AN UPDATE TO POLICY ANALYSIS SERIES NO. 6 THROUGH 9
THE FINANCIAL, CLIENT, AND PROGRAM STATUS OF MINNESOTA
DEVELOPMENTAL ACHIEVEMENT CENTERS: 1982
Contents
I. Introduction and Review of Literature
II. Methodology
III. Survey Results
Financial Results
Revenue
Expenditures
Operating Surplus or Deficit
Per Diems
Building Accessibility
Licensed Capacity
Average Daily Attendance Client Results
Client Characteristics Out-of-County Clients
Client Movement
Waiting Lists
Readiness for Work Placement Program Results
Program Personnel
Staff Turnover
Program Hours and Days
Current Program Activities
Work Components
Policy/Program Changes
IV. Summary
V. References
I. INTRODUCTION AND REVIEW OF LITERATURE
The purpose of this policy analysis paper is to present the findings of the 1982 survey of
Minnesota's 107 developmental achievement centers (DACS). This statewide survey updated the information collected by the 1981 survey on the financial, program, and client status of DACS.
DEVELOPMENTAL Disabilities PROGRAM l DEPARTMENT OF ENERGY, PLANNING AND DEVELOPMENT
201 CAPITOL SQUARE BLDG. 550 CEDAR STREET ST. PAUL, MN 55101 612/296-4018
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During the past year, funding for DAC services has continued to be a problematic issue.
There has been a disparity between counties in their level of support for DAC services. In some cases, funding cutbacks have caused service reductions, leading to appeals and a Minnesota Supreme Court decision on the provision of DAC services. The results of this survey will make it possible to assess changes in the fiscal status of DAC programs over the past year, and to analyze the implications of possible alternative funding mechanisms.
In addition, there is a continuing need for information on the programmatic and client status of DACS. This survey information should be of use in planning for the ongoing deinstitutionalization of state hospital residents under the Welsch v. Levine Consent Decree.
An extensive review of literature on day programs was included in Policy Analysis Papers No. 6, 7, 8, and 9. The reader is urged to refer to those papers for a historical background of day programs elsewhere in the United States.
II. METHODOLOGY
This study was conducted as a joint effort of the Minnesota Developmental Disabilities Program, the Department of Public Welfare--Mental Retardation Division (DPW), and the Minnesota Developmental Achievement Center Association (MinnDACA). Revision of the 1981 survey was accomplished with input from representatives of those three agencies The survey was field tested in DACS during August and September 1982 and reached its final form in November 1982.
The survey was conducted as a mail survey, with follow-up phone calls to obtain 100% participation, to obtain missing data, and to clarify responses. On November 29, 1982, a packet ,containing an instruction manual,, a cover sheet, and financial and administrative questionnaires were mailed to each of the 108, licensed community developmental achievement centers in the state. (State hospital DACS were not included in
the survey.) One facility which receives no public money refused to participate. All of the remaining 107 DAC's participated in the study, with 104 facilities returning their questionnaires during December, January, and February, and 3 facilities responding in phone interviews using the survey format.
Editing and coding of the surveys as well as computer entry of the data were done by staff of the Developmental, Disabilities Program during December, January, February, and early March.
III. SURVEY RESULTS
The format of the 1981 survey 1982 survey differed in two major ways from that of First, the random sample of clients was eliminated,
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and questions pertaining to individual client characteristics were incorporate into the administrative questionnaire. Second, the categories of infant, preschool, school-age, and adult programs were combined into children (aged birth to 4 years) and adults (21 years and over). I)AC directors were asked to include any school-age individuals (4 to 21 years old) served in the children or adult category based on the type of
services received.
Survey results will be presented in three major sections: financial, client, and program results. The figures are statewide totals unless otherwise noted. Regional data were available but were not included here for the sake of brevity.
A. Financial Results
The financial results will be presented in the following order: (1) revenue, (2) expenditures, (3) operating surplus or deficit, (4) per diems, (5) building accessibility, (6) licensed capacity, and (7) average daily attendance.
Revenue: The total revenue for Minnesota developmental achievement centers (DACS) for 1982 was $27,404,614 presented in Table 1. Total adult program revenues were $19,616,520, and total children program revenues were $7,788,094. The statewide average increase in total revenues was 5.5%. This represents a figure smaller than inflation for 1982 which was 9.7% for the Minneapolis-St. Paul area.l
In 1982, government revenues accounted for $25,641,453 or 93.6% of all DAC revenue while family support was $498,648 or 1.8%, and other types of support were
$1,264,513 or 4.6%. Government revenue as a percentage of total revenues declined from 94.9% in 1981 to 93.6% in 1982.
This reduction was compensated for by an increase in other types of support which increased from 3.4% of total revenues in 1981 to 4.6% of total revenues in 1982.
In comparison to 1981, government revenues increased 4%, family support 9.7%, and other types of support 45% in 1982. Total revenues from 1981 to 1982 increased 5.5%.
Table 1 also presents revenues by program. Adult programs rely more on government revenues for total revenues than children's programs, 95.4% to 89.0%. Children's programs rely more on family support than adult programs for total revenue, 5.7% to 0-3%. Children's programs also rely more on other types of support than adult pro
grams for total revenues, 5.3% to 4.3%.
