restoration services; voca­tional and other training services; maintenance; transportation; services to members of a handicapped individual's family necessary to the adjust­ment or rehabilitation of the handicapped individual; interpreter ser­vices for the deaf; reader services, rehabilitation teaching services, and orientation and mobility services for the blind; telecommunications, sensory, and other technological aids and devices; recruitment and train­ing services to provide new employment opportunities in rehabilitation, health, welfare, public safety, law enforcement, and other appropriate public services employment; placement in suitable employment; post­employment services necessary to assist handicapped individuals to main­tain suitable employment; occupational licenses, tools, equipment such as initial stocks (including livestock) and supplies; and other goods and services which can reasonably be expected to benefit a handicapped individual in terms of his employability.

Administration of non-VR Program for Life Saving Treatment for Chronic Renal Disease only with State dollars.

FUNDING: 80% Federal - 20% State The 1978 amendments to the Rehabilitation Act of 1973 (PL 95-602) Title I Section 110

Part 1361, Chapter XIII of Title 45 of Code of, Federal Regulations.

B. SPECIAL PROJECTS BUREAU:

This Bureau has been specifically assigned to ensure the effective estab­lishment and utilization of rehabilitation facilities, especially the work and evaluation oriented ones; to implement special rehabilitation

projects or programs in Montana for the most beneficial use of rehabili­tation clients and others; to evaluate the effectiveness of the Voca­tional Rehabilitation Program in Montana; and to monitor the expenditure of special funding available from Social Security Administration and Worker's Compensation Division for VR services.

Objectives:

1. To expand usage and resource power of the existing comprehensive rehabilitation work facilities, and work activity centers.

2. To promote usuage of such rehabilitation facilities by other than the State rehabilitation agency.

3. To assure appropriate professional and legal certification of reha­bilitation facilities.

4. To continue the development of comprehensive rehabilitation centers in a major population area.

5. To increase the number of Industrial Accident applicants and bene­ficiaries, Social Security beneficiaries, and Supplemental Security recipients served and successfully rehabilitated.

6. To direct special projects monies to the appropriate recipients. 7. To coordinate planning and implement evaluation for the vocational

rehabilitaiton program. 8. To subsidize extended employment services in workshops and work

activity centers. 9. To provide appropriate training to all levels of the VR staff.

Parts 1361 and 1362, Chapter XIII of Title 45 of Code of Federal Regulations.

C. DISABILITY DETERMINATION BUREAU:

The Disability Determination Bureau is responsible for allowance and denial decisions on applications for Social Security Disability Benefits on Montana residents. The primary purpose of the Disability Insurance Program is to provide partial replacement of earnings lost because an individual is precluded from engaging in substantial gainful activity due to a physical or mental impairment.

Applications for Supplemental Security Income Disability Benefits are also adjudicated by the Disability Determination Bureau. This is a new Federal Assistance Program which provided a national income floor for the aged, blind and disabled who have met an income and resource requirement.

This program is administered by the State of Montana (DSRS) for the Social Security Administration.

FUNDING: All Funding for the Disability Determination Bureau comes from the Social Security Administration, Bureau of Disability Insurance.

Title II and Title XVI of the Social Security Act.

RSD1/b

2

- AGENCY S/fs PROGRAM /IJ I/~ ~-.dt:I;/t;,v

Name SubProgram _____ ..!..-.. __________ _

-EXPEND. 1982 BUDGET

1980 Exec. Fiscal ~xec-LFA .. Actual· Budget Analyst. Variance FTE <ff~ .. '15 '8'5;Ij~ 661Sh /?"gf

Personal Svcs. //62~// 1'19162'1 9~3270- lf7t; 351 - " Operating Svcs.

