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HomeMy WebLinkAboutMINUTES - 03281995 - FC.1 r TO: BOARD OF SUPERVISORS ..L ..� ... Contra FROM: e.� � mance Committee, Tom Torlakson o ,/ 3 , Costa Jeff Smith � ,•r• Count DATE: March 28, 1995 cou SUBJECT: VIEW OF PROGRAMS RECEIVING KELLER CANYON LANDFILL SURCHARGE REVENUE SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1. ACKNOWLEDGE that the estimated budget shortfall of$232,200 in fiscal year 1995-96 for Keller Canyon and Acme Transfer Station revenue may be greater given more recent tonnage and revenue figures. 2. DISCONTINUE funding for the Rubicon SSI/Money Management Program and the Career Development Employment Program in fiscal 1995-96 and thereby reduce the shortfall by $75,000. 3. REDUCE the funding for the Recycling/Resource Recovery Program from $420,000 to $317,500 and thereby reduce the shortfall by another $102,500. 4. DIRECT the General Services Department and County Administrator staffs to pursue a public-private partnership for the County's Recycling/Resource Recovery Program to further reduce costs and maximize the use of General Assistance clients. 5. DIRECT the Social Services Department and Agricultural Commission staff to pursue the feasibility of using General Assistance clients in a farm related work program.\N 6. REFER this matter back to the Finance Committee for further review prior to budget hearings. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER_, SIGNATURE(S): Tom Torlakson 4ef ACTION OF BOARD ON MAK 2 APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED MAR 2 8 1995 Contact: PHIL BATCHELOR,CLERK OF THE BOARD OF CC: General Services SUPERVISORS AND COUNTY ADMINISTRATOR Personnel Rubicon Agriculture Commissioner BY [y1�lY�T-51�� DEPUTY County Administrator ` Page 2 BACKGROUND: The Board of Supervisors adopted a preliminary two year financial plan for use of Keller Canyon/Acme Landfill revenues December 20 which identified a$292,000 shortfall in the surcharge category (see attached). On February 6, the Finance Committee determined that a 20%reduction or$232,000 would need to be cut from programs receiving surcharge revenues in fiscal year 1995- 96. The Committee requested appropriate information from each program and scheduled March 20 as the date to review the programs. The Committee reviewed written reports and took testimony from representatives of the following three programs: (A) Recycling/Resource Recovery Program (General Services); (B) Career Development(Personnel); and (C) SSI/Money Management(Rubicon). Attached are the written reports presented by the program representatives. Also,the Social Services Department staff presented written recommendations and provided testimony to the Committee(see attached recommendations). The County Administrator concurred with the Social Service Department recommendations. The Committee formulated the six recommendations indicated above and expressed concern over the reduced revenue stream from Keller Canyon Landfill and the Acme Transfer Station. The Committee requested a follow-up review of this matter prior to final action at the 1995-96 budget hearings. I e. To: BOARD OF SUPERVISORS 5. Contra Costa FROM: -Finance Committee, Tom Torlakson Jeff Smith E;,,�,,,, f° County March 28, 1995 DATE: "count SUBJECT: REVIEW OF PROGRAMS RECEIVING KELLER CANYON LANDFILL SURCHARGE REVENUE SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1. ACKNOWLEDGE that the estimated budget shortfall of$232,200 in fiscal year 1995-96 for \" Keller Canyon and Acme Transfer Station revenue may be greater given more recent tonnage and revenue figures. 2. DISCONTINUE funding for the Rubicon SSI/Money Management Program and the Career Development Employment Program in fiscal 1995-96 and thereby reduce the shortfall by $75,000. 3. REDUCE the funding for the Recycling/Resource Recovery Program from $420,000 to $317,500 and thereby reduce the shortfall by another $102,500. 4. DIRECT the General Services Department and County Administrator staffs to pursue a public-private partnership for the County's Recycling/Resource Recovery Program to further reduce costs and maximize the use of General Assistance clients. 5. DIRECT the Social Services Department and Agricultural Commission staff to pursue the feasibility of using General Assistance clients in a farm related work program. 6. REFER this matter back to the Finance Committee for further review prior to budget hearings. CONTINUED ON ATTACHMENT: YES SIGNATURE: -RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD M TEE APPROVE OTHER SIGNATURE(S): Tom Torlakson J f Smith ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED Contact: PHIL BATCHELOR,CLERK OF THE BOARD OF cc: General Services SUPERVISORS AND COUNTY ADMINISTRATOR Personnel Rubicon Agriculture Commissioner BY 'DEPUTY County Administrator Page 2 BACKGROUND: The Board of Supervisors adopted a preliminary two year financial plan for use of Keller Canyon/Acme Landfill revenues December 20 which identified a$292,000 shortfall in the surcharge category (see attached). On February 6, the Finance Committee determined that a 20% reduction or$232,000 would need to be cut from programs receiving surcharge revenues in fiscal year 1995- 96. The Committee requested appropriate information from each program and scheduled March 20 as the date to review the programs. The Committee reviewed written reports and took testimony from representatives of the following three programs: (A) Recycling/Resource Recovery Program (General Services); (B) Career Development(Personnel); and (C) SSI/Money Management(Rubicon). Attached are the written reports presented by the program representatives. Also,the Social Services Department staff presented written recommendations and provided testimony to the Committee(see attached recommendations). The County Administrator concurred with the Social Service Department recommendations. The Committee formulated the six recommendations indicated above and expressed concern over the reduced revenue stream from Keller Canyon Landfill and the Acme Transfer Station. The Committee requested a follow-up review of this matter prior to final action at the 1995-96 budget hearings. 1 J TO: BOARD OF SUPERVISORS Contra FROM: Phil Batchelor Costa County Administrator Ocufty DATE: December 20, 1994 SUBJECT: Two Year Keller Canyon/Acme Landfill Revenue Forecastand Program Appropriations SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION RECOMMENDATION(S): I ACCEPT the report of estimated Keller Canyon revenue and program appropriations for fiscal years 1994-95 and 1995-96. (See attached spreadsheet) 2. Tentatively APPROVE the two year financial plan, which reflects a reduced waste stream, rates, revenues and the implementation of new franchise fees at Acme Transfer Station 3. DIRECT staff to explore alternatives for reducing the $292,200 shortfall as a result of this plan. BACKGROUND/REASON(S) FOR RECOMMENDATION(S): Over the past several months, the Board of Supervisors has worked to reconsider Keller Canyon mitigation fees and appropriate Keller mitigation fees to specific projects. Staff has incorporated the work of the Finance Committee, the Transportation Committee, the Internal Operations Committee and the EBRPD Liaison Committee into a proposed budget and expenditure plan for FY 94-95, (See attached spreadsheet) Staff is also providing a preliminary reconciliation of accounts and a projection of the amount of funds that will be generated for FY 94-95 and FY 95-96 in new fees, to enable departments and project proponents to make projections for future budgets. We have, therefore, prepared a budget forecast based on anticipated revenues, including estimated revenues from the Acme Transfer station as a result of new franchise fees, Staff is not asking the board to adopt the FY 95-96 budget at this time; however, it is important to consider areas of shortfall in future planning. CONTINUED ON ATTACHMENT. —YES SIGNATURE: —RECOMMENDATION OF COUNTY ADMINISTRATOR—RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON APPROVED AS RECOMMENDED—OTHER VOTE OF SUPERVISIC,11S I HEREBY CERTIFY THAT THIS IS A UNANIMOUS (ABSENT TRUE AND CORRECT COPY OF AN AYES: NOES: ACTION TAKEN AND ENTERED ABSENT: ABSTAIN: ON MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN, Contact Tony Enea,646-4094 ATTESTED PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR cc: GMEDA Steve Goetz-Community Development Van Mager-CAO BY DEPUTY 000000000 C/) (n (n 0 0 0 c c c :3 M =3 30 30 3 3 3 (D (D (D (V w - 4 M, 00000 S- a 'a 'a "a 'o '0 3 3 3 3 3 C/) C/) Cl) a c c c a '0 "D C() cn W 0 0 0 0 0 0 0 .0 '0 -0 n D �Q (B (M =r w W, w (D M m w (D 0 0 3 CD (D 00 (D (D o 3 Ln m > m > 0 0 0 0 0 3 CO (D �o 0 0 0 0 0 m 0 0 CD 0 M ro ' , I - WZ50 �n 3SB35r ;]D = ,"� 3 33ccm = 3coz = Z3 (D = =. 0 Q 3 3 3 3 m W 0 CD w m o w c c c c 0 5c c c c @ V, 5 Ln C :3. 21 2, > 0 2. 2. 2. 2 'D 0 CD Q 0. 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C . . 0 0 0 - cl o a 0 a CD -0 0 c) -, o -0 -N rQ C) C) 0 c) 0 0 80 0 0 C:) (0 0 0 c 0 cc)) 00 0 C:) 00 0 '-" C) o SO 0 (D 0 o C, 0 0 3 0 0 ro 0 4A 0 bo 4A N (D N ooO p O N 3' < CL 0 0 0 (D M, 1 c 2 0 0 0 0 ro C) 0 0 6 0 r.L (D 0 M C) @ -3 0 409 419 tQ O -4 (.00 O p P) (D p a o 0 C) B C) 0 CD C) 0 c roC P. co oo co co C) CD 0 0 C) :3 0 C) Cil 0 co C D (0 3 co3 0 co 'D 0 0 CD 4A > toX '0 co Cil 0 C) C) 0 W 0 61 N 4A 4A 0 3 t,j 'N W R 0 0 = CD C> CL I Ir GENERAL SERVICES DEPARTMENT ADMINISTRATION 1220 MORELLO AVENUE, SUITE 200 MARTINEZ, CALIFORNIA, 94553 510-313-7100 Date: March 7, 1995 To: Members of the Finance Committee From: Bart Gilbert, Dirof General Services By: Kathy Brow;%uty General Services Director Subject: Report on County Recycling/Resource Recovery Program and Use of Keller Funds Background: In January, 1995 you requested that recipients of Keller Recycling fees report back to the Finance Committee in March on the use of the fees and how any reduction of funding would affect service delivery in FY 1995-96. The County General Services Department has been budgeted previously for $420,000/year to support a Countywide Recycling Program using General Assistance (GA) welfare participants for the primary staffing of the Program with some County staff serving as Crew Leaders. The Recycling Program, as well as other work programs, have been supported by Local No. 1, the labor organization that represents the County Crew Leaders. ♦ Program Description: The General Services Departments Recycling/Resource Recovery Program collects white/mixed paper and cardboard from within County buildings, sorts the paper at the County Recycling Center, shreds confidential documents, and bales paper materials for sale. Collection work crews gather paper products from buildings, surplus furniture and equipment from departments that don't need it , and illegally discarded tires along public roadways. These crews bring the items to the Center where work crews sort and bale paper, pack tires for disposal, chip grounds debris for mulching, store and give out recycled paint for Environmental Health, -and allow departments needing furniture and equipment to view and select items, collected by General Services Department Recycling Report Page 2 the crews, from departments no longer needing them. All work crews consist of GA participants with Crew Leaders. Some crews go to County buildings to collect paper or salvaged furniture, some crews are located at the Recycling Center, and some crews work in field assignments. Approximately 80 GA participants/day work in the area of Recycling/Resource Recovery with 7 or 8 County Crew Leaders plus a Manager. These crews are in addition to other GA work crews that provide litter clean-up, weed abatement, tree planting, trail maintenance, and grounds work training. ♦ Program Benefits: The County Recycling Program staff collect 1.23 million pounds of paper annually that would otherwise go into the waste stream. This collection of paper materials allows the County to meet its SB939 legal mandate to reduce materials