1United States Department of Labor, Bureau of Labor Statistics, 1983. The Consumer Price Index is kept only for the Twin Cities metropolitan area" There is no statewide figure available.
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Table 1
Sources of Revenue by Program and Statewide Total
(Minnesota DACS: 1982, N = 107; 100% Reporting)
CHILDREN'S ADULT PROGRAMS
PROGRAMS
TOTAL
SOURCE OF REVENUEI
Revenue1
~
percent 1 Revenue
Percent
Government $18,~0~,6~2 95.4% $ 6,932,841 89.0%
$25,641,453 93.6%
Family support 54,800 0.3 443,848 5.7 498,648 1.8
Other types of support 853,108 4.3 411,405 5.3 1,264,513
4.6
TOTAL
$19,616,520
100.0%
$ 7,788,094
100.0%
$27,404,614
100,0%
Expenditures: The financial questionnaire separated expenditures into four categories: personnel, transportation, occupancy, and other program costs.
Like most human services, developmental achievement centers have a large labor component as a percentage of total expenditures. Personnel costs included salaries, employers' payroll taxes, and fringe benefits paid by the DAC for any employee. As Table 2 indicates, the total statewide personnel cost for 1982 was $16,957,503 or 62.3%
of total expenditures. As a percentage of total expenditures, personnel costs decreased from 63.3% in 1981 to 62.3% in 1982. Adult programs spent 63.2% of total expenditures for personnel costs while children's programs spent 60.4% of total expenditures for
personnel costs.
Table 2
Expenditures by Program and Statewide Total
=(Minnesota DACS: 1982, N = 107; 100% Reporting)
CHILDREN'S ADULT PROGRAMS
PROGRAMS
TOTAL
TYPE OF EXPENDITURE 'Expenditures I t
Percent
Expenditure
Percent
Expenditure
Percent
Personnel $12,040,646 63.2% $ 4,916,857 60.4%
$16,957,503 62.3%
Transportation 2,540,144 13.3 1,030,897
12.7 3,571,041 13.1
Occupancy 1,991,526 10.4 652,030 8.0
2,643,556 9.7
Program 2,493,359 13.1 1,538,139 18.9 4,031,498 14.8
TOTAL
$19,065,675
100.0%
$ 8,137,923
100.0%
$27,203,598
100.0%
The second largest cost component was program expenses. This category included expenses not incurred in the other three areas. Costs included program supplies, postage, office supplies, and subscriptions. Program costs were $4,031,498 in 1982 representing 14.8% of
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total expenditures. Children's programs spent a larger percentage of their expenditures on program costs than adult programs, 18.9% to 13.1%. As a percentage of total expenditures, program costs increased from 13.1% in 1981 to 14.8% in 1982.
The third largest cost area was transportation expenses. As Table 2 indicates, total transportation costs of 1982 were $3,571,041 or 13.1% of total expenditures. Adult programs spent 13.3% of total expenditures on transportation while children programs spent 12.7% of total expenditures on transportation. As a percentage of total
expenditures, transportation costs decreased from 15.2% in 1981 to 13.1% in 1982.
The fourth largest cost area was occupancy costs. Table 2 indicates total occupancy costs for 1982 were $2,643,445 or 9.7% of total expenditures. Adult programs spent a larger percentage of total expenditures on occupancy costs than children's programs in 1982, 10.4% to 8.0%. In comparison to 1981, occupancy costs as a percentage of total expenditures increased from 8.4% to 9.7%.
In an overall comparison to 1981, occupancy costs increased 21.4%, program costs increased 18.1%, personnel costs increased 3.0%, and transportation costs decreased 9.3%. The overall expenditure increase from 1981 to 1982 was 4.6%.
Home based expenditures statewide totaled $980,432 or 3.4% of the total statewide expenditures. Children's home based programs accounted for $971,888 or 12.0% of total statewide children expenditures while adult home based programs accounted for $8,544 or 0.05% of total statewide adult expenditures.
Operating Surplus or Deficit. Operating surplus or deficit is defined as operating revenues minus personnel, transportation, occupancy, and program expenditures. In 1982, 33 DACS (31% of the 107 DACS) reported an operating deficit. In 1981, 32 DACS (30% of the 106 DACS) reported an operating deficit.
These findings do not represent audited financial returns but rather are as reliable as the information reported by the DACS themselves. The findings suggest a wide range of financial operating status as some DACS were financially stable while others suffered operating deficits.
Per Diems: Respondents were asked to give both the program per diem and the transportation per diem for adult and children center and home based programs. These per diems are listed in Table 3 as averages and as a range.
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Table 3
Program Per Diems
(Minnesota DACS: 1982, N = 107;
100% Reporting)
Range
Number
Average
of
of
Type of Program Per Diem Per Diems Programs
Adult (in-center) $22.14 $11.98-$ 47.75
100
Adult (home-based) $33.81 $26.87-$ 42.29
4
Children (in-center) $33.45
$ 9.13-$ 71.50 51
Children (home-based) $40.79 $ 5.65-$101.83 40
The average statewide program per diem for adults was $22.14 (in-center) and $33.81 (home based) in 1982. Adult per diems (in-center) increased 5.4% in 1982. Adult per diems (home-based) increased 12.4% from 1981 to 1982. The average statewide program per diem for children was $33.45 (in-center) and $40.79 (home based) in 1982. T
Transportation per diems in Table 4 show that the statewide average adult (in-center) rate was $4.05 in 1982, while the statewide average children (in-center) rate was $6.02 in 1982. The statewide adult transportation per diem decreased 5.3% in 1982.
