The issues creating the impetus for this statewide study of developmental
achievement centers (DACS) are the same issues that generated similar reports
for the past several years. These issues are cost, purpose, and characteristics about
the agencies and clients served. Similar to previous studies, there is a pressing need for information since the combined federal, state, and local cutbacks have an effect on community-based programs such as DACS. In addition, the Community Social Service Act (CSSA) went into effect on January 1, 1980, thus terminating the existing Department of Public Welfare data base developed for DACS. The potential use of Title XIX as
one funding mechanism for DACS has created an intensified demand for information about clients, personnel, and services. This Policy analysis paper is the second of three issues to present the results of a statewide study of all DACS in Minnesota. The first paper (Policy Analysis Series No. 6) focused on the financial status of DAC programs, the third report
(Policy Analysis Series No.8) will profile individual characteristics and movement trends.
DEVELOPMENTAL DISABILITIES PLANNING DEPARTMENT OF ENERGY, PLANNING AND DEVELOPMENT
201 CAPITOL SQUARE BLDG. l 550 CEDAR STREET l ST. PAUL, MN 55101 612/296-4018
Policy Analysis Paper #7
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A Department of Public Welfare report completed in 1978 provides historical information
about DACS. Highlights from that report are presented as follows:
Prior to 1961, few DACS existed in Minnesota (p. 22).
In 1961, the Minnesota Legislature acted upon recommendations of the Interim Commission on the Problems of the Mentally Retarded, Handicapped and Gifted Children and funded a pilot project to develop nine DACS [Extra Sessions Law of Minnesota for 1961, Chapter 93.] (p. 22),
- In 1963, the Legislature appropriated funds for 14 additional centers under the Daytime Activity Center Act [Chapter 830 of the Session Law.] (p. 23).
- Title IVA and Title XX provided federal support to the state with minimal financial commitment of counties (p. 23).
- The Trainable Mentally Retarded Act of 1971 made the State Department of Education responsible for all school age children, who could reasonably expect to benefit socially, emotionally, or physically from their service. DACS shift focus to serving only preschoolers and adults (p. 23).
- In 1975, the Minnesota Legislature provided a special appropriation
to pay for 100 percent of approved costs for transportation
of DAC clients to and from DACS (p. 23).
-In 1976, Assistant Commissioner Mike Weber requested a study of DACS including characteristics of the population, movement of clients, administrative standards and practices as well as unmet needs (p. 24).
-In 1976 an internal DPW working paper Policy Alternatives for Daytime
Activity Centers highlighted major problems including the "absence of a clear goal for
DACS as well as inadequate definitions of services, lack of information on clients being
served, impact of services and measures of program effectiveness" (p. 3).
-In 1977, the DAC Evaluation Project was funded to develop an instrument
to evaluate DACS (p. 24).
-In 1978, DPW completed a comprehensive study of 104 DACS serving 4,221
participants at a total cost of $15 mill ion (p. 34).
A review of the literature on day program services revealed little information.
National surveys of activity programs were undertaken in 1963, 1971, and 1979 (Cortazza, 1972; and Bellamy, Sheehan, Homer, & Boles, 1980). In 1963, there were 94 programs identified nationwide. By 1971, the number increased by 612 programs and tripled by 1979 to an estimated 1,989. The primary purpose of activity centers in 1971 was described by Cortazzo (1972) as:
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The severely mentally retarded have a potential and are entitled as human beings in our
society to have their potential developed to capacity. It is the responsibility of society to develop and make maximum use of their potential (P.9).
The rapid reinstitutionalization during the 1970s as well as funding changes cited by
Bellamy et al (1980) "drastically altered the scope, economics, and role of ADPs."
The 1980 report continued:
Today these programs represent a significant element of each state's adult service
planning and have become critical in efforts to disperse residents of public
institutions into community programs. Adaptive day programs frequently are viewed as
providing the initial services for newly deinstitutionalized individuals [DHE] Report
on Reinstitutionalization, 1978], and placement of individuals out of institutions
frequently is contingent on availability of space in adaptive day programs (p. 309).