going to landfills by 50%. GA participants in the Recycling Program provide approximately 96,000 hours of labor each year at no additional salary above a GA grant. At $5.00/hour this labor would be worth $480,000/year to benefit the community. if County Custodians are used to collect the recycling materials instead of work crews, at least 5 Custodians would have to hired at a cost of approximately $250,000 annually. They would not do other work provided by the work crews. GA participants in the Recycling Program learn work skills, especially the GA participants who request to be in the Recycling Training component , where GA participants volunteer to work in a 6-week-assignment to learn how to use equipment such as the baler and chipper. Successful Trainees receive Certificates of Completion, and some GA participants have acquired jobs in the private sector. The Social Service Department assigns GA referrals to work crews; and after proper notifications to participants, can issue sanctions to participants who fail to meet work assignments. If a participant doesn't meet work program requirements and has been given the opportunity to respond without providing valid explanations, then the GA participant can have his/her grant discontinued for a period of time. Since approximately 50% of scheduled participants don't appear and some don't have good causes for not meeting work assignments, then GA grants can be discontinued for some period. Approximately 3,300 GA don't meet GA work assignment requirements in a year. If these individuals receive at least one month sanction, loss of grant, in a year, then the reductions in GA costs, at an average grant of $300/month, would be $990,000. Longer periods sanctions result-'in more reductions. General Services Department Recycling Report Page 3 Confidential document shredding and sale of white paper results in annual revenue of $60,000, depending on the price of paper. County departments receive the benefits of the reissuance of furniture and office equipment. Some departments don't need some items, and our crews pick up these items and take them to the Center where departments are offered the opportunity to obtain desks, chairs, bookcases, and other equipment and furniture that they don't have to buy. This is a popular program with departments because it represents a savings to departments that don't have to buy new items and certainly meets the spirit of recycling. Approximately 4,000 illegally dumped tires are collected by work crews from along public roadways each year. People dump them on the roadways instead of taking them to disposal sites. It is expensive to take them to the dump, and there's no market to purchase them, even though there are some firms that recycle tires. By having the Recycling crews band them in disposal containers, the tires can be disposed of to a vendor who charges a disposal free of $.814.85/tire. Otherwise disposal costs are $3.0041 0,00/tire. This results in an average annual cost that is $24,000 less than what it would cost the County for disposal. The Recycling Center is also the site for storage and distribution of recycled paint collected by special hazardous waste collections by Environmental Health. Recycling staff give paint to any agencies and the public that want it. The Center is used to chip brush, tree branches, and green waste that is then used as mulch around County buildings to save on water and not have to take these materials to a dump. County garbage costs would increase if recycling were not done. While General Services staff have been carefully monitoring the collection of garbage to save departments money, some of the savings would disappear if recycling isn't done. Garbage service would have to increase, and this would cost something around $135,000/year. Even if recycling is able to be done at some buildings by garbage companies, private companies require materials to be placed at curbside once/week in approved containers where materials have been sorted and tied or bagged. Someone would have to collect the materials from inside buildings, sort them, and containerize them. Then someone has to put the materials outside for collection. This is labor intensive, and it would be handled by Custodians. In contract-custodial buildings there would be an extra charge for Recycling service. If it's too difficult and expensive, then departments won't recycle. Paper will go into the trashcans. General Services Department Recycling Report Page 4 ♦ Synopsis of County Recycling Program: Revenues and Expenditures-FY 94/95 Keller Fund Appropriation for Recycling Program $420,000 Paper sale and confidential document shredding revenue 60,000 Charges to departments for furniture collection 20,000 Total Revenue $500,000 Total Costs-County labor, materials, equipment, occupancy $500,000 *Value of Services-Direct GA labor $480,000 Garbage service reduced costs 135,000 Brush and limb chipping for mulch and water savings 14,500 Furniture and equipment savings to departments 20,000 Tire disposal cost reduction 24,000 Estimate of GA sanctions if 1 month/year 990.000 Total Value of Direct Services $1.663,500 *Value of Services-Indirect Old computers given to schools(with CCC plaque as donor) Reconstituted paint is brought to Center to give away County furniture, books, and equipment salvaged and recycled Recycling of 1.25 pounds of paper materials diverted from dumps Provision of work experience for GA participants General Services Department Recycling Report Page S ` ♦ Conclusion: The County Recycling Program is a multi-faceted operation that benefits Contra Costa County. The use of Keller funds has allowed the Center to save money and provide work opportunities for GA participants to improve the community and meet the goals of recycling materials to keep them out of landfill. If these funds are significantly reduced or eliminated, then the savings and direct and indirect value of the Program will be drastically curtailed or eliminated. The costs of having County staff assume the labor for collecting the paper materials and the reductions in costs for the GA Program will exceed the money provided by the Keller funds. The additional activities described above won't be possible. Paper revenues will disappear. The Recycling and clean up activities can't be done without funding. General Services is interested in expansion of recycling and other work activities to outside the County and has prepared a Fact Sheet describing available services. If other agencies contract with the County for services, such work won't address the County's need to fund its Program. County work crews could be reassigned to other agencies, but the County's needs couldn't be met without funding. For next fiscal year, departments will be assessed a fee for recycling services, and this will add $102,454 to the revenue side. The General Services Department's request to the Finance Committee for continued Keller funding for Recycling is thus being reduced from $420,000 for next year to $317,546. The Department respectfully requests that the Committee recommend that this amount be funded by the Board of Supervisors. BG: KB st: Personnel Department L Contra i .f ' AdministrationBldg. 9- County 651 Pine Street lrll �� x� _,`".,-,•'` •'•� /lJ , y` Martinez, California 94553-1292 �G - a Jr Tia court Date: March 14, 1995 To: Finance Committee From: Leslie T. k9t, Director of Personnel Subject: Career Development Employment Program - (Custodial/Recycling Project) BACKGROUND On May 19, 1992 the Personnel and the Social Service Departments were directed by the Board to seek ways in which they could cooperate in the identification and placement of General Assistance recipients through the Career Development Employment Program. They also asked staff to explore ways in which training methods developed by the Career Development Employment Program might be used to assist G.A. recipients who would be working in County departments in connection with their workfare agreements. Costs associated with implementing the changes were recognized by the Board and the Board allocated$15,000 to the Personnel Department to assist G.A. recipients in obtaining private sector employment based on their skills obtained through the Recycling Center Workfare Program. The Board has continued each fiscal year to allocate $15,000 to the Personnel Department. DISCUSSION The Custodial Training Program which was considered a joint project between the Social Services, General Services and Personnel Departments, was converted to a Home Study/On The Job Training Program in August 1992 to accommodate the different work schedules and work locations of the G.A. participants. In 1993 the County experienced a budget crisis that resulted in over five.hundred jobs being eliminated and approximately a hundred and thirty employees being either laid off or displaced to lower level positions. Many more employees were forced to accept part-time or temporary work. This subsequently led to the suspension of the Career Development Employment Program because of the layoffs that were occurring in the County. The Personnel Department began directing its efforts towards the implementation of the Tactical Employment Team Program (TETP). This program was established to provide a wide range of employment counseling to laid-off County employees. As depicted in Attachment 1, many of the employees who were adversely impacted by the layoffs were minorities and persons hired through the Career Development Program. County departments were asked for their full cooperation in implementing TETP in order to insure that employees who were facing layoff were r given every opportunity to continue their employment with the County in another capacity or to be placed in positions in the private sector. The TETP objectives are as follows: ► Develop and maintain an employee skills inventory bank to match employees with available job opportunities; ► Offer a variety of services and training to meet the needs of affected employees and the County; • Facilitate job placement for laid-off County employees in positions; • Monitor layoffs, rehires, and employment referrals by job class, gender and ethnicity; ► Identify actions that will enhance the placement of County employees before and/or after layoff. As part of the TETP, the Personnel Department expanded its employment counseling to include job search and placement activities in areas such as resume preparation and job search planning. The Personnel Department was also available to provide workshops and seminars on a variety of subjects such as job re-training and alternate career exploration through the:TETP. Most of the County employees who were laid off were rehired in permanent and temporary positions as depicted in Attachment 2. Tactical Employment Team Program activities are summarized in Attachment 3. The Personnel Department has kept the Custodial/Recycling Training Program training materials current and is prepared to meet with both the Social Services and General Services staff to revisit and formalize the Custodial/Recycling Training Program. However, in light of the current fiscal projections and anticipated layoffs (departments have been asked to prepare for a 20% budget reduction), the Personnel Department will continue to direct its efforts towards its Tactical Employment Team Program. FISCAL IMPACT ► $15,000 allocated to the Personnel Department from Keller Canyon/Acme Landfill Surcharge for FY 1994-95. RECOMMENDATION Continue to staff and expand the services provided under the Tactical Employment Team Program. LTK:LM Attachments a o rn 00 c� 0 7 o a C CD c� CD y r .D Cp 0 a > �MMc CCD y � N cn COO ] O N >'}> }" N ,: : :.......: �C Oji-i-'j`Y•. .y y 22 O }FS. :.: : #j# tTj CD CD V ,--gxv...SYv}v `• 00 CIO cl V.