Table 4
Transportation Per Diems
(Minnesota DACS: 1982, N = 107;
100% Reporting)
Range
Number
Average
of
of Type of Program
Per Diem
Per Diems
Programs
Adult (in-center) $ 4.05
$0.17-$ 8.72 93
Adult (home-based) $ 0.00 --
0
Children (in-center) $ 6.02
$0.30-$17.77 41
Children (home-based) $ 3.81 $0.20-$ 7.66 3
aThe difference between the number of programs reporting transportation per diems and those reporting program per diems is due to the fact that some DACS were unable to break out transportation per diems from the program per diems.
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The total adult (in-center) average per diem was $26.19 in 1982 compared to $25.33 in 1981, a 3.4% increase. The total children (in-center) average per diem was $38.29 in 1982.
Building Accessibility: DAC directors were asked about the exterior and interior accessibility of the buildings housing their programs. There were 153 buildings used for the 107 I)AC programs in 1982. Of those 153 buildings, 75% (N = 115) were reported to be accessible on the exterior. With regard to interior accessibility, 59% (N = 91) were totally accessible, 28% (N = 41) were partially accessible, and 137. (N = 20) were not accessible.1 The number of exterior accessible buildings increased by 10 from 1981 and the number of barrier-free interior buildings increased by 6 from 1981.
Licensed Capacity: Table 5 shows the licensed capacity for DACS by program and statewide total in 1982. DACS are licensed by the Licensing Division of the Department of Welfare to provide adult programs or preschool programs or both. DAC licenses indicate a facility's client capacity, which is determined by building characteristics and staff
capabilities. Licensed capacity is for in-center programs only; home-based programs are not licensed.
Table 5
Licensed Capacity:
Statewide Totals
(Minnesota DACS: 1982, N = 107;
100% Reporting)
Range
Number
Licensed
Average
of
of
Type of Program Capacity
Capacity Capacity Programs
Children 1,208 22.79 4-134 53a
Adults 4,869 48.69 4-23o 100
TOTAL
6,077
56.79
4-257
107
aTwo programs have a licensed capacity to serve children but are not currently serving any children. The total licensed capacity for 1982 for 107 DACS statewide was 6,077.
This is an increase of 493 or 8.8% over 5,584 for 1981. The statewide average total capacity was 56.79 per agency.
1 A building was considered to be totally accessible on the interior if a person in a wheelchair can move about and use all floors and restroom facilities. A building was partially accessible if at least one floor and one restroom on that floor were accessible.
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In 1982, the statewide licensed capacity for adult programs was 4,869 compared to 4,436 in 1981. The statewide average adult capacity was 48.69. The statewide licensed capacity for children programs was 1,208 compared to 1,148 in 1981. The statewide average children capacity was 22.79 per agency.
Average Daily Attendance: Table 6 indicates statewide total average daily attendance was 4,450 in 1982 compared to 4,429 in 1981, an increase of 0.5%. Total adult average daily attendance was 3,633, an increase of 2.3% over 1981. Total children average daily attendance was 817 in 1982.
Table 6
Average Daily Attendance: Statewide Totals
(Minnesota DACS: 1982, N = 107;
100% Reporting)
Average
Average
Range
Number
Daily
Per
Per
of
Type of Program Attendance Program Program Programs
Children 817 15.71 2-111 51
Adults 3,633 36.33 4-2o4 100
TOTAL
4,450
41.59
2-204
107
B. Client Results
The client results will be presented in the following order: (1) client characteristics, (2) out-of-county clients, (3) client movement, (4) waiting lists, and (5) readiness for work placement.
Client Characteristics:
Age: Table 7 presents I)AC enrollment totals for 1982 by age categories.
These figures include all persons who were enrolled in Minnesota's DAC programs--including homebound programs--at the time of the survey. The total
enrollment for the 107 DAC programs is 5,399. Over one half of the clients (57%,
N = 3,083) are 21 to 50 years old; 73% (N = 3,945) are over 21 years old. Children aged birth to 4 years account for 24% (N = 1,305) of the total DAC enrollment. The school-aged population is 149 (3%).
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Table 7
Age of Clients:
Statewide Totals
(Minnesota DAC's: 1982, N= 107;
100% Reporting)
Number
Percent
of
of
Age of Client Clients Clients
Birth up to 2 years 487 9%
2 years up to 4 years 818
15
4 years Up to 21 years 149
3
21 years up to 50 years 3,083
57
50 years up to 65 years 67o
12
65 years and older 192 4
TOTAL
5,399
100%
Level of Functioning: Table 8 reports the level of functioning of DAC clients during 1982.