21 Contr. Svc. 5t:f~71 7rJ3Z1 t?52cgZ. 5o;rf

22 Supplies· ~327 9909 11bg 71// 23 Commun. 41555 bZ;5h L)'1n~ j'5/pg - 24 ,Travel 7/05<6 9397'7 75"210(; /37/3 25 Rent g 7~'f(, /01153 9C,CJO! lZ(P5Z-26 Utilities .'. -27 Repairs 200'2- 2"7 2Z6~ '1to/ 28 Other 370/ 3701 LJ9tLf.o ·z/Zl/i) - SubTotal,

Opere Exp. 2~Z.%O 3523'1l1 Jozl/57 ij2y'13Z-31 Equipment 3/.35 /200 3L/..tiR /Z21p(P)

Subtotal Il/l/g/o? /g/32/~ 1295/73 5/Z0Z5 .. NonOperating

1. &:1i:;.~; ~~~ ;).--oiJ' : r5m) ;2{5 0 tJD :J-a 0, irv-D' s ?l5'V

.. ! 2 . ~~ J 4/: ;;J.3J J b:2. ()1Ji) 'lbS. 00\): 3 a-zrU

3. IJflO"J.~M,.';.l:n... ~d...30,'o6fc ~'!>fD. g5:;>...... ~, 3.9-23'J-:k - -

4. :::;~A Q" LL lDQ' SSlj J ..

/0<6. ozri) J O~1r1JV OJ -O~ /5 b!oLf. "

--

5. J4f.

L//1/L/50} L/f,Y! 070 NOO75f15' 67ft/&; TOTAL EXPEND. "- ./ -

Funding - Gene'ral Fund e I "2, ~/~ ;; '. It.,./, ."..,. J 1L/o 9pi <g8o~3 \- 54SE} 93

Other Funds

1 . ~£/ :J ! n '--I b I /DC,;,lSD . /00, 'J5-D -<l-

2. ~;,;,... liD {) 4 c'boSfo :2 b?-o'3t:,1 ~,0:;oafol -.,..-

3. ~1~ J..fRS 7/0 cX!. c"" ~j(fD I :ZS~?rro "-0, -;-

4. hlo~i., ~1i 'C' 10 Ci CJ5 19t 30'7 I ~9 331j ;)'15-_1

... 5.~ f ~ ::::: <:::" (~ ~ J--', /Q L/FJ ,-

': ) ~ -3(:.0 S'f Y ;L/fY6103k c ~:'.'

." -73'1SI M~ - :7 $ --" ~ :..

Exhibit 2 1/15/81

Executive Budget Page 7/.55 FiscaL.. Analyst's Page 1a7Z-

1983 BUDGET Exec. Fiscal ~xec. -LF

Budqet Analyst Variance ~5, £/5" b3,77 Zl,h~

/LJ6aS?5' 71/3~/ 5/921'l

7bCW 6go,!C? 775'1 ji/ztfz 7'919 J2J{9

0f/5/ 573'~ J/755 /o~ o7~ 7ZZ£;3 -Z1<lL3 /ZOC,3(P . lolt/O~ 11230

,

'3tJS(o 23// 7'15 3701/ 9~'i 27 J/a

311if7/ 3171<65 73 fit, 1200 3~31 <2tf3l?

/~5321& 12b?'J77 ;-.:10 i b1 -::J/ '""

.:L3 U,cP]'i) .;2 v;;,:,en-o 1::1.. v:ro -~

/;&:ro I 7~ 00'.) 1 ~ J; ~<) v"""O

:~.$'?~ 731 oZ Y:;" 9 '/31j. i< ~.

/

t> ID~ ij-:JD k / OR ,jUT.,) J f 0

'I?~/f<63 I (L; 1/5 OJ ,,-:: ) '8'1b072 '- ./

-/ t:, 3?' ??'I '1211a51 --690J)JS

/ DG .'2.0 1()6 ;2.$0 ---c.:j--

.'

;;'7~5:D91 ;)9'/5091 -0-

../ . , ;2~, "'7r-" dSb70') r- u-~ --

192 //9 ;lo9 v:.:.:. JO, 103

If, ()'~ ~ I[?,?-{,:J ':3~ I 1./ 2. "'2.. (;l,O - - •

- IJlb1~'t ~~ r.,.'_"'II~

Exhibit 3 1/15/81

VR - 1982-83 Budget Prepared 1-13-81

GOALS: To furnish on going rehabilitative services currently being provided, (which is considered a minimal level), for 1982 and 1983.