The summary of the Bellamy et al report was to call for greater coordination of
policies and the development of practical service models that include greater
opportunities for work and vocational outcomes (p. 321). Other literature on
day programs includes technological applications for severely retarded adults
(Bellamy, Homer, and Inman, 1979) guidebooks for establishing activity centers (Bergman, 1976), and specific training operations within centers (Salmon, 1975; Wehman, 1976; and DeMars, 1975)
The purpose of the current study of developmental achievement centers is to assess the
financial, programmatic, and client status during 1980, 1981, and 1982.
A three-year time period was selected because little information existed at a statewide
level since January 1, 1980. The study was conducted as a joint effort of the Department
of Public Welfare, the Minnesota Developmental Achievement Center Association, and the
Minnesota Developmental Disabilities Program.
II. METHODOLOGY
The methodology for this study will be presented in abbreviated fashion. According to
DPN, there were 108 DACS listed as licensed facilities. One facility is a satellite of the Glacial Ridge Training Center of Willmar State Hospital, one other facility receives
no public money and refused to participate. None of the State Hospital DACS were included in the DPkJ list nor were they included in this study. Information about satellite DAC programs was collected from the respective central administrative offices. In order to get 100% participation, mail and telephone surveys were discarded in favor of on-site interviews. Interview studies typically yield a higher response rate, greater accuracy, and higher reliability than other methods. All 106 DACS participated in the study.
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The general areas of investigation were outlined in a working document prepared by DPW and MNDACA. A joint meeting of representatives from DPW, DD, and MNDACA was held on September 1, 1981 to discuss the purpose, method, timeline, procedures, and questionnaire areas. Suggested questions were generated at that meeting. The Developmental Disabilities Program drafted the questionnaires with assistance from DPW staff. On September 11, 1981 the MNDACA Board of Directors gave its approval to the study. Revisions were made until September 15th, when a briefing was held with three interviewers from DPW and five interviewers from DD. On September 29, 1981$ interview materials were distributed to all the surveyors. An interview packet contained:
1. an interviewer manual which outlined the purpose, selection of respondents, data privacy, question-by-question instructions, and sampling instructions;
2. cover sheet with identification information about the DAC;
3. administrator questionnaire;
4. financial questionnaire;
5. individual client forms;
6. eligible client roster form; and
7. respondent determination sheet.
Interviewers were responsible for setting up appointments with the assigned DACS.
Interviews began on September 30, 1981, and ended in December 1981.
Editing and coding of the protocols occurred during November and December 1981
by staff of the Developmental Disabilities Program. Key to disc entry of the data was made by the Land Management Information Center of the Department of Energy, Planning and Development under contract with the Developmental Disabilities Program. The codebook (data file layout) and formats for the output were designed by the staff of the Developmental Disabilities Pro! of the questionnaires are available from the Developmental Disability written request.
III. RESULTS
The results section will be presented in the following order: (a) program personnel, (b)
staff training, (c) staff turnover, (d) staff wages, (e) program hours and days, (f) out-of-county clients, (g) parent/client fee schedules, and (h) policy changes.
Program Personnel. Table 1 displays the full-time equivalent (FTE) staff for Minnesota's developmental achievement centers during the past two years and projections for calendar year 1982. DACS reported FTEs by three major categories: administrative, professional and paraprofessional (program), and facility support (non-program) staff. Staff patterns are presented by regional and statewide totals.
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Table 1
Type of Personnel (FTE) by Region and Statewide Total
The statewide total administrative staff complement for 1981 was 253.96. Administrative
staff included directors, executive directors, program coordinators, secretaries,
accountants or bookkeepers. The average number of program staff during 1981 was 9.2. The total number of employees (978) included teachers/instructors who are or were at one time licensed or certified teachers, non-certified and non-licensed teachers, teacher aides and therapists. Support staff during 1981 totaled 142. Support, non-program services included maintenance, food service, and transportation.
A study by the Mental Retardation Program Division of the Department of Public Welfare
(1978) reported that 104 centers employed 977 full-time and 232 part-time employees
during 1978. The study did not report those figures in full-time equivalents.
