DADS Rider 21 — Cost Comparison Report Summary
| Setting | Cost | Average Monthly Cost Per Individual — FY 2013 | Average Monthly Cost Per Individual — FY 2015 | Percent Change FY 2013 to FY 2015 |
|---|---|---|---|---|
| State Operated ICF (State Supported Living Centers) | Long-Term Care Costs | $14,143.81 | $17,637.46 | 24.70% |
| Administrative / Overhead Costs | $5,090.40 | $6,697.12 | 31.56% | |
| Total State Operated ICF: | $19,234.21 | $24,334.58 | 26.52% | |
| HCS Waiver — Residential | Long-Term Care Costs | $5,116.89 | $5,170.80 | 1.05% |
| Acute Care Costs | $356.21 | $761.74 | 113.85% | |
| Total HCS — Residential Costs: | $5,473.10 | $5,932.54 | 8.39% | |
| HCS Waiver — All Settings | Long-Term Care Costs | $3,472.29 | $3,522.26 | 1.44% |
| Acute Care Costs | $465.15 | $744.97 | 60.16% | |
| Total HCS — All Settings Costs: | $3,937.44 | $4,267.23 | 8.38% |
Notes
SSLCs include residential services, habilitation services, medical services, skills training, and adjunctive therapy services.
Medicaid reimbursed acute care services, such as hospitalization and doctor visits, provided to people in the HCS Waiver program are paid by HHSC. For SSLCs, these costs are covered in the per diem reimbursement rate.
HCS waiver acute services transferred from Fee For Service to Managed Care in FY 2015. This transition correlates with the increase in acute costs in the HCS waiver program.
Average Dollars Paid by Month for HCS Waiver Services for People who Transition from SSLCs — Fiscal Years 2013 and 2015
| Residence Type | Mean FY 2013 | Number of People FY 2013 | Mean FY 2015 | Number of People FY 2015 |
|---|---|---|---|---|
| Non-Residential | $4,115.44 | 54 | $3,743.37 | 33 |
| Residential | $5,622.79 | 318 | $5,695.04 | 234 |
| Total: | $5,403.98 | 372 | $5,453.82 | 267 |
Comparison of Select Consumer Characteristics at State Operated ICF (SSLC) Fiscal Year 2015 as of August 31, 2016
| Selected Characteristic | Number of People | Percent of Total People | Number of HCS and TxHML Waivers | Percent of Total HCS and TxHML Waivers |
|---|---|---|---|---|
| Level of Need 1: Intermittent | 370 | 9.13% | 10,804 | 31.56% |
| Level of Need 5: Limited | 1,457 | 43.31% | 15,334 | 44.80% |
| Level of Need 8: Extensive | 1,076 | 31.99% | 5,438 | 15.89% |
| Level of Need 6: Pervasive | 508 | 15.10% | 2,499 | 7.30% |
| Level of Need 9: Pervasive Plus | 16 | 0.48% | 153 | 0.47% |
| Total People: | 3,364 | 100.01% | 34,228 | 100.0% |
| Selected Characteristic | Number of People | No data | Number of HCS Waivers | No data |
| Mental Health Diagnosis: Schizophrenia | 212 | 1,792 | ||
| Physical / Ambulatory Status: Non-Ambulatory | 1,027 | 2,357 |
Date: February 6, 2017
Sources
DADS Budget Information see Rider Reports section and Comparison Reports.