� y 4P- o r^ M r b � CD p � O CD CD r CD C �c 0 o �. o. 0CD d O 0 0 bd c� co e ytTj -------------- CD c� - '«< .. a+ .z W z } n z y a A CD y w d CD CD C CD � h--1 O • w Attachmn nt 3 TACTICAL EMPLOYMENT TEAM PROGRAM ACTIVITIES • A memo explaining T E.T.P. goals and objectives was distributed to all County employees with their December 10, 1993 pay checks All County employees scheduled to be laid off during the period August - October, 1994 individually received a T.E.T.P. information package that included the following: ■ T.E.T.P. Services ■ Employee Benefits ■ Employee Rights Four T.E.T.P. workshops were held covering the following topics: ■ Layoff Policy and Procedures ■ Employee Benefits and Rights ■ Temporary Employment Opportunities a Retirement ■ "Surviving a Layoff" ■ Crisis Intervention Counseling ■ Stress Management ■ Financial Planning ■ Other Employee Assistance Services 102 laid-off employees appointed to permanent positions 0 16 laid-off employees appointed to temporary positions • 21 laid-off employees currently available for work 5 laid-off employees retired 24 laid-off employees will not accept temporary work, relocated or have not responded to T.E.T.P. correspondence T e Center For .applied.Local Wesearck 120 BROADWAY, Sun -21 • RICF 4OND, CA 94804•(510)970.7520• FAX(510)970.7526 EVALUATION OF RUBICON SSI AND MONEY MANAGEMENT PROGRAM I - JANUARY 13, 1995 Iraj J. Imam, Ph.D. Thomas L. Foster M.S. Revonda Downs TABLE OF CONTENTS EXECUTIVE SUMMARY............... I. INTRODUCTION.............................................................................7 II. METHODS....................................................................................8 III. COST SAVINGS AND COST AVOIDANCE.........................................9 A. SHIFT FROM GA TO SSI.......................................................................9 B. HOMELESS SHELTERS--SOCIAL SERVICES DEPARTMENT SAVINGS.......................9 C. MENTAL HEALTH SERVICES--HEALTH DEPARTMENT SAVINGS ........................ 11 D. HOSPITAL AND EMERGENCY ROOM SERVICES--HEALTH DEPARTMENT SAVINGS.... 12 E. JAIL AND PRISON COST AVOIDANCE ....................................................... 15 W. OVERALL COST AVOIDANCE AND PROJECTIONS FOR 1995.......... 16 A. COST AVOIDANCE FOR COMBINED SERVICES............................................. 16 B. PROJECTION OF COST AVOIDANCE FOR 1995 ............................................. 17 V. SUMMARY AND CONCLUSIONS.................................................... 19 ACKNOWLEDGMENTS .....................................................................22 APPENDIX.......................................................................................23 Evaluation of Rubicon's SSI Advocacy and Money Management Program EXECUTIVE SUMMARY IEvaluation of SSI Advocacy and Money Management Program, Rubicon Programs Inc. I. Introduction Since 1990, Rubicon Programs has operated an SSI Advocacy and Money Management Program for Contra Costa County. Rubicon Programs secured a $10,000 grant from the Northern California Grantmakers to conduct an independent costs and benefits evaluation of the program. Rubicon Programs Inc. contracted with The Center for Applied Local Research (CAL 1 Research) to conduct the evaluation of their SSI Advocacy and Money Management Program. CAL Research is a non-profit organization founded in 1987 to use social science and related skills to improve the quality of human service delivery systems at the local level. ' H. Methods In this evaluation, we focus on estimating the financial costs and benefits of the Rubicon's SSI Advocacy and Money Management Program to Contra Costa County. The evaluation does not include the organizational, administrational, and policy implementation aspects of the program. We estimated the financial benefits of the SSI Advocacy and Money Management Program to the County in two ways: (1) The direct savings resulting from shifting people from the General Assistance (GA) to SSI and staying on SSI, and (2) The cost avoidance or, "multiplier" savings, resulting from reduction in utilization of County services by people in the Money Management Program. 1 Data came from various County Departments.artments. We contrasted the use of these services by Rubicon's clients before their enrollment in the Money Management Program with their use during the enrollment. We calculated the differences in service use by these clients to estimate cost avoidance to the County. Where the actual data were not available, we used the estimates based on a survey of clients in the Money Management Program. (Because it relies on the memory of clients, the survey tends to under- estimate service use. For example, clients under-estimated their use of homeless shelters by more than four times the actual data.) Finally, we used the average annual savings estimates to project total financial saving to the County for 1995 (based on the 95 clients currently contracted with Rubicon by the County). The Center for Applied Local Research 3 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM l Evaluation of Rubicon's SSI Advocacy and Money Management Program s M. Cost Savings and Cost Avoidance Both the actual and the sum!ey data show that when people are in Rubicon's Money t Management Program they use less of County services (in all service categories). These data demonstrate the benefits of the Rubicon's Program to clients and to the County. Clients' life situations seemed to become more stabilized and hence their needs for services tended to decrease. This reduction in service utilization directly translates to financial benefits to the County. A. Shift from GA to SSI • Based on the data provided by the Hawkins Center, the annual net recovery to the County after reimbursement of attorneys fees is about $579,996. B. Homeless Shelters--Social Services Department Savings • The data from Richmond and Concord shelters indicate that, on the average, clients ' spent 82.9 days before coming to Rubicon and only 20.5 day during their stay in the program. The savings are close to 63 days of shelter not used by Rubicon clients. With the average $27 per night, the average cost per client is about $2,241 ' before joining Rubicon and about $554 per client during their stay in the program.. This amounts to $333,857 for the duration of the program. • On the annual basis, the savings are $83,507. • Projected savings for 1995 are estimated at $160,265 (based on 95 clients). C. Mental Health Services--Health Department Savings • The Mental Health data demonstrate the average savings per client per year is about $1,494 or, $295,812 for 198 clients served between 1991 and 1994. • Average annual savings for average number of clients per year (49.5) equals $73,953. • Projected savings for 1995 are estimated at $141,930 (based on 95 clients). D. Hospital and Emergency Room Services--Health Department Savings • The average use of hospitals was 75.7 days for clients before joining Rubicon and 8.7 days while in the program. This amounts to savings of 66.9 days per year per client. The average annual saving of hospital days equals 3,043.9 days (based on average of 45.5 clients per year). We estimate 50% ratio of recoupment of general The Center for Applied Local Research 4 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(5 10)970-7520 FAX:(5 10)970-7526 Internet: CALRFSCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program funds to the County based on patients with Medical or Medicare. According to Patient Accounting, room and board with doctor visit costs about $700 and, , Emergency Room visits cost about $444. • Factoring in these rates, annual cost avoidance for using hospital room amounts to $1,159,043. • Using the same methods, on the average, Rubicon clients had 5.5 Emergency Room Visits prior joining Rubicon compared to 3.38 visits while in the program. The net saving per year are 2.12 visits for each client or, 96.45 visits for all clients. • Factoring the same 50% ratio, the Emergency Room visit savings amount to $23,297, annually. • Combined hospital use and Emergency Room visit cost avoidance total to $1,182,332 per year. • Projected savings for 1995 are at $2,269,122. E. Jail and Prison • On the average, each client spent 45.9 days in jail or prison before coming to Rubicon vs. 4.5 days while in the program. Based on $56 average cost per day, the annual average cost for clients before coming to Rubicon amounts to $116,980 compared to $11,800 for clients in the program. • The net average savings to the County, or cost avoidance, on the annual basis equals $114,705. • Projected saving for 1995 are at $220,115. F. Prevention of Return From SSI Back to GA Without Representative Payee Status • In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients returning from SSI to GA ranges from $346,560 (100% return) to $86,660 (25% return). These figures are preliminary estimates and more accurate estimates require further research. The Center for Applied Local Research 5 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH a AOL.COM n's SSI Advocac and Mone Management Program Evaluation of Rubtco y y g IV. Overall Cost Avoidance and Projections for 1995 • The overall annual average cost avoidance / savings to the County is estimated at ` $2,034,479 ($1,454,483 + $579,480; items A-E, excluding F). • The total projected cost avoidance / savings to the County for 1995 amount to $3,371,476 (based on 95 clients, $2,791,480 + $579,480; items A-E, excluding item F). Acknowledgments We would like to thank the staff of Mental Health Division, Health Services Department, Social Services Department, and the Housing Authority for their cooperation with this evaluation. The Center for Applied Local Research 6 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Evaluation of SSI Advocacy and Money Management Program, Rubicon Programs Inc. I. Introduction Rubicon Programs Inc. contracted with The Center for Applied Local Research (CAL Research) to conduct the evaluation of their SSI Advocacy and Money Management Program. CAL Research is a non-profit organization founded in 1987 to use social science and related skills to improve the quality of human service delivery systems at the local level. The SSI Advocacy and Money Management Program is a cooperative venture between the Contra Costa County Department of Social Services, The Hawkins Center of Law and Services for the Disabled and Rubicon Programs, Inc. Since 1990, the Hawkins Center and Rubicon Programs have operated an SSI Advocacy and Money Management Program for Contra Costa County. The program operates in two stages: First, shifting people from General Assistance (GA) to SSI; and Second, keeping people on SSI by managing their money--by becoming their representative payee. The Hawkins Center manages the first part of the program and the Rubicon Programs manages the second part. The benefits to the clients include an increase in their income, access to MediCal, and improvement in their living conditions such as permanent housing and learning new skills. Financial benefits to the County include direct recovery for prior GA disbursements from the retroactive benefits of the clients entitled to SSI and MediCal, and cost avoidance: of future GA payments to clients successfully transferred to SSI', of health care costs of clients transferred to MediCal; and of reduction in use of the County human services by the clients in Rubicon Programs. Rubicon Programs secured a $10,000 grant from the Northern California Grantmakers to conduct an independent costs and benefits evaluation of the program. This report is organized in four parts: I. Introduction; 11. Methods; III. Cost Savings and Cost Avoidance; and IV. Conclusions. The Center for Applied Local Research 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH Q AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program U. Methods In this evaluation, we focus on estimating the financial costs and benefits of Rubicon's SSI Advocacy and Money Management Program to Contra Costa County. The evaluation does not include the organizational, administrational, and policy implementation aspects of the program. We estimated the financial benefits of the SSI Advocacy and Money Management Program to the