An earlier DPW study (Community Programs Division, 1976) stated that data from 96 of
the 101 DACS operating in 1976 indicated a 1:2.5 staff to client ratio in preschool
programs, a 1:5.2 ratio in adult day activity programs and a 1:6.5 ratio in work
activity components. There were approximately 3,600 participants in those 96 programs.
Licensed or certified teachers included all licensed teachers; not just those certified as special education instructors.
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Table 2 provides a further breakdown of the three major by job titles.
The total FTE complement increased from in 1981 and is projected to decrease in 1982 to 1,350. is expected to occur among program and facility support of personnel will occur using a standard FTE equivalent DACS currently define FTE in several ways from 1,200 to personnel categories 1,338 in 1980 to 1,374 The decline in employees staff. Further analysis such as 2,080 hours. 2,080 hours.
Staff Training. The Department of Public Welfare reported in 1978 that 26 percent of all full-time DAC staff were certified teachers. Fifty-four (54) percent had at least a four-year college degree; 51 percent of the part-time staff had college degrees. In this study respondents were asked to estimate the percentage of program staff (excluding administrators and facility support staff) with college degrees (four-year or more). Table 3 presents the results by region and by year.
The statewide average was 47 percent during 1981 and changed only moderately
between 1980 (45 percent) and 1982 (50 percent--projected).
Staff Turnover. The issue of staff turnover has received greater attention in residential facilities than in day programs. Respondents were asked about the turnover rates for administrative and program staff during the years 1980 and 1981. Administrative staff were included in those calculations because turnover in these positions can be as disruptive to a program as changes in instructional personnel. The results appear in Table 4. The average turnover rate (statewide) was 17 percent in 1980. During 1981 the statewide average increased to 20 percent. Regional patterns are also presented in Table 4 with Region 4 reporting the highest turnover in 1980 (28%) and Region 7 reporting 28.9 percent in 1981.
DAC directors were also asked to identify the primary reasons why personnel left employment. The most frequently stated reasons are presented in rank order
below:
1980
Salary or pay
Family, maternity leave, or personal reasons
Career changes, better positions
Moved or relocated
Returned to school
Layed off or terminated
1981
Seek other employment, career changes
Family, child care, maternity leave, personal reasons
Moved or relocated
Layed off or terminated
Salary or pay
Returned to school
Retired, health or medical reasons
The reasons are similar to results of other labor economics studies, Particularly
Staff Wages. The average hourly wage paid to DAC program personnel is an issue of importance to most policymakers since personnel costs have a direct impact upon per diem rates. Personnel costs for program, support and administrative staff accounted for 62.4 percent of all DAC expenditures during 1980; 63.3 percent during 1981; and are projected to represent about 63.6 percent during 1982 (Policy Analysis Paper #6, 1982, page 6).
The average hourly wage for program personnel in community day programs is presented
in Table 5. Program personnel are defined as "direct care" staff: teachers or instructors, teacher's aides, and therapists (consultants or in-house). They do not include personnel employed in administrative capacities or other support personnel such as food service, bus and van drivers or maintenance staff. The average hourly wage presented in Table 5 for program staff with four year degrees or more also includes therapists. Quite often, a DAC will utilize therapeutic services only intermittently--an hour a week, for example. The consultant hourly fee rate is, however, much higher than professional staff wages.
Consequently, the average wage rate maximum for staff with a four-year degree or more is skewed upward.
The statewide average hourly wage was $7.06 during 1981 for employees with college degrees and $4.78 for program personnel with less than four-year degrees.
Program Hours and Days. In 1976 the Department of Public Welfare reported that the average days of operation for adult or combined adult/preschool programs (N=99) was 209 days. The average for preschool programs (N=18) was 176 days.
The Department of Public Welfare reported in 1978 that 81 of the 97 adult DAC programs in Minnesota provided more than 5.5 hours of service per day to their participants. Fourteen DACS provided from .10 to 4.5 hours of daily service to preschool participants; 52 of the 66 adult programs provided from 4.6 to 7.5 hours of programming per day.