During 1980: 8,190 vocationally handicapped Montana citizens were served by this State-Federal Program (80% Federally funded) with 1,066 clients placed into gainful employ­ment, (an increase of 25 over the previous year).

New referrals to the program in 1980 indicatsc ar. increase of 370 over 1979.

For 1981 it is anticipated to serve 9,600 handicapped with 1,150 being able to obtain gainful employment.

The program had a decrease in Federal Funding; from Social Security for use on recipients of Social Security Disability Insurance and Supplemental Security Income.

However, this shouldn't justify taking the $300,000 decrease al: from our 1982 budget for personnel. The decreases in Federal Funding from Social Security caused a dollar decrease in funds for personnel in 1981 over 1980 of $115,000.

1980 Personnel - Auth. $1,290,880

From Social Security $ 279,649 for Administration

Total All Funds $4,394,116

1981 $1,385,636

$ 164,128

$4,236,271

LFA 1982 $1,071,765

$ 165,000

$4,096,080

OBPP 1982 $1,459,629

$ 165,000

$4,639,070·

For 1981 there was $115,000 less from Social Security to help administer the program. Yet for 1982 $313,871 in the LFA Budget was taken from oersonnel -twice as much as the actual loss of funds.

Notice also, our overall budget authorization for 1982 is $140,191 less than actual funding for 1981. In 1981 there was $100,000 less in case service funds than 1980.

The funds available from regular federal sources will increase not decrease, part of law can't receive less of section 110 funds than did year before.

State appropriation for the State-Federal VR Program.

1977 $499,060

1981 $540,342

1982 $510,000

To keep up with inflation would need $765,000 to maintain a 1977 level.

We are attempting to provide a quality service, comply with our legislative audit (which requires more staff time documenting, etc) with less state funds. We would be taking longer to see clients, provide service later, doing poor documentation.

- L -

In 1974 when I was appointed Administrator, there were 13 staff in our central office, now there are 9.

In the last session 7 FTEls were taken as they were empty. 19 additional will cause major cutbacks in this program. In 1979 we were authorized 92 FTEls, for 1983 it could be 64 FTEls a decrease of 30%.

The Non VR Kidney and Extended Employment programs are all state funds and all service funds. In effect the State-Federal VR program is paying administrative costs for these programs. With decreases in VR staff and personnel funds, by 1983 10% of our staff time will be spend on Non VR activities and this could be a federal audit exception. The legisiature has always been generous with the Non VR Kidney Rrogram, but this session is contemplating drastic cuts in the Federal-State VR program. If cuts have to be made the preference is to discontinue or reduce funding of the Non VR Kidney program, with these funds utilized for the Federal-State program.

MONTANA

GENERAL AGENCY ACCOMPLISHMENTS

EX~libit 4 FY - 80 1/15/31

At the end of the 1980 fiscal year this agency had 4,454 open cases, with 8,190 clients served; 1,066 rehabilitated. In-service training and staff conferences have stressed the national and state priorities, the severely disabled, and the Industrial Injured. The average cost of services provided during the fiscal

. year was $781. 50% of those closed as gainfully employed were severely disabled.

Severely Disabled. 4,194 clients who met the definition of a severe disability were served during the year, 51% of those served. Of the total rehabilitations, 538 or 51% were severely disabled. Through in-service training and staff conferences staff are being indoctrinated to increase service to this group.

Mental Retardation. 874 clients with this disability were served at an average· cost of $1,136. 153 clients were rehabilitated with this disability during the year.

91 clients were served during the fiscal year at an average 12 clients being successfully rehabilitated.

Epilepsy. 203 clients were served in the fiscal year at an average cost of $803, 31 of them rehabilitated. Increased emphasis on clients with epilepsy and outreach to this group will be continued.

Emotionally Ill. 568 clients were served, and 64 were closed as successfully employed that had been patients in the State Mental Hospital--average cost of $600 for these cases.

Deaf. This agency has a state coordinator for the deaf who also is a rehabili­tation counselor for the deaf. Currently the state has 3 counselors who can communicate with the deaf located in Missoula, Great Falls, and Billings.