The statewide totals indicate that 2.5% of all DAC clients are not retarded (N = 133), 4.o% (N = 217) are borderline, 14.6% (N = 789) are mildly retarded, 26.8% (N = 1,445) are moderately retarded, 25.7% (N = 1,385) are severely retarded, 9.5% (N = 514) are profoundly retarded, and 16.9% (N = 916) have an unknown/undetermined level
of retardation or are classified as developmentally delayed. Of the last category, 95.6% (N = 876) are children.
1In addition to serving persons with mental retardation, developmental achievement centers may be licensed under state statute and DPW Rule to serve persons with cerebral palsy.
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Table 8
Level of Client Functioning:
Statewide Totals
(Minnesota DACS: 1982, N = 107;
100% Reporting)
NUMBER
NUMBER
OF
OF TOTAL
~
LEVEL OF FUNCTIONING CHILDREN ADULTS
Not retarded
Borderline
Mild
Moderate
Severe
Profound
Unknown or 'undeter
mined (developmentally delayed)
TOTAL
111
58 92
151
63 45
876
1,396
22
159 697
1,294 1,322
469
40
4,003
133
217 789
1,445 1,385
514
916
5,399
2.5%
4.0 14.6 26.8 25.7
9.5
16.9
100.0%
aIn addition to serving persons with mental retardation, developmental achievement centers may be licensed under state statute and DPW rule to serve persons with cerebral palsy.
Place of Residence: Table 9 indicates the type of residential setting for all DAC clients in 1982. The majority of clients live in natural or adoptive homes (44.5%, N = 2,402) or in ICF-MR settings (43.3%, N = 2,339). Nursing homes are the residences of 4.6% of the population (N = 247) while 4.1% (N = 220) live in foster care homes, and the remaining 3.4% live in other settings. Nearly all children live in natural, adoptive, or fostercare homes (99.1%, N = 1,384). Adults live in a range of residential settings. The largest group of adults live in ICF-MRS (58.2%, N = 2,328); 27.7% (N = 1,108) live in natural or adoptive homes, and the remaining adults reside in other residential settings.
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Table 9
Client Residence:
Statewide Totals
(Minnesota DACS: 1982, N = 107; 100% Reporting)
CHILDREN
ADULTS
TOTAL
r
I
~
IWSIOENTIAL SETTING Number
Percent
Natural/adoptive home 1,294 92.7% 1,108 27.7% 1,402
44.5%
Foster care home 90 6.4 130 3.2 220 4.1
ICF-MR group home 11 0.8 2,328 58.2 2,339 43.3
Semi-independent living o 0.0 40 1.0 40
0.7
Independent living o 0.0 51 1.3 51 0.9
Board and lodging/board and care o 0.0 99 2.5
99 1.8
Nursing home o 0.0 247 6.2 247 4.6
Other 1 0.0 0 0.0 1 0.0
_ .
_
TOTAL
1,396
100.WO
4,003
100.0%
5,399
100.0%
Secondary Disabilities: Table 10 reports the incidence of disabilities in addition to, or other than, mental retardation in the DAC population. Because some clients are multiply handicapped, there is some duplication in this count. The 53 DAC programs serving children which responded to this question reported a total of 806 other disabilities among their populations. The highest incidence of other disabilities were cerebral palsy (N = 200), other physical handicaps (N = 152), and epilepsy (N = 121). The 99 adult programs re
ported a total of 2,818 other disabilities, with the highest incidence being significant behavior problems (N = 498), epilepsy (N = 496), and other physical handicaps (N = 418).
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Table 10
Incidence of Disabilities in Addition to or Other than Mental Retardation
(Minnesota DACS: 1982, N = 107; 100% Reporting)
Number
Number
of
of
Type of Disability Children Adults
Cerebral palsy 200 320
Other physical handicap 152 417
Epilepsy 121 496
Autism/autistic like 33 79
Deaf/hearing impairment 56 316
Blind/vision impairment 90 297
Mental illness 8 276
Significant behavior problems 52
498
Other 94 119
TOTAL
806
2,818
a This is a duplicated count; some clients are multiply handicapped.
Out-of-County Clients: DAC directors reported that 23.2% (N =1,254) of the clients enrolled in their programs were out-of county placements. The 1982 figure shows a slight increase over the 1,244 out-of-county clients for 1981.
DACS were also asked to indicate whether any of their out-of-county clients were being provided with different program hours or days than in-county clients. In response to this question, DACS reported that 76 out-of-county clients received reduced services during 1982. Twenty counties of financial responsibility were involved in the service reductions for the affected clients.
Client Movement: In order to examine the movement patterns of DAC clients, administrators were asked for their 1982 new admission, readmission, transfer/demission, and death statistics for children and adults. These data are summarized in Table 11. These numbers
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indicate that there was a net movement of 121 children and 252 adults into the DAC system during 1982. Caution should be exercised in using these numbers, however. Comparison of 1981 and 1982 enrollment data with this net movement data indicate numerous reporting errors on the individual facility level. (Enrollment data indicate an increase of 245 clients from 1981 to 1982; movement data indicate a net gain of 373 clients.)