The next three tables will present the average number of program days per year, the average number of program days per week, and the average number of program hours per day for each age group (infant, preschool, school age, and adult) as well as by region and year.
The average number of days per year for 1981 (statewide) was 90 for infants, 184 for preschool, 189 for school age, and 211 for adults. (See Table 6)
The average number of days per week (Table 7) remained stable across all
programs during the three year period. The number of preschool programs, however, de
creased from 58 in 1980 to an estimated 50 in 1982. The statewide average number of program days for 1981 was 2 for infants, 4.58 for preschool, 4.90 for school age, and 5 for adults. The average number of program hours is presented in
Table 8 with similar stability noted in all three years.
Forty-one DACS reported having homebound programs in 1980; 29 of those programs were for infants. In 1981, 41 DACS again reported having homebound programs with
30 infant homebound programs. Thirty-eight (38) DACS estimated that they will offer homebound services during 1982 with 31 for infants.
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Table 5
Average Hourly Wage for Program Personnel by Region and Statewide Total
Region and Statewide Total (Minnesota DACS: 1980, 1981, 1982; 100% reporting)
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Table 7
Average Number of Program .bays Per Week by
Region and Statewide Total (Minnesota DACS:
1980, 1981, 1982; 100% reporting)
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Table 8
Average Number of Program Hours Per Day by
Region and Statewide Total (Minnesota DACS:
1980, 1981, 1982; 100% reporting)
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Out-of-County Clients. In addition to serving their own county residents, DACS also
serve individuals from other counties. The extent and number of purchase of service (POS) contracts for out-of-county clients may have programmatic and financial implications for host county agencies. During 1980 there were 1,143 out-of-county clients enrolled in Minnesota's 106 DACS. There were 1,244 out-of-county clients reported for 1981 and the DAC directors expect 1,111 out-of-county clients enrolled in 1982. Table 9 presents both regional and statewide numbers for all three years.
Parent/Client Fee Schedule. In 1981 there were 11 DACS reporting a fee schedule for infants, 17 DACS reporting a schedule for preschoolers, and 7 DACS reporting a fee
schedule for adults. No fee schedules were reported by DACS in Regions 1, 3, 5, and 8.
Parent/client contributions are probably more extensive than reported. In some
localities, family fees are paid directly to the county; hence the DAC would not report
having a fee schedule even though fees are being collected. DACS also reported that they expect revenue derived from family support/fee payments to increase slightly during 1982 (Policy Analysis Paper #6, 1982, pages 6 and 7).
Admission Policy Changes. DAC directors were asked to report recent and anticipated changes in agency admission and demission policies (because of budget considerations) for their infant/preschool and adult programs. The responses of the DACS are summarized in Table 10. Other policy and program changes due to budgetary considerations will be presented in Policy Analysis Paper #8.
IV. IMPLICATIONS
The results presented in this paper provide the necessary baseline to assess the potential changes in DACS due to budget considerations. The total staff complement of DACS has been increasing at a steady rate, but is projected to decline in 1982, particularly in program and support staff. About one-half of the program personnel have college degrees which is comparable to previous DPW reports. Turnover is lower than residential facilities but showed a 3% increase from 1980 to 1981. There is stability in the reported number of days and hours provided, but given the 1,244 out-of-county placement contracts and budget constraints, there may be complex changes at the individual level in terms of units of service received. Finally, the type of admission and demission policy changes presented
in Table 10 verify informal reports about "retirement" policies.
The third paper in this series will examine individual client characteristics and movement in and out of DACS. In addition, a summary of other policy and program changes due to budget considerations will be presented.
Client age considered, e.g. retirement; categorical limits; county 21 mandates; county limits on purchase of service clients; maintenance; years of participation
Transportation cost, problems may be considered
May establish limits on behavior or medical problems
Lower functioning clients may be more likely to be demitted
Push to move people into SILS and sheltered work
Possible cutback in service days
Restricted enrollments, county residents
Review of out-of-county contracts, must accept full-time services
Review of programming capacity of residential placements, e.g. nursing homes
There were 47 clients aged 65 years or older enrolled in the 21 agencies which reported probable age-related demission policy changes for 1982. There were an additional 174 clients aged 50 to 65 years old enrolled in those 21 DACS.