This will provide better services to the deaf client and also let the agency coordinate VR activities with other agencies involved with the deaf such as the School for the Deaf and Education Agencies.

The division is actively working with the Montana Association of the Deaf and the Montana Registry of Interpreters for the Deaf to both increase the number of interpreters and the number of certified interpreters within the state.

Deaf: 170 served with 32 rehabilitated at an average case cost of $1,349. Hard of Hearing: 172 served with 39 rehabilitated at an average case cost of $814.

Public Assistance Recipients. 1,512 clients were served, with 182 rehabilitated. VR staff served on the WIN teams throughout the state.

Alcoholism. 376 clients received service during the year at an average case. service of $350, with 41 of them rehabilitated.

- 2 -

Manpower Related. RSD had a total of 55 clients in various CETA programs in FY 179. With 20 placed in gainful employment. 84 joint cases with the WIN program, with 19 placed in gainful employment VR coordination with manpower related programs has increased a great deal the past year. A State Occupational Information Coordinating Committee (SOICC) has been formed and this should also increase coordination of programs for more comprehensive service to applicants, plus increase program evaluation.

Minority. Efforts for the minority client, primarily the Indian have been in­creased. VR staff are working on all of the seven Indian reservations in the State with staff hired from the reservation working with their own people pro­viding VR services. 516 Indian clients were served during the year.

Beneficiary Rehabilitation Program. A total of 44 Social Security Disability Insurance beneficiaries were rehabilitated under the Trust Fund program. This was 61% of the projected goal. Persons served in this program numbered 556, 68% of the projected goal. A total of 179 certified Trust Fund clients were on the active caseload (status 10-24) at the end of FY 180.

Supplemental Security Income. A total of 18 certified SSI clients were rehabili­tated. This was 36% of the projected goal. Persons served in this program numbered 334, 53% of the projected goal. A total of 103 Certified SSI clients were on the active caseload (status 10-24) at the end of FY 180. Five regional peer reviews were conducted in the state; these reviews were planned so that a large number of SSI/SSDI cases were carefully reviewed.

Rehabilitation Facilities. 1,225 plus state agency clients utilized eight (8) rehabilitation facilities (seven work-oriented and one medically-oriented). All of these clients were referred to a facility and then subsequently assessed by an assessment needs committee at each facility. All rehabilitation facilities in Montana utilized by VR are CARF accredited. In addition, all of these facilities are involved in systems of program evaluation, the results of which are used to feed specific requested information back to the VR agency in the form of a Management Information System.

Program Evaluation. A number of accomplishmenns were realized in the padt year in the area of Program Evaluation. The sixth state report was submitted in response to the General Standards for the Evaluation of Programs and Projects. The report included a variety of tables with pertinent information broken out by each district office. This information should be particularly valuable in terms of caseload management. An evaluation of the Statels Extended Employ­ment Program in facilities was completed. Also, two reports, one on the referral flow between the RSD and DDD programs, and one concerning the use of Counselor Aides, were filed. For the first time, a segment on Program Evaluation was presented at RR-CEPls Orientation for new Region VIII staff. Other areas in which new ground was broken included a report on the use of specialized counselors with Social Security cases, and a new system to conduct follow-up studies on closed cases. In the planning area, a contingency plan was developed in the event severe cutbacks are required, and newly revised goals and objectives were established for all segments of the program.

- ~ -

Staff Development. The emphasis remains on training RSD staff on the current rehabilitation resources for the severely disabled. Special emphasis has been placed in the area of job placement for disabled clients. All training is coordinated with SRS Staff Development, Regional RSA offices and the Regional Rehabilitation Continuing Education Program at the University of Northern Colorado.

Industrially Injured. 383 industrially injured clients were referred through the RSD-WCD coordinated program. This is an increase of 33% over the previous year. There were 165 successfull rehabilitations and the active caseload was 681 clients at the end of FY 80.

Non VR Programs:

Extended· Employment. A total of 63 (all severely disabled) individuals were eligible for and did participate in extended employment services in seven (7) rehabilitation facilities. This state funded VR administered program was initiated to subsidize overhead costs incurred in VR certified sheltered workshops and work activity centers who are providing sheltered employment and work activity services to severely disabled persons.