County in two ways: (1) The direct savings resulted from shifting people from the General Assistance (GA) to SSI and staying on SSI, and (2) The cost avoidance or, "multiplier" savings, resulted from reduction in utilization of the County services by the people in the Money Management Program. (The first six months of this program was analyzed in the Hawkins/Rubicon "Six Month Progress Report", July 1991.) Cost avoidance benefits to the County are particularly significant, due to the at-risk life situations of most Rubicon clients. These clients, according to the Hawkins Center, tend to be high users of the County emergency services. If Rubicon Programs can assist these at-risk clients to stabilize their living conditions, then the clients will tend to use less of the County emergency services. In the absence of the Rubicon Programs, those at-risk clients were likely to have remained high user of the County's emergency services. The primary source of data came from various County departments. We contrasted the use of these services by Rubicon's clients before their enrollment in the Money Management Program with their use during the enrollment. We calculated the differences in service use of these clients to estimate cost avoidance to the County. We used the actual data on utilization of Mental Health and Homeless Shelter services by the Rubicon clients. Where the actual data were not available, we used the estimates based on our survey of active clients in the Money Management Program. (Because it relies on the memory of clients, the survey tends to under-estimate the service use. For example, clients under-estimated their use of homeless shelters by more than four times the actual data.) We used the actual data on direct savings from the report prepared by the Hawkins Center (in progress). Finally, to make the data comparable, we normalized the cost and savings data on the annual basis for each client. For each category, we calculated average annual costs per client. We used these computed average annual savings estimates to project total financial saving to the County for 1995 (based on the 95 clients currently contracted with Rubicon by the County). The Center for Applied Local Research 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program 111. Cost Savings and Cost Avoidance A. Shift from GA to SS In this part, we use the data from a report by the Hawldns Center SSI Advocacy Program to estimate the financial benefits to the County. According to the Hawkins Center, between January 1, 1992 and June 30,1994, "the total recovery of GA benefits alone the county has made from all clients represented by the Hawkins Center is $1,159,991.90. The net recovery to the county after reimbursement of attorneys fees has been $869,993.92". This is for 18 months. Normalizing on the annual basis, the net recovery to the County amounts to $579,996 per year. This figure does not include any of the possible retroactive benefits. For example, according to the Hawkins Center, each client who is awarded retroactive SSI benefits is also entitled to MediCal benefits for all the months since the date the application was filed. Also not included are possible savings to the MIA health plan funds resulting from the clients' future and retroactive entitlement to MediCal. B. Homeless Shelters--Social Services ftartment Savings In this section, we estimate the costs and savings of the Rubicon's Money Management Program to the County. The program has operated for four years and has served 198 clients, with average of 49.5 clients per year. We calculated the data on use of homeless shelters for each Rubicon's client (data provided by the Contra Costa County Housing Authority). These data from Richmond and Concord shelters--normalized on the annual basis-- indicate that, on the average, each client spent 83 days in shelter programs before coming to Rubicon and only 20.5 day during his or her stay in the program. The savings are about 62.4 days of shelter not used by Rubicon clients. Table 1 shows that with an average $27 cost per night (according to the Housing Authority), the average annual cost per client is about $2,241 before joining Rubicon and about $554 per client during their stay in the program (see Figure 1). This amounts to $334,028 for the duration of the program. On an annual basis, the savings are about $83,507 or, $1,686 per client. The Center for Applied Local Research 9 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Table 1 Homeless Shelter Cost Avoidance Homeless Shelter Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $2,241 Average Annual Costs per Client During Rubicon Program $554 Average Annual Cost Avoidance and Savings per Clien $1,687 Average Annual Cost Avoidance $83,507 Shelter Cost per Day $27 Average Days of Shelter Use Before Joining Rubicon 83.00 Average Days of Shelter Use During Rubicon Program 20.50 Average Number of Clients Served, 1991-94, 49.5 Total Number of Clients Served, 1991-941 198 Source: Housing Authority. Figure I Annual Average Homeless Shelter Costs and Benefits per Client- Year X., Cost Avoidance Per K� en ear .......... X Cost During Rubicon ............ ProgramNear ............ ...... ..... ............. .. .. ......... .... ..... Cost Before Joining 6 OPA 0. 4 RubiconNe; $0 $500 $1,00 $1.50 $2,000 $2,50 In our survey of the Rubicon's active clients, we found that all respondents indicated that they used more County services before joining the Rubicon's Money Management The Center for Applied Local Research 10 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH Q AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Program than they did while in the pr.ogram. For example, they systematically under- estimated their use of homeless shelters. We show in Table 1 that the average annual shelter days avoided, or saved, is about 62.5 days (83 - 20.5 = 62.5). Using the survey data, however, the average annual shelter days avoided is about 15.4 days (31.4 - 16 = 15.4). Because it relies on the memory of clients, the survey data tends to under-estimate the service use. In the case of homeless shelter use, the data are under- estimated by factor of four (62.5 / 15.5 = 4.05). The actual data, as mentioned above, include only Richmond and Concord homeless shelters and hence do not include other public or private shelter. On the annual basis, the savings are about $83,507, or $1,687 per client. C. Mental Health Services--Health Department Savings We used the actual Mental Health service utilization data for each Rubicon client and calculated the cost avoidance savings to the County. In Table 2, we show the annual average cost of Mental Health services used by the clients. We used the data on service use for each client before coming to Rubicon and on service use during their stay in the program. We computed annual average costs for all clients served between 1991 and 1994 in Figure 2. Table 2 Mental Health Cost Avoidance Mental Health Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $4,959 Average Annual Costs per Client in Rubicon Program $3,465 Average Annual Cost Avoidance / Savings per Client $1,494 Average Annual Cost Avoidance $73,953 Avera.ge Number of Clients Served, 1991-94 49.5 Total Number of Clients Served, 1991-94 198 Source: Mental Health Division,Health Services Department. The Center for Applied Local Research 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Figure 2 Average Annual Mental Health Costs and Benefits per Client-Year Cost Avoidance per ClientfYcar ......... ...... Cost During R bicon Program/Year CostBefore Joining Rubicon[Year . ....... ........ . ................ $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 The Mental Health data demonstrate that the annual average savings per client is about $1,494 or, $295,812 for 198 clients served between 1991 and 1994. Average annual savings for 49.5 clients equals $73,953. Q. Hospital and Emergency Room Services--Health Department Savings For those services that actual data were not able, we used the estimates of service use from our survey of the active Rubicon clients. These estimates, in general, tend to under-estimate service use. In Table 3, we show that average use of hospital beds was 75.7 days for clients before joining Rubicon and 8.7 days while in the program. This amounts to savings of 66.9 days per year per client. The average annual saving of hospital days equals to 3,311.5 days (based on average of 49.5 clients per year). We estimate 501 ratio of recoupment of general funds to the county based on patients with MediCal or Medicare. According to Patient Accounting, room and board with doctor visit costs about $700 and Emergency Room visits cost about $444. Factoring in these rates, annual cost avoidance for using hospital room amounts to $1,159,042. In Figure 3, we show estimates of average annual costs per client. The Center for Applied Local Research 12 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH Q AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Table 3 Hospital.Bed Cost Avoidance Hospital Bed Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $52,990 Average Annual Costs per Client During Rubicon Program $6,160 Average Annual Cost Avoidance/ Savings per Client $46,830 Average Annual Cost Avoidance (50% ratio of recoupment) $1,159,042 Hospital Bed and Doctor Visit Cost per Day $700 Average Days of Hospital Use Before Joining Rubicon 75.70 Average Days of.Hos pital Use During Rubicon Program 8.80 Total Number of Clients Served, 1991-94 198 Source: Survey of Active Clients in Rubicon's Money Management Program;Patient Accounting. Fligure 3 Average Annual Costs and Benefits of Hospital Use per Client-Year Cost Avoidanceper ........... ....... ........... Client/Year ........ Cost Du nn .... ................... 9 .............. ... ..... .............I I.......... .............. ... Prograrn/Year ............. ...... ..... ............. ......... ... ........ ... ............ ..... —.... .... .... .... ...I ...... ........... ......... I............. ...... .. ..... .. .... ..... . .......... Cost Before Joining Rubicon/Year ............. ........... ---------- ................ ........ .. ....... ..... .— . .......... ... .... .... $0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 We show in Table 4 cost avoidance for Emergency Room visits by Rubicon clients. Using the same methods, on the average, Rubicon clients had 5.5 Emergency Room Visits prior joining Rubicon compared to 3.38 visits while in the program. The net saving per year are 2.12 visits for each client. Factoring the same 50% ratio, the Emergency Room visit savings amount to $23,297 per year. In Figure 4, we show estimates of average annual costs per client. The Center for Applied Local Research 13 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(5 10)970-7520 FAX:(5 10)970-7526 Internet: CALRESCH C AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Table 4 Hospital Emergency Room Cost Avoidance Hospital Emergency Room Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $2,442 .Average Annual Costs per Client During Rubicon Program $1,501 Average Annual Cost Avoidance/ Savings per Client $941 Average Annual Cost Avoidance (50% recoupment) $237297 - Emergency Room Cost per Visit $444 Average E. R. Visits Before Joining Rubicon 5.50 Average E. R. Visits After Joining Rubicon 3.38 Average Number of Clients Served, 1991-94 49. Total Number of Clients Served, 1991-941 198 Source: Survey of Active Clients in Rubicon's Money Management Program;Patient Accounting. Figure 4 Average Annual Emergency Room Costs and Benefits per Client-Year ... ...... .......... Cost Avoidance per Client/Year ..... ..... ........ ...... ..... ............ ......... .............. ..... Cost During Rubicon . ..... ............. M Program/Year .................. OEMCost Before I om* m* g X., Rubicon/Year ... ..... . ..... $0 $500 $1,000 $U00 $2,000 $2,500 The Center for Applied Local Research 14 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program E. Jail and Prison Cost Avoidance Table 5 shows that, based on the survey data, each client spent an average of 45.93 days in jail or prison before coming to Rubicon vs. 4.55 days while in the program. Based on $56 cost per day (according to the Six Month Report by Hawkins/Rubicon), the average annual cost per client before coming to Rubicon amounts to $2,572 compared to $255 for clients in the program. The average annual cost avoidance per client is about $2,317, shown in Figure 5. For the average 49.5 clients per year, the total annual cost avoidance amounts to $114,705. Table 5 Jail and Prison Cost Avoidance Jail and Prison Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $2,572 Average Annual Costs per Client During Rubicon Program $255 Average Annual Cost Avoidance / Savings per Client $2,317 Average Annual Cost Avoidance $1141705 -- Cost per Day $56 Average Days of Jail and Prison Before Joining Rubicon 45.93 Average Days of Jail and Prison During Rubicon Program 4.55 Average Number of Clients Served, 1991-94 49.5 Total Number of Clients Served, 1991-94, 198 Source: Survey of Active Clients in Rubicon's Money Management Program;Six Month Progress Report. The Center for Applied Local Research 15 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Figure 5 Average Annual Jail and Prison Costs and Benefits per Client-Year Cost Avo' ytla nceP er f Client/ Year Cost s ' S Du rm Rubicon icon ProS ram e Y ar Cost Before Joining min B Rubic o n1Ye arX. ? f� $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 F. Prevention of Return From SSI Back to GA Without Representative Payee Status In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients' returning from SSI to GA ranges from $346,560 (100% return) to $86,660 (25% return). These figures are preliminary estimates (based on GA $304 monthly payment) and more accurate estimates require further research. IV. Overall Cost Avoidance of Services to the County and Projections for 1995 A. Cost Avoidance forCombiined Services ! Based on the calculations in the previous section, we will estimate the overall financial benefits of cost avoidance to the County, shown in Table 6. The combined overall average annual cost avoidance per client is estimated at $29,384. Factoring 49.5 average clients per year, average annual cost avoidance amounts to $1,454,483. Adding the net recovery to the County due to shift from GA to SSI, the total average annual cost avoidance is estimated at $2,034,479. The Center for Applied Local Research 16 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAR:(510)970-7526 Internet: CALRESCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program ' Table 6 Overall Cost Avoidance of Services , f Services: Homeless Shelter Costs and Benefits Average Annual Cost Avoidance/ Savings per Client $1,687 Average Annual Cost Avoidance $83,507 Mental Health Costs and Benefits Average Annual Cost Avoidance/ Savings per Client $1,494 Average Annual Cost Avoidance $73,953 Hospital Bed Costs and Benefits Average Annual Cost Avoidance/ Savings per Client a 50% $23,415 Average Annual Cost Avoidance $1,159,043 Hospital Emergency Room Costs and Benefits Average Annual Cost Avoidance/ Savings per Client @509 $471 ' Average Annual Cost Avoidance $23,297 Jail and Prison Costs and Benefits Average Annual Cost Avoidance / Savings per Client $2 317 Average Annual Cost Avoidance $114,705 Overall Services Benefits Average Annual Cost Avoidance for Overall Services per Client $29,384 Average Annual Cost Avoidance for Overall Services (49.5 $1,454,483 clients 1 Shift from GA to SSI Net Recoveg $579,996 Total Cost Avoidance and Net Recovery $2,034,479 Source: Tables 1-5 B Projection of Cost Avoidance for 1995 We will use these estimates to project the financial benefits to the County for 1995. Based on the contract of Rubicon Programs with the County, we will assume a total of 95 clients for 1995. In Table 7, we show overall cost avoidance projections for 1995. The annual average cost avoidance for overall services amounts to $29,384 per,client. Projections for 95 clients in 1995 amount to $2,791,480. Adding the net recovery to The Center for Applied Local Research 17 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRBSCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program the County due to shift from GA to SSI, the total projected figure for 1995 amounts to $3,371)476. Table 7 Projection of O'l-erall Cost Avoidance of Services for 1995 Services.- Homeless Shelter Costs and Benefits Average Annual Cost Avoidance/ Savings per Client $1,687 Average Annual Cost Avoidance $160,265 Mental Health Costs and Benefits AveLa ge Annual Cost Avoidance / Savings per Client $1OA,494 Average Annual Cost Avoidance $141,930 Hospital Bed Costs and Benefits Avera e Annual Cost Avoidance I Savings per Client (0 50%) $23,415 Average Annual Cost Avoidance $2,224,425 Hospital Emergency Room Costs and Benefits Average Annual Cost Avoidance/ Savings per Client (aso%) $471 Average Annual Cost Avoidance $442698 Jail and Prison Costs and Benefits Average Annual Cost Avoidance / Savings per Client" $2,317 Average Annual Cost Avoidance $2201115 Overall Services Benefits Average Annual Cost Avoidance for Overall Services per Client $29,384 Average Annual Cost Avoidance for Overall Services 95 clients) $2791,480 — Shift from GA to SSI Net Recovery $579,996 Total Cost Avoidance and Net Recovery $3,371.476 Source- Tables 1-6 The Center for Applied Local Research lg 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(5 10)970-7520 FAX:(5 10)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program V. Summary and Conclusions Both the actual and the survey data show that when people are in Rubicon's Money' ` Management Program they tend to use less of County services (in all service categories). These data demonstrate.the benefits of the Rubicon's Program to clients and to the County. Clients' life situations seemed to become more stabilized and hence their needs for services tend to decrease. The reduction in service utilization directly translates to financial benefits to the County. We estimated the financial benefits of the SSI Advocacy and Money Management O Program to the County in two ways: (1) The direct savings resulted from shifting people from the General Assistance (GA) to SSI and staying on SSI, and (2) The cost avoidance or, "multiplier" savings, resulted from reduction in utilization of the County services by the people in the Money Management Program. Below, we summarize the estimated financial benefits to the County: A. Shift from GA to SSI • Based on the data provided by the Hawkins Center, the annual net recovery to the County after reimbursement of attorneys fees is about$579,996. B Homeless Shelters--Social Services Department Saving, • The data from Richmond and Concord shelters indicate that, on the average, clients spent 82.9 days before coming to Rubicon and only 20.5 day during their stay in the program. With the average $27 per night, the average cost per client is about 1 $2,241 before joining Rubicon and about $553.5 per client during their stay in the program. • On the annual basis, the savings are about$83,507(for 49.5 clients). C. Mental Health Services--Health Department Savings • The Mental Health data demonstrate the average savings per client per year is about $1,494 or, $295,812 for 198 clients served between 1991 and 1994. • Average annual savings per year equal $73,953 (for 49.5 clients). D Hospital and Emergency Room Services--Health Department Savings • The averse use of hospitals was 75.7 days for clients before joining Rubicon and g P Y J g 8.7 days while in the program. This amounts to savings of 66.9 days per year per The Center for Applied Local Research 19 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(5 10)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program client. The average annual saving of hospital days equals 3,043.9 days (based on average of 45.5 clients per year). We estimate 50% ratio of recoupment of general, funds to the county based on patients with MediCal or Medicare. According to Patient Accounting, room and board with doctor visit costs about $700 and Emergency Room visits cost about $444. • Factoring in these rates, average annual cost avoidance for using hospital room amounts to $1,159,043. • Using the same methods, on the average, Rubicon clients had 5.5 Emergency Room Visits prior joining Rubicon compared to 3.38 visits while in the program. The net saving per year are 2.12 visits for each client or, 96.45 visits for all clients. o Factoring the same 50% ratio, the annual average Emergency Room visit savings amount to $23,297. • Combined hospital use and Emergency Room visit cost avoidance total to $1,182,332 per year. E. Jail and Prison o On the average, each client spent 45.9 days in jail or prison before coming to Rubicon vs. 4.5 days while in the program. Based on $56 average cost per day, the annual average cost for clients before coming to Rubicon amounts to $116,980 compared to $11,800 for clients in the program. • The average savings to the County on the annual basis equals $114,705. F._ Prevention of ReturnFrom SSI Back to GA Without Representative Payee Status • In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients returning from SSI to GA ranges from $346,560 (100% return) to $86,660 (25% return). These figures are preliminary estimates and more accurate estimates require further research. Therefore, we will not these figures in our estimates. G. Overall Cost Avoidance • The overall annual average cost avoidance / savings to the County is estimated at $2,034,479 ($1,454,483 + $579,480; items A-E, excluding F). The Center for Applied Local Research 20 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH Q AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Below, we summarize the projected Cost Avoidance savings to the County for 1995: A. Shift from GA to SSI 9 Based on the data provided by the Hawkins Center, the annual net recovery to the County after reimbursement of attorneys fees is about$579,996. B. Homeless Shelters—Social Services Department Sayiags * Projected savings for 1995 are estimated at $160,265 (based on 95 clients). C. Mental Health Services—Health Department Savings e Projected savings for 1995 are estimated at $141,930 (based on 95 clients). D. Hospital and Emergency Room Services—Health Department Savings 9 Projected savings for combined hospital use and Emergency Room visit for 1995 are estimated at $2,269,122. E. Jail and Prison 0 Projected jail/prison cost avoidance/ savings for 1995 are estimated at $220,115. F. Prevention of Return From SSI Back to GA Without Representative Payee Status 9 In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients returning from SSI to GA ranges from $346,560 (100% return) to $86,660 (25% return). These figures are preliminary estimates and more accurate estimates require further research. Therefore, we will not these figures in our estimates. G. Overall Cost Avoidance The total projected cost avoidance and savings to the County for 1995 amount to $3,371,476 (based on 95 clients, $2,791,480 + $579,480; items A-E, excluding item F). The Center for Applied Local Research 21 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Acknowledgments We would like to thank the :staff of Mental Health Division, Health Services Department, Social Services Department, and the Housing Authority for their cooperation with this evaluation. The Center for Applied Local Research 22 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH a AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program ® APPENDIX The Center for Applied Local Research 23 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM • Evaluation of Rubicon's SSI Advocacy and Money Management Program Rubicon Programs Inc. CLIENT INTERVIEW This interview will help us to find out how well the Rubicon's Money Management Program is serving its clients. We will not ask your name, and no one will know how you answered the questions. We will ask you question about possible changes in your housing condition, personal safety, and security concerns before joining the Rubicon's program and afterwards.