Table 11
Client Movement:
Statewide Totals
(Minnesota DACS: 1982, N = 107;
100% Reporting)
Number
Number
of
of Type of Movement
Children
Adults
Total
New admissions 951 639 1,590
Readmissionsb 25 72 97
c,d
Transfers/demissions
(834) (436) (1,270)
d
Deaths ( 21) ( 23) ( 44)
NET INCREASE
121
252
373
aNew admission: an individual entering the agency for the first time.
b Readmission: a client who entered, left the program, and then reentered the agency.
c Transfer/demission: a client who transferred to another DAC or left the program.
d Parentheses indicate a negative value, i.e., movement out of DAC programs.
DAC directors were also asked to report how many of their admissions, readmissions, transfers, and demissions came from and went to other placements such as public school, work programs, etc.
These data are summarized for children and adults in Tables 12 and 13. As with the overall movement data in the previous table, the reader is urged to exercise caution in using these numbers. Nonetheless, it is possible to examine some general trends in the movement of children and adults into and out of L)AC programs.
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Table 12 indicates that the vast majority of children in DAC programs have had no previous day program placement (80.1%, N = 788). Other DACS (N = 87), preschool programs (N = 60), other programs (N = 31), and public schools (N = 10) each account for a small
amount of the previous placements for children.
More than half (51%, N = 425) of the demitted/transferred children go to public schools,
with 21.7% (N = 181) not going to any program, 11.3% (N = 94) going to other DACS, 10.1% going to preschool programs, 5.8% (N = 48) to other programs, and 2 children going to state hospitals.
Table 12
Placements of Children Admitted/Readmitted to
and Demitted/Transferred from DACS in 1982
(Minnesota DACS: 1982, N = 107;
100% Reporting)
Number
Number
of Children
of Children
Admitted/ Demitted/ Readmitted
Transferred
Type of Placement to DACS from DACS
Public schools 10 425
Another DAC 87 94
Preschool program (e.g.,
nursery school, Headstart,
day-care program) 60 84
No program 788 181
State hospital day program o
2
Other 31 48
TOTAL
976
834
As shown in Table 13, the majority of adult DAC clients come from public schools (30.0%, N = 213), no program (20.4%, N = 145), an other DAC (18.8%, N = 134), and state hospitals (16.7%, N = 119), with small numbers also coming from sheltered work (N = 39), work activity (N = 34), competitive employment (N = 5), and other settings (N = 22).
The largest numbers of adult transfers/demissions go to other DACS(23.6%, N = 103), no program (22.7%, N = 99), sheltered work (17.2%,
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N = 75), and work activity (15.6%, N = 68). According to this data, 27 adults were also
demitted to state hospitals, 50 to other settings, 8 to public schools, and 6 to competitive employment.
Table 13
Placements of Adults Admitted/Readmitted from
and Demitted/Transferred to DACS in 1982
(Minnesota I)ACS: 1982, N = 107;
100% Reporting)
Number
Number
of Adults of Adults Admitted/
Demitted/
Readmitted Transferred Type of Placement
to DACS from DACS
Public schools 213 8
Sheltered work 39 75
Work activity 34 68
Competitive employment 5 6
Another DAC 134 103
No program/no employment 145
99
State hospital day program 119 27
Other 22 50
TOTAL
711
436
Waiting Lists: Respondents to the 1982 DAC survey reported that 402 persons, including 82 children and 320 adults, were on waiting lists at 28 of Minnesota's 107 developmental achievement centers. DACS in Region Eleven account for 88.8% of all people on waiting
lists. One metropolitan area DAC reported having more than 100 people on their waiting list.
The reader is advised to use the waiting list numbers with caution. Where it was possible to determine duplication, duplicate names
1This is an unduplicated count. The actual number reported by DACS was 409, but 7 adults were identified on lists at other agencies.
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were removed from the total waiting list. As noted in Table 14, some of the people on waiting lists are currently enrolled in a day program but are awaiting placements more appropriate to their needs.
Table 14
Current Placement of Individuals
on DAC Waiting Lists (Minnesota DACS: 1982, N = 107)
100% Reporting)
Number
Number
of
of
Type of Placement Children Adults Total
No program 38 79 117
Unknown/unspecified 32 14
46
Another DAC program 9 135a
144
Work activity o 2 2
Public school o 71 71
State hospital o 14 14
Other 3 5 8
TOTAL
82
320
402
aAt least 90 people in this group are in need of work activity program services.
Readiness for Work Placement: DAC directors were asked for an unduplicated count of their adult clients who were ready to move into the following work placements: work activity, sheltered work, competitive employment, and other programs. They were also asked to indicate the primary reasons (one per person) why these clients were not moving.
1The reader should also be aware that there is a duplication of 125 adults between this DAC waiting list and the sheltered workshop waiting list described in Policy Analysis Paper No. 16. Three agencies with sheltered work, work activity, and DAC programs (Opportunity Workshop, Mankato Rehabilitation Center/Blue Earth DAC, and Brighter Day Achievement Center) listed individuals on both waiting lists.
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As Table 15 shows, a total of 528 adults were reported to be ready for the following placements: work activity (N = 349), sheltered work (N = 154), competitive employment (N = 21), and other (N = 4). Lack of available slots was the primary reason for lack of movement for 32.0% (N = 112) of the work activity ready clients and 31.0%
(N = 47) of the sheltered work ready clients. Reluctance or unwillingness to make the
change on the part of parents or clients was the primary reason for 17.8% (N = 62) of the
work activity ready clients and 46.8% (N = 72) of the sheltered work ready clients.