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v. REFERENCES
Bellamy, G., Homer, R. & Inman, D. Vocational habilitation of severely retarded adults:
A direct service technology. Baltimore: University Park Press, 1979.
Bellamy, G., Sheehan, M., Homer, R., & Boles, S. Community programs for
severely handicapped adults: An analysis. Journal of the Association for Severely
Handicapped, 1980, 5 (4), 307-324.
Bergman, A. A guide to establishing an activity center for mentally retarded persons. Washington: U.S. Government Printing Office, 1976.
Community Programs Division, Minnesota Department of Public Welfare. Final
statistical data for FY '77. St. Paul: Author, 1977.
Community Programs Division, Minnesota Department of Public Welfare. Final statistical data for FY '78. St. Paul: Author, 1978.
Community Programs Division, Minnesota Department of Public Welfare. DAC status report for July 1, 1978 - June 30, 1979. St. Paul: Author, 1978.
Community Programs Division, Minnesota Department of Public Welfare. DAC status report for July 1, 1979 - June 30, 1980. St. Paul: Author 1979.
Community Programs Division, Minnesota Department of Public Welfare. Unit
costs for developmental achievement centers JULY 1 - December 31, 1979. St. Paul:
Author, 1979.
Constantine, E. Internal DPW memorandum: 1978-1979 status report-developmental
achievement center grant-in-aid. St. Paul: Department of Public Welfare, October 27,
1978.
Cortazzo, A. Activity centers for retarded adults. Washington, D.C.: President's Committee on Mental Retardation, 1972.
Demars, P. Training adult retardates for private enterprise. American
Journal of Occupational Therapy. 1975, 29 (l), 24-25.
DHEW Report on Reinstitutionalization. Task Force on Deinstitutionalization of
the Mentally Disabled. Decision memorandum. Washington, D.C.: Department of Health, Education and Welfare, Office of the Secretary, 1978.
Kaufman, B. Internal DPW memorandum: 1979-1980 status report-developmental
achievement centers. St. Paul: Department of Public Welfare, November 27, 1979.
Mental Retardation Program Division, Minnesota Department of Public Welfare. A study of daytime activity centers in Minnesota. St. Paul: Author, 1976.
Mental Retardation Program Division, Minnesota Department of Public Welfare. An analysis of client and program characteristics in Minnesota developmental achievement
centers. St. Paul: Author, 1978.
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page 22 Revised 1/26/82
Mental Retardation Program Division, Minnesota Department of Public Welfare.
Internal working paper: Results of adult DAC phone survey. St. Paul: Author, 1981.
Minnesota Developmental Achievement Center Association. DAC demographic data as of June 30, 1980. St. Paul: Author, 1980.
Research and Statistics Division, Office of Evaluation, Minnesota Department of Public Melfare. Persons enrolled in daytime activity centers, December 31, 1975, a special report. St. Paul: Author, 1976.
Salmon, D. Training and jobs for the mentally handicapped. Industrial Education, 1975, 24-25.
Social Services Division, Monitoring and Reporting Section, Minnesota Department of Public Welfare. Trends in social services: April - June, 1979. St. Paul:
Author, 1979.
Wehnan, P. Vocational training of the severely retarded: Expectations and
The Policy Analysis Series is published by the Minnesota Governor's Planning Council on Developmental Disabilities and the Developmental Disabilities Program, Department of Energy, Planning and Development.
Bruce W1OW, Ph. D., Council Chair Colleen Wieck, Ph.D., Director
The purpose of this series is to enhance communication among state and local agencies, service providers, advocates, and consumers on timely issues. We encourage reader participation by giving us feedback on your ideas and perceptions of this problem.
This paper may be cited:
Developmental Disabilities Program. Policy Analysis Series #7: The Program Status of Minnesota Developmental Achievement Centers: 1980-1982. St. Paul, MN: Developmental Disabilities Program, Department of Energy, Planning and Development, January, 1982.