* Finally, we would like to know how do you feel about our program. Gender: M F Ethnicity: White African American Latino Asian Native American Other Age: How long have been in the Rubicon's Money Management Program? Years Months How many times have you moved in the six months BEFORE joining Rubicon? How many times have you moved in the six months AFTER joining Rubicon? How many nights have you used homeless shelters in the six months BEFORE joining Rubicon ? How many nights have you used homeless shelters in the six months AFTER joining Rubicon ? How many DAYS have you stayed in hospitals in the six months BEFORE joining Rubicon? How many DAYS have you stayed in hospitals in the six months AFTER joining Rubicon? How many visits to hospital emergency rooms did you have in the slx months BEFORE joining Rubicon? How many visits to hospital emergency rooms did you have in the six months AFTER joining Rubicon? How many months did you stay in a Drug Treatment Program in the six months BEFORE joining Rubicon? The Center for Applied Local Research 24 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH 0 AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program How many months did you stay in a Drug Treatment Program in the six months AFTER joining Rubicon? How many times have you lots money, or your money was stolen, during the six months BEFORE joining Rubicon? How many times have you lots money, or your money was stolen, during the six months AFTER joining Rubicon? How many DAYS have you been in Jail, orprison, in the six months BEFORE joining Rubicon? How many DAYS have you been in jail in the six months AFTER joining Rubicon? How many times have you been arrested in the six months BEFORE joining Rubicon? How many times have you been arrested in the six months AFTER joining Rubicon? How many times have you been taken advantage of, or your property stolen in the six months BEFORE joining Rubicon? How many times have you been taken advantage of, or your property stolen in the six months AFTER joining Rubicon? How many days did your monthly payment last in the six months BEFORE joining Rubicon? How many days your monthly payment lasts AFTER joining Rubicon? Do you feel safer with Monthly or Weekly payments? LET ME ASK YOU ABOUT HOW YOU FEEL ABOUT RUBICON PROGRAMS. How your life situation has changed after you came to Rubicon? NO Change Changed for BETTER Changed for WORSE On the scale of 1 to 10 (1=least satisfied, and 10=most satisfied), how satisfied are you with Rubicon Programs? ------ Ile Center for Applied Local Research 25 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Which of the Rubicon services was most helpful to you? Why do you say that? What can we do to improve our services? I The Center for Applied Local Research 26 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH®AOL.COM SOCIAL SERVICE DEPARTMENT CONTRA COSTA COUNTY DATE: March 16, 1995 MAR 16 1995 TO: Members of the Finance Committee FROM: Robert Hofmann 'Q RE: Report on Social Service Use of Keller Surcharge Revenue Recommendations: The current budget crisis in the County has compelled the Social Service Department to devise a 20% reduction plan for the next fiscal year and is requiring careful consideration and prioritization of existing funding to programs. In attempting to maintain funding for programs with the greatest direct benefit to the GA program, we are recommending the following: 1) Social Service Department respectfully requests that the Finance Committee recommend that full funding to the Recycling Center be maintained by the Board of Supervisors. 2) Social Service Department respectfully requests that the Finance Committee recommend that funding to Rubicon be maintained through June 30, 1995. Thereafter, Social Service would not foresee the need for GA money management services and recommends funding be terminated. 3) Social Service Department respectfully requests that the Finance Committee recommend that fimding to the Personnel Department for job training and development for Recycling trainees be terminated. 4) Social Service Department respectfully requests that the Finance Committee recommend that Keller surcharge revenue be allocated in fiscal year 95/96 for expanding and enhancing our SSI Advocacy Program to strengthen our ability to cope with the anticipated new SSI regulations for recipients with a primary diagnosis of drug or alcohol problems. Gen 9c (New 3/86) i l Back round: In 1993, the Board of Supervisors approved the allocation of Keller surcharge revenue to fund three County programs with the goal of controlling costs in the Social Service Department General Assistance program. Keller surcharge revenue was allocated to the County Recycling Center, Rubicon money management program and the County Personnel Department. County Recycling Center The Recycling Center provides work experience to GA recipients who are referred by Social Service staff and is part of an coordinated effort to assist clients to prepare for and obtain unsubsidized employment. The Recycling Center affords clients the opportunity to learn specific job skills in an constructive supervised work environment and reinforces positive work habits and attitudes which will enhance opportunities for achieving the goal of client self sufficiency. Keller surcharge revenue was allocated to support and maintain an expanded and enhanced program for GA clients at the Recycling Center. Rubicon Money Management The Rubicon money management program was intended to provide representative payee services to GA clients or SSI recipients who were deemed as high risk for becoming GA eligible due to their inability to secure a representative payee to manage their grant. The Keller surcharge revenue was used to enhance the existing West County money management contract with Rubicon and expand it to serve GA recipients in East county. Personnel Department Job Training The Personnel Department was allocated Keller surcharge revenue to develop a job training and placement program for Recycling trainees. The intent was to provide job ready Recycling Center participants with job club and other support activities that would enable them to obtain unsubsidized employment. Findinjzs: Recycling Center The Recycling Center has provided valuable job training opportunities to GA clients and has proven to be cost effective as well in the reduction of the County waste paper stream, clean up and reduction of illegally dumped tires, litter clean up and weed abatement. The Recycling Center is a key component of the GA program and instrumental in allowing us to meet our goal of assisting employable and able bodied GA recipients to obtain unsubsidized employment. The Social Service Department endorses full funding of Keller surcharge revenue to the County recycling Center. 2 a Rubicon Money Management The GA program has demonstrated little need for money management services in the pa:± two years. Our audit of the Rubicon contract in July, 20, 1994 revealed that only 6 of the 32 Rubicon money management cases sampled were previously active or known to the GA program. The reason for the minimal use of money management services by GA recipients is that money management is a voluntary service and GA recipients who feel the need to have the service are free to designate friends or acquaintances as their representative payee and have had little trouble obtaining payee services, if necessary. The assumption that Social Services Department requires money management services to prevent shifting of SSI recipients to the GA Program has not proven to be the case. GA regulations require a GA applicant to access other sources of income that may be available to him/her. We do not anticipate and have seen little evidence that SSI recipients will want to risk discontinuance from the higher ($600) SSI grant due solely to failure to obtain a representative payee. Social Service would deny GA to an applicant who would be eligible for SSI but for his/her failure to obtain a representative payee. A potential problem may arise with the implementation of the new SSI regulations which require SSI recipients diagnosed with a primary drug or alcohol diagnosis to participate in a drug or alcohol rehabilitation program as a condition of eligibility, and places a three year term limit for them to receive SSI benefits. It is possible that an enhanced money management program with strong emphasis on case management services to ensure SSI recipients stay in their drug or alcohol program would help prevent shifting of SSI recipients to GA, but other program enhancements such as an expanded SSI Advocacy program would be a more effective prevention measure. Many current SSI recipients who have been receiving SSI with a primary diagnosis of a drug or alcohol problem have multiple disabilities, and with the assistance of SSI advocates, may be able to shift their primary diagnosis from drug or alcohol to another diagnosis which will permit them to remain eligible to SSI. The need for money management services in GA is very insignificant. The greater impact is felt by Mental Health, Social Security Administration, and perhaps Housing Department and Sheriffs Department. Many other counties fund money management services through their Mental Health Departments, such as Alameda County. If money management services in Contra Costa County is considered valuable and necessary, the Departments with greatest need and benefit for the service should food it. Social Security regulations permit providers of money management services to retain $50 per month from the recipients grant for the cost of service. We are currently not using this funding source to offset money management costs and any future contract for money management services should require the contract provider to claim the allowable offset. The $50 per month charge may in fact be 3 r sufficient to fund the costs of services of any organization to provide money management services. Personnel Department Personnel Department and Social Services staff met on April 8, 1993 to discuss development of a job club program to assist Recycling trainees to obtain unsubsidized employment. Personnel staff were to devise the curriculum for the job club and Social Service staff were to investigate use of Private Industry Council assistance to place the trainees. Social Service staff have not heard further from Personnel staff and PIC advised our Department that they were involved only with job training and not job placement. PIC staff suggested Recycling trainees be referred to Employment Development Department for job placement services. 4 • J At SQdJAL SERVICE DEPARTMENT CONTRA COSTA COUNTY DATE: March 16, 1995 MAR 16 1995 TO: Members of the Finance Committee FROM: Robert Hofmann RE: Report on Social Service Use of Keller Surcharge Revenue Recommendations: The current budget crisis in the County has compelled the Social Service Department to devise a 20% reduction plan for the next fiscal year and is requiring careful consideration and prioritization of existing funding to programs. In attempting to maintain funding for programs with the greatest direct benefit to the GA program, we are recommending the following: 1) Social Service Department respectfully requests that the Finance Committee recommend that full funding to the Recycling Center be maintained by the Board of Supervisors. 2) Social Service Department respectfully requests that the Finance Committee recommend that funding to Rubicon be maintained through June 30, 1995. Thereafter, Social Service would not foresee the need for GA money management services and recommends funding be terminated. 3) Social Service Department respectfully requests that the Finance Committee recommend that funding to the Personnel Department for job training and development for Recycling trainees be terminated. 