Kidne Pro ram. The 1975 legislature enacted this program and appropriated 200,000 for the biennium. The appropriation for the 1980-1981 biennium

was increased to $300,000. The legal intent of the program was and is to provide life saving treatment and related case services for people medically diagnosed as having Chronic End Stage Renal Disease. Basic program components remain: 1) to financially assist CESRD patients with treatment costs when necessary.to prevent a serious family economic inbalance; 2) to ensure the appropriation does not supplement other existing Department of Social and Rehabilitation Service program budgets; 3) to secure and utilize all other federal, state, and private funding as the first dollar resource. During the first five full years of operation the program delivered services to 134 eligible people. 40 patients have left the program for varying reasons and 94 patients remain. The average service costs per patient approximated $1,100 for FY 80. It is anticipated the program will increase by 26 new patients per year and at what level the program stabilizes remains to be seen. 10% increase annually with 10% leaving the program yearly. Only time will indicate if the present level of funding will meet the basic needs.

* * * ADDENDUM * * *

The 958 Montana Citizens placed in competitive employment during 1980 earned an average yearly wage of $8,848. In addition there were 65 persons restored to their role of a homemaker, 16 unpaid family workers and 27 placed at their highest level of performance in sheltered employment. This makes a total of 1,066 rehabilitated during the year.

CI~OW Agency

Current Caseload

00-24

22

REDUCTION IN FORCE

Physical & Personnel

Costs

Tel e ~_ho_n_e_-;r-$ _~2~5/.,...-n_1O_ Rent $ 125/1110 S"l I il r-v-----;rS-9",-=7"4-=>7'1 :-n-' -

lnL: ~ .. ., - ~. - ,

:. :...'-+ I / '

Exhibit 5 1/15/81

Travel & Office Budget

FFY '79

Travel $ 900

Cudoet $ 3,500

~ ",.r, - . -; • -r .;,;

--------.-;11, ____ - --_._--------- -------~-----

Telenhone 5: 25/rno Hellt"- S 125/1111.;

P,)plar 13 Salol:'': S H,959/yr

Totill $10.759/yr

. __ . -=--="0'-. -.-_ ----

Lame D~er 29

Total

Telepho~n~e ______ ~O~ __ Rent 0

Deer Lodge

( ! ______ -1

B)'ovm; ng

,.. 1 r; i Inr ' ~ -_ .. ~-{'I

.)J ~,lS()/YI •

$ 9,330/yr

33 Sal u I'V S 13 • 57~b~ i _~_,~_!91;Y ~r},~9~/YL I I =-_' u_~_t._. ___ .,,_-_-_'_'.~--"",' I=_V=-'~ . -r 1 C !.~~:...:..IC:_!l-=-e -7----;-:­

I' (): ' : -~d·j(lr" ! ~-ta 1 __ ---:..._!...C.---'-''-_

45

I

HIS!;,'

$ 100/mo . \ $ 50/rno

Ronan IOU $ 8,959Lvr

Total $10.7~9/yr

I

T I'ave 1 Caseloaa Budqet

lot21 Cost::

Case'load --.B!l.ciq e t

Total (rst

L3SE::IOoG

budget

Co::::

~ '-.'::" ...... ................

~ ~Jace t

Total Cost

[:Jseload r:' Jdoet

lota1 Cost

$ 900

$ 3,044

$ 3,944

$ 4,290

$ 5,390

$ 400

$30,000

$30.4C~

$ Sr:;1 .. 1.'

$16,910

S 1,400

$15,000

$16,400

_1-,,_2 '_.'FJ...:..I ____ x..$ _...!..7~O:.-"!0_ Case10ad GlJdo~e~t ______ ~$~1~8~,~OO~0~

Total Cost $18,700

REDUCTION IN FORCE

*This chart a reduction of 9 FTEls, a savings of $9,240 in operating expenses and $118,000 in personnel costs.

Three counselor aides in Great Falls, Billings and Glasgow would save $36,300 in personnel costs.