An additional 26.4% (N = 92) of the work activity ready clients and 11.8% (N = 18) of the
sheltered work ready clients are prevented from program participation because of a
characteristic, such as a behavior problem. The primary reasons for the remaining clients are a lack of community support services or because they are awaiting evaluation, referral, or placement.
Table 15
Clients Ready for Work Placement and Primary Reasons for Lack of Movement
(Minnesota DACS: 1982, N = 107; 100% Reporting)
NUMBER OF CLIENTS READY FOR WORK PLACEMENT I
I
REASON FOR LACK In Work In Sheltered In Competitive In Other
OF MOVEMENT Activity Work Employment Settings
Lack of available work
activity/sheltered work
slots 112 47 0 0
Lack of community support
services such as residential and
transportation services
Parents or clients reluctant
or unwilling to make change (e.g., do
not want to leave home, community, or unwilling to participate)
Client has a characteristic which
prevents him/her from participating in
WA/SWS program
(e.g., behavior problem, inappropriate
social behavior, inadequate production
rate, etc.)
16
62
92
8
72
18
6
6
6
0
0
Clients are awaiting eval
uation, referral, or
placement 21 8 0 0
Other 46 1 3 4
TOTAL
349
154
21
4
0
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C. Program Results
The program results will be presented in the following order: (1) program personnel, (2) staff training, (3) staff turnover, (4) program hours and days, (5) current program activities, (6) work components, and (7) policy changes.
Program Personnel: DAC administrators were asked to report the total number of administrative, direct service, and support function hours worked by personnel. These totals were divided by a standard full-time equivalent (FTE) of 2,080 hours to determine the FTE complement in each personnel category, as shown in Table 16.
Table 16
Total Personnel Hours and Full-Time
Equivalents: Statewide Totals (Minnesota DACS: 1982, N = 107;
98% Reporting)
Total
Full-Time
Personnel
Equivalents
Type of Personnel Hours
(FTEs)
Administrative 410,216 197.22
Direct service 1;643,293
790.04
Support function 240,106 115.44
TOTAL
2,293,615
1,102.70
Administrators were also asked to indicate the total number of staff positions in their
agency by type of personnel. These totals include both full- and part-time staff members and consultants employed by the DAC. Table 17 presents the statewide totals by position.
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Table 17
Personnel Positions: Statewide Totals a
(Minnesota DACS: 1982, N = 107; 99% Reporting)
Number
of
Positions
Type of Personnel Position
Administration:
l Directors/administrators
117
l Program coordinators 109 l Secretaries/clerical/Office managers 99 l
Bookkeepers/accountants 62
TOTAL ADMINISTRATION 387
Professional/Paraprofessional :
l Teachers
486
l Teachers' aides/assistants
403 l Therapists
199
TOTAL PROFESSIONAL/
PARAPROFESSIONAL 1,088
Facility
Support--Nonprogram:
l Maintenance
55
l Food service 26 l Transportation
128
TOTAL FACILITY SUPPORT-
NONPROGRAM 209
Other 35
TOTAL DAC PERSONNEL POSITIONS
1,719
aThese figures are not adjusted using a standard full-time equivalent. Some individuals hold more than one position; these 1,719 positions are filled by 1,609 persons.
Staff Turnover: Statewide, the average turnover rate for program and administrative staff was 13.5%. Turnover rates at individual facilities ranged from 0.0% to 63.0%. DAC directors were asked to identify the primary reasons why personnel left employment. The most frequently stated reasons are presented in rank order below:
moved, relocated;
career changes, took another position;
layoffs, terminations;
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salary or pay;
family, maternity leave, child care, personal reasons;
returned to school;
resignations;
retirement.
Program Hours and Days: As of December 1982, 51 DACS were serving children in center-based programs, and 100 DACS were serving adults in center-based programs.
For full-time participants in center-based programs, the average number of service days per year was 193.8 for children and 209.65 for adults. Children's programs reported an average of 4.76 program days per week while adult programs reported an average of
4.99 days. The average hours of service per day was 4.72 for children and 6.14 for adults.
In home-based programs, 5 DACS served a total of 12 adult participants, and 41 DACS served a total of 677 children during 1982. Overall, the average number of home visits per month and hours per visit were 3.49 visits and 1.60 for adults and 3.98 visits and 1.65
hours for children. On the individual facility level, the average number of visits ranged from 2.00 to 6.25 for adults and from 0.75 to 9.00 for children, and the average numbers of hours per visit ranged from 1.00 to 4.85 for children and 1.00 to 2.00 for adults.
Current Program Activities: DACS were asked to report the average percentage of time adult clients spent in various program activities. Table 18 indicates that the largest proportion of time is spent in the work skills/prevocational area (29.8%). Other program activities include education/academics/cognitive (15.6% of program
time), recreation/leisure (12.8%), independent living community orientation (12.7%), self-care (11.6Y0)j communication/language (10.3%), and Sensory motor/motor skills development (7.2%).