4) Social Service Department respectfully requests that the Finance Committee recommend that Keller surcharge revenue be allocated in fiscal year 95/96 for expanding and enhancing our SSI Advocacy Program to strengthen our ability to cope with the anticipated new SSI regulations for recipients with a primary diagnosis of drug or alcohol problems. Gen 9c (New 3/86) Backjround: In 1993, the Board of Supervisors approved the allocation of Keller surcharge revenue to fund three County programs with the goal of controlling costs in the Social Service Department General Assistance program. Keller surcharge revenue was allocated to the County Recycling Center, Rubicon money management program and the County Personnel Department. County RecyclingCenter The Recycling Center provides work experience to GA recipients who are referred by Social Service staff and is part of an coordinated effort to assist clients to prepare for and obtain unsubsidized employment. The Recycling Center affords clients the opportunity to learn specific job skills in an constructive supervised work environment and reinforces positive work habits and attitudes which will enhance opportunities for achieving the goal of client self sufficiency. Keller surcharge revenue was allocated to support and maintain an expanded and enhanced program for GA clients at the Recycling Center. Rubicon Money Management The Rubicon money management program was intended to provide representative payee services to GA clients or SSI recipients who were deemed as high risk for becoming GA eligible due to their inability to secure a representative payee to manage their grant. The Keller surcharge revenue was used to enhance the existing West County money management contract with Rubicon and expand it to serve GA recipients in East county. Personnel Department Job Training The Personnel Department was allocated Keller surcharge revenue to develop a job training and placement program for Recycling trainees. The intent was to provide job ready Recycling Center participants with job club and other support activities that would enable them to obtain unsubsidized employment. Findings: Rept Cg enter The Recycling Center has provided valuable job training opportunities to GA clients and has proven to be cost effective as well in the reduction of the County waste paper stream, clean up and reduction of illegally dumped tires, litter clean up and weed abatement. The Recycling Center is a key component of the GA program and instrumental in allowing us to meet our goal of assisting employable and able bodied GA recipients to obtain unsubsidized employment. The Social Service Department endorses full funding of Keller surcharge revenue to the County recycling Center. 2 Rubicon Money Management The GA program has demonstrated little need for money management services in the past two years. Our audit of the Rubicon contract in July, 20, 1994 revealed that only 6 of the 32 Rubicon money management cases sampled were previously active or known to the GA program. The reason for the minimal use of money management services by GA recipients is that money management is a voluntary service and GA recipients who feel the need to have the service are free to designate friends or acquaintances as their representative payee and have had little trouble obtaining payee services, if necessary. The assumption that Social Services Department requires money management services to prevent shifting of SSI recipients to the GA Program has not proven to be the case. GA regulations require a GA applicant to access other sources of income that maybe available to him/her. We do not anticipate and have seen little evidence that SSI recipients will want to risk discontinuance from the higher ($600) SSI grant due solely to failure to obtain a representative payee. Social Service would deny GA to an applicant who would be eligible for SSI but for his/her failure to obtain a representative payee. A potential problem may arise with the implementation of the new SSI regulations which require SSI recipients diagnosed with a primary drug or alcohol diagnosis to participate in a drug or alcohol rehabilitation program as a condition of eligibility, and places a three year term limit for them to receive SSI benefits. It is possible that an enhanced money management program with strong emphasis on case management services to ensure SSI recipients stay in their drug or alcohol program would help prevent shifting of SSI recipients to GA, but other program enhancements such as an expanded SSI Advocacy program would be a more effective prevention measure. Many current SSI recipients who have been receiving SSI with a primary diagnosis of a drug or alcohol problem have multiple disabilities, and with the assistance of SSI advocates, may be able to shift their primary diagnosis from drug or alcohol to another diagnosis which will permit them to remain eligible to SSI. The need for money management services in GA is very insignificant. The greater impact is felt by Mental Health, Social Security Administration, and perhaps Housing Department and Sheriffs Department. Many other counties fund money management services through their Mental Health Departments, such as Alameda County. If money management services in Contra Costa County is considered valuable and necessary, the Departments with greatest need and benefit for the service should fund it. Social Security regulations permit providers of money management services to retain $50 per month from the recipients grant for the cost of service. We are currently not using this funding source to offset money management costs and any future contract for money management services should require the contract provider to claim the allowable offset. The $50 per month charge may in fact be 3 sufficient to fund the costs of services of any organization to provide money management services. ' Personnel Department Personnel Department and,Social Services staff met on April 8, 1993 to discuss development of a job club program to assist Recycling trainees to obtain unsubsidized employment. Personnel staff were to devise the curriculum for the job club and Social Service staff were to investigate use of Private Industry Council assistance to place the trainees: Social Service staff have not heard further from Personnel staff and PIC advised our Department that they were involved only with job training and not job placement. PIC staff suggested Recycling trainees be referred to Employment Development Department for job placement services. 4 1 ' 9 e Center Tor .Applied,focal WesearcFr 120 BROADWAY, SUITE 21 • RICHMOND, CA 94804•(510)970-7520• FAX(510)970.7526 1 EVALUATION OF ' RUBICON ' SSI AND MONEY MANAGEMENT PROGRAM 1 ' JANUARY 13, 1995 Iraj J. Imam, Ph.D. ' Thomas L. Foster M.S. Revonda Downs ' TABLE OF CONTENTS EXECUTIVE SUMAlARY......................................................................3 tI. INTRODUCTION.............................................................................7 II. METHODS....................................................................................8 ' III. COST SAVINGS AND COST AVOIDANCE.........................................9 ' A. SHIFT FROM GA TO SSI.......................................................................9 B. HOMELESS SHELTERS--SOCIAL SERVICES DEPARTMENT SAVINGS .......................9 C. MENTAL HEALTH SERVICES--HEALTH DEPARTMENT SAVINGS ........................ 11 D. HOSPITAL AND EMERGENCY ROOM SERVICES--HEALTH DEPARTMENT SAVINGS.... 12 E. JAIL AND PRISON COST AVOIDANCE ....................................................... 15 ' IV. OVERALL COST AVOIDANCE AND PROJECTIONS FOR 1995.......... 16 A. COST AVOIDANCE FOR COMBINED SERVICES............................................. 16 B. PROJECTION OF COST AVOIDANCE FOR 1995 ............................................. 17 ' V. SUNEVIARY AND CONCLUSIONS.................................................... 19 ' ACKNOWLEDGMENTS .....................................................................22 APPENDIX.......................................................................................23 1 ' Evaluation of Rubicon's SSI Advocacy and Money Management Program , EXECUTIVE SUMMARY . ' Evaluation of 1 SSI Advocacy and Money Management Program, Rubicon Programs Inc. I. Introduction ' Since 1990, Rubicon Programs has operated an SSI Advocacy and Money Management Program for Contra Costa County. Rubicon Programs secured a $10,000 grant from the Northern California Grantmakers to conduct an independent costs and benefits evaluation of the program. Rubicon Programs Inc. contracted with The Center for Applied Local Research (CAL 1 Research) to conduct the evaluation of their SSI Advocacy and Money Management Program. CAL Research is a non-profit organization founded in 1987 to use social science and related skills to improve the quality of human service delivery systems at ' the local level. ' H. Methods In this evaluation, we focus on estimating the financial costs and benefits of the Rubicon's SSI Advocacy and Money Management Program to Contra Costa County. The evaluation does not include the organizational, administrational, and policy implementation aspects of the program. ' We estimated the financial benefits of the SSI Advocacy and Money Management Program to the County in two ways: (1) The direct savings resulting from shifting ' people from the General Assistance (GA) to SSI and staying on SSI, and (2) The cost avoidance or, "multiplier" savings, resulting from reduction in utilization of County services by people in the Money Management Program. ' Data came from various County Departments.artments. We contrasted the use of these services ' by Rubicon's clients before their enrollment in the Money Management Program with their use during the enrollment. We calculated the differences in service use by these clients to estimate cost avoidance to the County. Where the actual data were not ' available, we used the estimates based on a survey of clients in the Money Management Program. (Because it relies on the memory of clients, the survey tends to under- estimate service use. For example, clients under-estimated their use of homeless ' shelters by more than four times the actual data.) Finally, we used the average annual savings estimates to project total financial saving to the County for 1995 (based on the 95 clients currently contracted with Rubicon by the County). ' The Center for Applied Local Research 3 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program III. Cost Savings and Cost Avoidance ' Both the actual and the survey data show that when people are in Rubicon's Money ' Management Program they use less of County services (in all service categories). These data demonstrate the benefits of the Rubicon's Program to clients and to the County. Clients' life situations seemed to become more stabilized and hence their needs for services tended to decrease. This reduction in service utilization directly translates to financial benefits to the County. ' A. Shift from GA to SSI • Based on the data provided by the Hawkins Center, the annual net recovery to the ' County after reimbursement of attorneys fees is about $579,996. B. Homeless Shelters--Social Services Department Savings ' • The data from Richmond and Concord shelters indicate that, on the average, clients spent 82.9 days before coming to Rubicon and only 20.5 day during their stay in ' the program. The savings are close to 63 days of shelter not used by Rubicon clients. With the average $27 per night, the average cost per client is about $2,241 ' before joining Rubicon and about $554 per client during their stay in the program.. This amounts to $333,857 for the duration of the program. ' • On the annual basis, the savings are $83,507. • Projected savings for 1995 are estimated at $160,265 (based on 95 clients). ' C. Mental Health Services--Health Department Savings • The Mental Health data demonstrate the average savings per client per year is about $1,494 or, $295,812 for 198 clients