The four special counselors for Social Security caseloads would save' $80,000 in personnel.

After a reduction in force imposed by the legislature; this would mean:

16 FTEls saved and a reduction in administrative costs of: Operating Expenses $ 9,240 Personnel $234,300

The three unfilled Dosi+ions at this time would equal 19 FTEls and $279,000 in personnel.

The difference between the LFA Budget and the Governors Budget in personnel services is 5387,864. The $108,864 remaining would have to come from benefits and claims.

*Chart on reverse side of offices to be closed.

FTE

Personal Svcs.

EXPEND. 1980

Executive Budget Page f/s, Fiscal, Analyst's Page ~

Operating Svcs. r-------..-----+---------......----_-----.---21 Contr. Svc. ~~~~~~~~~~~~~~~~4-~~~~~~~~--22 Supplies

23 Commun.

24 Travel

25 Rent

26 Utilities

27 Repairs

28 Other

SubTotal,

Oper. Exp.

31. Equipment

Subtotal

NonOperating

2521

/'-/2

1.-________ r-2_2~72~1~_3~~~~5~O~~2~7~9'9~Z~~~~,~~S~~_r~~~VO~3~O~-=3~o3~7~l~~~~~~51~ 2 : .. c· "' , '.

3. -'" t e';,::: , - -.. -:~;,;,."

. " -

4 ', .. ---------r------~----_+-----_4-----~----_+----_+-~ . . -- .. ~.-. 5. : ' --------r-------~-----_+-----_4-----~------~------_+-----

TOTAL EXPEND. ~//1/1() I2I$zot 91>5551 ZsZ~tf1 /zla'l&sLf /(')V175f.o Zt.j5()q~

Funding

General Fund

Othe~A,[,ufjds

J 1. ~TjfJJ't.~ 2. f~~

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TO:

STATE OF MONTANA DEPARTMENT OF SOCIAL & REHABILITATION SERVICES

INTER-OFFICE CORRESPONDENCE

Exilibi t 7 1/15/01

Sub-Committee on Appropriations for SRS Burt L. Hurwitz, Chairman

Date: January 15, 1981

Pat Regao,Pete Story, Gary C. Aklestad, Francis Bardanouve a~d Steve Waldron.

FROM: William A. Vollmer, Chief, DDB

pc . . '.--

"

Budget Hearing for Disability Determination Bureau (SRS)

The Disability Determination Bureau within the Rehabilitation Services Divis'ion has 3 program sections consisting of: Social Security Disability Program (Title 2), Supplemental Security Income Disability Program (Title 16) and the Medically Needy Program related to the Medical Assistance Program of SRS. The operating funds for the Title 2 and the Title 16 programs are 100% Federal funds. The funds to operate the Medically Needy Program are advanced by the Medical Assistance Bureau, SRS. At the present time disabled Montana residents are receiving benefits in excess of $ 46,000,000., annually. Each disability determination represents approximately $ 40,000., in long term benefits, if allowed. Our overall current decision ratio is 35% allowances and 65% denials.

There have been no audit findings by the Office of the Legislative Auditor.

The 1980 Disabil ity Amendments (P.L. 96-265) have the following provisions:

1. Administration of the State Disability Determination Programs by Regulation, rather than contract. (effective July 1,1981). Regulation is tied in with standards of performance in production and decision quality. The standards (par) are as follows:

Title 2

Nat'l Montana Experience

1. Processing Time par 6ldays .\.' .. 2. Accuracy par 93.3%

37.2 days 96.8%

Title 16

Nat'l

46days 93.3%

Montana Experience

42.8 days 96.0%

If we fall below either par for 2 successive 6 month periods the Social Security Administration has the option to take over the program.

2. Payment to providers for medical evidence of record in Title 2 program (began December 1, 1980).

3. Requirement of a personalized denial notice to be prepared for each denied clajmant. Each notice will require at least an hour of internal preparation. This workload is estimated at 3300 hours for FY 82 (begins July 1, 1981).