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Table 18
Average Percentage of Time Spent
in Program Activities (Minnesota DAC Adult Programs:
99% Reporting)
N = 100;
Percent
of Time
Spent
Program Activity
Work skills/prevocational
Self-care
Communication/language
Recreation/leisure
Education/academics/cognitive
Independent living/community orientation
Sensorimotor/motor skills development
TOTAL
29.8%
11.6
10.3
12.8
15.6
12.7
7.2
100.0%
Work Components: DAC directors reported that 91 of the 100 in-center DAC programs serving adult clients had work component programs. A total of 2,859 clients were enrolled in these work components as of December 1, 1982.
Work component programs are required to have wage and hour certification from the Department of Labor (DOL). Sixty DACS have working agreements with sheltered workshops which hold the wage and hours certificate. Twenty-nine DACS carry their own wage and hour certificates, and two DACS indicated that both the DAC and the cooperating sheltered workshop have DOL certification.
DAC directors were asked what were the types of work and major sources of work performed in their work component programs. The 86 responses to this question indicated that DAC work components utilize a variety of sources to obtain work. Sheltered workshops were mentioned as a source of work for 53 programs, local businesses and companies for 35 programs, their own or another DAC for 23 programs, the general public/community for 11 programs (through sales, etc.), and other sources (local service organizations, charities, and one local government) for 4 programs. Many programs cited 2 or more work sources.
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Packaging and assembly work were the most frequently mentioned types of work, followed by collating, sorting, manufacturing of prime products, recycling,
janitorial/maintenance work, and crafts. Twenty directors specifically mentioned simulated work provided by the sheltered workshop, or in some cases by the DAC, as a type of work.
DACS were also asked a series of questions regarding client earnings from work during 1982. In the 91 programs with work components, a total of 2,860 clients earned wages during 1982. Wage data were reported for 2,669 clients in 83 programs. The total annual payroll for these clients was $355,820.00, yielding average annual client earnings of $133.32. On an agency basis, average annual client earnings ranged from a low of $6.50 to a high of $750.00. Facilities were also asked what were the least and most amounts earned by clients during the year. The highest earnings figures ranged from
$19.40 to $2,300.00; the lowest earnings figures ranged from $0.07 to $315.00.
(Some individuals in the lowest earnings group did not work all year.)
Policy/Program Changes: DAC directors were asked to identify any major policy or program changes which occurred during 1982 because of budgetary or programmatic reasons. The identified changes have been grouped into the following categories: (1) addition or closure of programs, (2) changes in units of service provided, (3) staffing?
changes, (4) changes in program activities and services, (5) changes in the number and type of clients served, and (6) admission/demission policy changes.
Program Additions/Changes: One DAC reported adding home bound services for children,
and one reported expanding their early intervention services to include a center-based program for children. One new in-center program serving adults opened during the year. One DAC closed an in-center children's program, and one closed in-center and homebound children's programs and ended adult home visits. Two children's programs moved infants from homebound to in-center services to reduce costs.
Changes in Units of Service: Two children's programs and seven adult programs reported reducing their days and/or hours of service for all clients during 1982, while one adult program reported an increase in days of service. An additional ten adult programs indicated that hours and/or days of service were reduced for some of their participants. Of the ten DACS involved, four noted that the affected participants were out-of-county clients; two stated that they were older (over 60 years) participants; the remaining four programs did not specify. One DAC noted that the service reductions for older clients have since been eliminated. (See page 12 for more detailed statewide information on service differences for out-of-county clients.)
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Staffing Changes: Budgetary cutbacks, increases or decreases in enrollment, and changing client needs were the primary reasons for the DAC staffing changes made during 1982.
Fifteen adult and three children's programs reported reductions in program staff accomplished by layoffs, reducing hours worked and not filling vacant positions or replacing staff on leave. Five adult programs reported adding staff: four because of increases in the number of clients with higher needs and one because a vocational staff person was needed to expand vocational training.
One adult program noted that additional staff were needed because of the admission of new
clients with severe and multiple disabilities, but that no funds were available.
Three programs indicated that they had redistributed job duties, with administrators and
program coordinators taking on more direct service hours and program staff adding
janitorial and transportation duties. One adult program reallocated staff from other clients to develop a behavioral training group for clients in need of this service.
Three directors reported that staff salaries had been cut or increased by a very small amount. Four centers noted that they had reduced expenditures on in-services, training, and conferences for staff.
Changes in Program Activities and Services: Several adult programs reported making changes in their program activities during 1982. Academic activities were reduced by one
program and eliminated by another. One program dropped arts and crafts; three added or
expanded independent living skills activities; and one placed more emphasis on self care. Two programs reported reductions in vocational training because of lack of work and
fees charged to the DAC by the sheltered workshop. Seven programs indicated that they
had increased their emphasis on work skills/vocational training. One program noted that they had begun a cooperative program with a sheltered workshop to facilitate transition between the two programs.
A number of DACS indicated they had made changes in the provision of speech, physical,
occupational, and music therapy services. Two children's programs described general reductions in therapeutic services. Another program noted that children had benefited from
receiving therapy in small groups rather than individually--a change required by funding
cuts. One adult program reported adding consultant hours in therapy. Several DACS switched to contractual arrangements for the provision of therapy, with mixed results.
There were several changes in transportation services during 1982 as well. Four programs reported reducing the amount of
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transportation they provided. Three DACS reduced costs by switching from contracted transportation to providing their own. One center added a self-supporting early morning daycare program because their morning transportation had to be cut.
A number of DACS reported eliminating anything "extra" in the way of programming-seven programs 'reported eliminating such activities as summer and evening programming, camping, field trips, recreational activities, and a lunch program. Two centers began charging participants' families for the costs of out-of-center trips and other activities.
Changes in the Number and Type of Clients Served: The client characteristics and movement data presented earlier in this paper (pages 9, 12 through 14) and historical information on DAC programs (see Policy Analysis Papers No. 6, 7, 8, and 9) indicate that there has been an increase in the numbers of more severely disabled persons in the statewide DAC population. On the individual facility level, seven adult programs specifically indicated that during 1982 they had added severely and/or multiply disabled persons requiring special programming.
Admission/Demission Policy Changes: The out-of-county plac-placement issue was a factor in admissions/demissions for three programs. Two DACS reported demitting clients whose county of financial responsibility would not pay for full services; another facility indicated that they will not admit participants unless their county will pay for the level of service deemed appropriate in the individual's IPP (individual program plan).
Waiting lists were a factor in policy decisions made by two DACS: one children's program decided not to place older preschoolers (those eligible for public school in the upcoming year) on their waiting list for admission. One adult program decided to offer only full-time services because of the number of people on their waiting list needing full-time services.
IV. SUMMARY
This policy analysis paper presented the findings of the 1982 survey of Minnesota's 107 developmental achievement centers. The major findings of this survey included:
Statewide, total DAC revenues for 1982 were $27,404,614, an increase of 5.5% over 1981. Government revenues accounted for 93.6%, family support 1.8%, and other support for 4.6% of total revenues.
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Total DAC expenditures for 1982 were $27, 203,598. Personnel costs accounted for 62.3%, transportation 13.1%, occupancy 9.7%, and program 14.8% of this total.
Of the DACS, 31.0% (N = 33) reported operating deficits for 1982.
Statewide, average program per diems for adults were: $22.14 (in-center) and $33.81 (home-based). The average program per diems for children were: $33.45 (in-center) and $40.79 (homebased). Transportation per diems for in-center programs averaged $4.05 for adults and $6.02 for children. The average adult total per diem (program and transportation) increased 3.4% from 1981 to 1982.
Total licensed capacity of DACS was 6,077. Average daily attendance was 4,45o in 1982, a 0.5% increase over 1981.
As of December 1982, total DAC enrollment was 5,399. Adults (21 years and over) accounted for 73.0% of the total DAC population.
The majority of DAC clients live in natural or adoptive homes (44.5%) or ICF-MRS (43.3%). Nearly all children live in natural, adoptive, or foster care homes (99.1%). ICF-MRS are the residential settings of 58.2% of adult DAC clients.
Nearly 1 in 4 of DAC clients (23.2%) were out-of-county placements in 1982.
DACS reported that 76 out-of-county clients received reduced services during 1982.
Respondents reported that 402 persons, including 82 children and 320 adults, were on waiting lists at 28 DACS. Metropolitan area DACS accounted for 88.8% of all people on waiting lists.
A total of 528 adults were reported to be currently ready for work placements, including work activity (N = 349), sheltered work (N = 154), competitive employment (N = 21), and other (N = 4). These individuals cannot currently move to these placements for a variety of reasons including lack of available slots, reluctance on the part of parents or clients, client characteristics, and lack of community support services.
Using an FTE of 2,080 hours, DAC personnel included 197.22 administrative FTEs, 790.04 direct service FTEs, and 115.44 support function FTEs for a total personnel complement of 1,102.70 FTEs.
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V. REFERENCES
Developmental Disabilities Program. Policy analysis paper no. 6: The financial status
of Minnesota developmental achievement centers: 1980-1982. St. Paul: Developmental Disabilities Program, Department of Energy, Planning and Development, January 1982.
Developmental Disabilities Program. Policy analysis paper no. 7: The program status of Minnesota developmental achievement centers: 1980-1982. St. Paul: Developmental Disabilities Program, Department of Energy, Planning and Development, January 1982.
Developmental Disabilities Program. Policy analysis paper no. 8: The client status of Minnesota developmental achievement centers: 1980-1982. St. Paul: Developmental Disabilities Program, Department of Energy, Planning and Development, January 1982.
Developmental Disabilities Program. Policy analysis paper no. 9: Summary of issues,
programs, and clients in Minnesota developmental achievement centers:
1980-1982. St. Paul: Developmental Disabilities Program, Department of Energy, Planning and Development, February 1982.
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.
Richard Nelson, M.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 feed back on your ideas and perceptions.
This paper may be cited:
Developmental Disabilities Program. Policy Analysis Series Paper No. 17:
An Update to Policy Analysis Series No. 6 through 9: The Financial, Client, and Program Status of Minnesota Developmental Achievement Centers: 1982. St. Paul, MN: Developmental Disabilities Program, Department of Energy, Planning and Development, March, 1983.