4. Pre-effectuation Review began October 1, 1980 .. This additional step requires that certain high risk decisions of allowances be reviewed at a subsequent review level either in Denver or Baltimore prior to effectuation of disability payments. This has impacted on the DDB by an increase in our purchase of additional consultative examinations on high risk allowances.

**

- 2 -

5. Periodic review of all allowed Title 2 and Title 16 claims at least once every three years. This factors out to an additional workload of 550 continuing disability investigations each Fiscal year. It is anticipated at least 50% will require the purchase of a consultative examination (effective July 1, 1980). **SEE FOOTNOTE.

The base year data for Fiscal year 1980 and 1981 is reflected as follows:

Year· Workload FTE's Individual Case Cost Total Costs-OBPP

1980 6282 27.8 $ 138.79 S 871 ,888. 1981 7168 32.4 137.78 987,620

*1981 (Revised) 7168 32.4 170.45 1,187,765

* Even with our recent budget modification the FY 81 budgeted amount is expected to be low. Based on fresh estimates due to the impact of the 1980 amendments, the revision is presented.

1982 1983

7386 7940

33.4 35.9

New estimates $ 188.46

204.59

New estimates :: $1,395,966. 1,624,447.

The above figures do not include the Medically Needy workload. The projections are 198 cases per year. Accordingly, .9 FTE should be added to the FTE's reflected for 1982 and 1983. The medical costs are directly charged to the Medical Assistance Bureau.

The amount~reflected in contracted services in the OBPP Budget for 1981 is $ 316,321. The LFA budget for contracted services in 1982 is $ 299,564. With the obvious increases in workloads mandated by 1980 Disability Amendments, this area alone will be under funded for 1982 and 1983 if the LFA budget recommendations are implemented.

At the present time we are fully staffed at 33.08 positions, in an effort to prepare for the program requirements impacting on the DDB in the next several months. Hopefully, we will not have to use as much clerical overtime (562 hours) as this past 9 months required.

I hope I have capsulized the DDB program needs as clearly as possible. I will be happy to respond to any questions.

** The reason· for this amendment resulted from several studies showing many long term beneficiaries \'Jere no longer considered disabled when their cases were reviewed at the end of a three year period. This cessation rate ranged from 25% to .35%, depending on the state. Therefore, this amendment was put in place to police the disability roles.

...

Exhibit 8 1/15/81

(J'!; nr;!;}niz:tlioI) is ('ornp()s('d ()f II Il()n-profit rt'habilitatinn agenciL's prl)'.·idin\..'. c":::::1Unity-has{!d servin's for physically handicapped, mentally retarded and e~p­t jonaJly disturhl'd adults throughout Montana. Last year our facilities alonl~ ~., 'r-v i ed ovr'r 1 300 i nd j v i d ua 1 S • -I-n-:--i-"H'9--wc-seL'-'lted 1116.

'r~,~ '*-\ /"-1 ,clic

\ VJU.~

V()('ational Rehahilitation services vary according to the specific needs and han­dicapping ('(mditions for (';]('11 individual. Our primary focus of attention in pro­viding facility-based services is to emphasize the use of real work in a rehabi­litation plan designed to place or return the handicapped individual into compe­titive employment. During the past biennium nearly 300 of our clientele have hl"en successfully placed into competitive employment. Many others have been pla­ced into skill-training programs, on-the-job training, apprenticeships or advan­ced learning situations which will enable them to be more productive and self­sufficient, and thus Jess dependent on continued financial support from the go-

~ ~.v-As SRS wi 1 1 no doubt inform you,ll rehabil itation services ha'f;e been hurt drast i­cally by the recent $300,000 reduction in Social Security funds. This funding cut alone \.)i11 result in nearly $160,000 in facility services not being made av~j}able to rehabilitation clients throughout Montana. Program services have a~~een reduced in our facilities in Helena, Kalispell, Miles City, Billings,

Butte and Hissoula. Some training components have been modified; others have been eliminated entirely. Individuals requiring vocational assessments and work training servicesvare now being told they will have to wait for services.

,::.v.o f"t- """Qlcy ~, our non-profit organizations have developed rehabilitation services in order to maximize the vocational potential of every Montana citizen who has a handicap. '1'hl'se sl'rvic('s provide the :lilswer for many who, after experiencing an injury or illness, wish to return to competitive employment. For those with disabilities encountered at birth or in the early developmental years, it pro­vides hope in that upward mobility, training and employability become a reality not merely a fantasy.

With the recent reduction in Social Security dollars, and the announced cuts com­ing from the Congress in Washington, the outlook for handicapped Montanans is hleak. Our facilities alrc;]dy anticipate serving 200 less individuals this year due to the existing reduction in rehabilitation funds. Already 364 development­ally disabled adults are on community waiting lists, some for over 1 or 2 years now. Now, individuals requiring r~habilitation services are also being placed ---on waiting lists.

Dollars spent in Montana for Vocational Rehabilitation are not a mish-mash of bureaucratic bull and red-tape. to provide a variety of critical necessary services to help - when they need it, and however they need it.

are not being wasted. They They are real dollars used

handicapped folks who need

A critical period has arrived for handicapped Montanans. They can and should be helped. If we wish to continue our efforts to assist them in becoming more pro­ductive and more self-sufficient -- we will have to put our dollars on the line. If we are not prepared to face this challenge head-on -- to provide adequate funds to meet their needs then we are doing them a terrible disservice, and we, too, are the losers.

On behalf of those individuals throughout the State with mental, physical or emo­r tional handicaps which prevent them from appearing before you today -- I urge you

., .,. provide adequate funds to get the job done!

)

~6D () refvvtJ t-v ~l> /(0vV ~ f.l' ~ cfv....( 't 1"'->0/" \ t) f v6f)t.n{, v d y

bJ+ v'(oI.vcir ~ I"J jOv+- f'f" .. \e..!;

+ Ma~f l~pUY~ - hvtlf'-Va.PU~~

c2. Ilf' "" -t b-eM ef>f .:. 5£ fA-f Wu /-')

·monTAnA·RIIOCIATlon·OF·REHABllITATlon· FACILITIEJ.

" Purpose:

MONTANA ASSOCIATION OF REHABILITATION FACILITIES (MARF)

A non-profit association of work-oriented rehabilitation facilities serving the handicapped in Montana. Seven of our facilities (see attached MARF reports) provide direct vocational services to reha­bilitation clients, under the sponsorship of the Rehabilitation Ser­vices Division.

Program Services Provided to Vocational Rehabilitation Clients:

(See attached MARF Report for service definitions)

Vocational Evaluation Skill Training Outreach Training

Clients Served: Vocational

Rehabilitation

1979 1980

581 716

Work Adjustment Training Extended (Sheltered) Employment On-the-job Training

Developmentally Disabled

434 505

Other

101 119

Total served in last 2 years

Total

1116 1340 2456

Individuals placed or returned to competitive employment through our facilities:

Year

1979 1980

Number

162 134

Projected Client Service Losses as a Result of Cuts in V.R. Social Security Funds:

Miles City Billings Kalispell Helena Butte

Dollar Value

$ 23,400 10,000 28,548 78,000 17,550

Total $ Loss (1 year $157,498 period) In Client Services

Decrease in Number Served

24 18 39

100 15

196

Financial Note: In 1980, the three largest rehabilitation facilities in Montana (Helena Rehabilitation Industries, Billings Sheltered Workshop and Flathead Indus­tries in Kalispell) contributed over $226,000 toward the actual costs of providing training to their handicapped adults. By using work-oriented facility programs you get more for your dollar and you guarantee earnings for clients, which in turn means fewer dollars spent on disability payments, financial assistance and unemp1oy-ment compensation •

."

VISITORS' REGISTER

.- JOIHT BG~~E APPROPRIATOINS SUB COMMITTEE ON HUMAN RESOURCSS

T~.L ________________________________ ___ Date -------------------~.Jr.SOR. ____________________ _

- NAME RESIDENCE REPRESENTING SUPPORT OPPOS

/~/L_ &IVU/~ If.4-iSf'# /:t--~ ~dn,L. /1>'SN. or Zt' h1f-6. h4c ikln' (

v

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