served between 1991 and 1994. ' • Average annual savings for average number of clients per year (49.5) equals $73,953. ' • Projected savings for 1995 are estimated at $141,930 (based on 95 clients). D. Hospital and Emergency Room Services--Health Department Savings • The average use of hospitals was 75.7 days for clients before joining Rubicon and 8.7 days while in the program. This amounts to savings of 66.9 days per year per client. The average annual saving of hospital days equals 3,043.9 days (based on ' average of 45.5 clients per year). We estimate 50% ratio of recoupment of general The Center for Applied Local Research 4 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM 1 Evaluation of Rubicon's SSI Advocacy and Money Management Program funds to the County on patients atients with Medical or Medicare. According to Patient Accounting, room and board with doctor visit costs about $700 and ' Emergency Room visits cost about $444. • Factoring in these rates, annual cost avoidance for using hospital room amounts to $1,159,043. • Using the same methods, on the average, Rubicon clients had 5.5 Emergency Room Visits prior joining Rubicon compared to 3.38 visits while in the program. The net saving per year are 2.12 visits for each client or, 96.45 visits for all clients. ' • Factoring the same 50% ratio, the Emergency Room visit savings amount to $23,297, annually. ' • Combined hospital use and Emergency Room visit cost avoidance total to P g cy $1,182,332 per year. • Projected savings for 1995 are at $2,269,122. ' E. Jail and Prison ' • On the average, each client spent 45.9 days in jail or prison before coming to Rubicon vs. 4.5 days while in the program. Based on $56 average cost per day, the annual average cost for clients before coming to Rubicon amounts to $116,980 ' compared to $11,800 for clients in the program. • The net average savings to the County, or cost avoidance, on the annual basis ' equals $114,705. ' • Projected saving for 1995 are at $220,115. F. Prevention of Return From SSI Back to GA Without Representative Payee Status 1 • In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients returning from SSI to GA ranges from $346,560 (100% return) ' to $86,660 (25% return). These figures are preliminary estimates and more accurate estimates require further research. ' The Center for Applied Local Research 5 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM ' Evaluation of Rubicon's SSI Advocacy and Money Management Program ' IV. Overall Cost Avoidance and Projections for 1995 ' • The overall annual average cost avoidance / savings to the County is estimated at . $2,034,479 ($1,454,483 + $579,480,- items A-E, excluding F). ' • The total projected cost avoidance / savings to the County for 1995 amount to $3,371,476 (based on 95 clients, $2,791,480 + $579,480; items A-E, excluding ' item F). ' Acknowledgments We would like to thank the staff of Mental Health Division, Health Services ' Department, Social Services Department, and the Housing Authority for their cooperation with this evaluation. 1 ' The Center for Applied Local Research 6 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet. CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Evaluation of ' SSI Advocacy and Money Management Program, Rubicon Programs Inc. I. Introduction ' Rubicon Programs Inc. contracted with The Center for Applied Local Research (CAL Research) to conduct the evaluation of 'their SSI Advocacy and Money Management ' Program. CAL Research is a non-profit organization founded in 1987 to use social science and related skills to improve the quality of human service delivery systems at the local level. ' The SSI Advocacy and Money Management Program is a cooperative venture between the Contra Costa County Department of Social Services, The Hawkins Center of Law and Services for the Disabled and Rubicon Programs, Inc. Since 1990, the Hawkins Center and Rubicon Programs have operated an SSI Advocacy and Money Management Program for Contra Costa County. ' The program operates in two stages: First, shifting people from General Assistance ' (GA) to SSI; and Second, keeping people on SSI by managing their money--by becoming their representative payee. The Hawkins Center manages the first part of the program and the Rubicon Programs manages the second part. ' The benefits to the clients include an increase in their income, access to MediCal, and improvement in their living conditions such as permanent housing and learning new ' skills. Financial benefits to the County include direct recovery for prior GA disbursements from the retroactive benefits of the clients entitled to SSI and MediCal, and cost avoidance: of future GA payments to clients successfully transferred to SSI; ' of health care costs of clients transferred to MediCal; and of reduction in use of the County human services by the clients in Rubicon Programs. ' Rubicon Programs secured a $10,000 grant from the Northern California Grantmakers to conduct an independent costs and benefits evaluation of the program. This report is ' organized in four parts: I. Introduction; II. Methods; III. Cost Savings and Cost Avoidance; and IV. Conclusions. ' The Center for Applied Local Research 7 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH®AOL.COM 1 r . Evaluation of Rubicon's SSI Advocacy and Money Management Program II. Methods ' In this evaluation, we focus on estimating the financial costs and benefits of Rubicon's SSI Advocacy and Money Management Program to Contra Costa County. The ' evaluation does not include the organizational, administrational, and policy implementation aspects of the program. We estimated the financial benefits of the SSI Advocacy and Money Management Program to the County in two ways: (1) The direct savings resulted from shifting people from the General Assistance (GA) to SSI and staying on SSI, and (2) The cost avoidance or, "multiplier" savings, resulted from reduction in utilization of the County services by the people in the Money Management Program. (The first six months of this program was analyzed in the Hawkins/Rubicon "Six Month Progress Report", July 1991.) Cost avoidance benefits to the County are particularly significant, due to the at-risk life ' situations of most Rubicon clients. These clients, according to the Hawkins Center, tend to be high users of the County emergency services. If Rubicon Programs can ' assist these at-risk clients to stabilize their living conditions, then the clients will tend to use less of the County emergency services. In the absence of the Rubicon Programs, those at-risk clients were likely to have remained high user of the County's emergency ' services. The primary source of data came from various County departments. We contrasted the ' use of these services by Rubicon's clients before their enrollment in the Money Management Program with their use during the enrollment. We calculated the differences in service use of these clients to estimate cost avoidance to the County. ' We used the actual data on utilization of Mental Health and Homeless Shelter services by the Rubicon clients. Where the actual data were not available, we used the ' estimates based on our survey of active clients in the Money Management Program. (Because it relies on the memory of clients, the survey tends to under-estimate the ' service use. For example, clients under-estimated their use of homeless shelters by more than four times the actual data.) We used the actual data on direct savings from the report prepared by the Hawkins Center (in progress). Finally, to make the data comparable, we normalized the cost and savings data on the annual basis for each client. For each category, we calculated average annual costs per client. We used these computed average annual savings estimates to project total financial saving to the ' County for 1995 (based on the 95 clients currently contracted with Rubicon by the County). r ' The Center for Applied Local Research 8 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM 1 Evaluation of Rubicon's SSI Advocacy and Money Management Program ' III. Cost Savings and Cost Avoidance A. Shift from GA to SSI , ' In this part, we use the data from a report by the Hawkins Center SSI Advocacy Program to estimate the financial benefits to the County. According to the Hawkins Center, between January 1, 1992 and June 30,1994, "the total recovery of GA benefits alone the county has made from all clients represented by the Hawkins Center is $1,159,991.90. The net recovery to the county after reimbursement of attorneys fees has been $869,993.92". This is for 18 months. Normalizing on the annual basis, the ' net recovery to the County amounts to $579,996 per year. This figure does not include any of the possible retroactive benefits. For example, according to the Hawkins Center, each client who is awarded retroactive SSI benefits is also entitled to MediCal benefits for all the months since the date the application was filed. Also not included are possible savings to the MIA health plan funds resulting ' from the clients' future and retroactive entitlement to MediCal. ' B. Homeless Shelters--Social Services Department Savings In this section, we estimate the costs and savings of the Rubicon's Money Management ' Program to the County. The program has operated for four years and has served 198 clients, with average of 49.5 clients per year. We calculated the data on use of homeless shelters for each Rubicon's client (data provided by the Contra Costa County Housing Authority). These data from Richmond and Concord shelters--normalized on the annual basis-- indicate that, on the average, each client spent 83 days in shelter programs before coming to Rubicon and only 20.5 day during his or her stay in the program. The ' savings are about 62.4 days of shelter not used by Rubicon clients. Table 1 shows that with an average $27 cost per night (according to the Housing Authority), the average annual cost per client is about $2,241 before joining Rubicon and about $554 per client during their stay in the program (see Figure 1). This amounts to $334,028 for the duration of the program. On an annual basis, the savings are about $83,507 or, $1,686 per client. ' The Center for Applied Local Research 9 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM 1 , Evaluation of Rubicon's SSI Advocacy and Money Management Program ' Table 1 Homeless Shelter Cost Avoidance Homeless Shelter Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $2,241 -Average Annual Costs per Client During Rubicon Program $554 Average Annual Cost Avoidance and Savings per Client $1,687 Average Annual Cost Avoidance $83,507 Shelter Cost per Da $27 ' Average Days of Shelter Use Before Joining Rubicon 83.00 Average Das of Shelter Use During Rubicon Program 20.50 Average Number of Clients Served 1991-94 49.5 Total Number of Clients Served, 1991-94 198 Source: Housing Authority. ' Figure 1 Annual Average Homeless Shelter Costs and Benefits per Client- Year Cost A oidanceP er Client/Ye r a ..iM XXXX Cost During Rubicon s>s:. / Pro9 ramNear S.. /,., cii1 si Cost Before Joining ' ssuf Sss Rubicon/Year 0 500 . $1,00 . $ <<><1>i50 `2000 >>'??2 50 ' In our survey of the Rubicon's active clients, we found that all respondents indicated that they used more County services before joining the Rubicon's Money Management rThe Center for Applied Local Research 10 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH a AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Program than they did while in the program. For example, they systematically under- estimated their use of homeless shelters. We show in Table 1 that the average annual- ! shelter days avoided, or saved, is about 62.5 days (83 - 20.5 = 62.5). Using the survey data, however, the average annual shelter days avoided is about 15.4 days (31.4 - 16 = 15.4). Because it relies on the memory of clients, the survey data tends to under-estimate the service use. In the case of homeless shelter use, the data are under- estimated by factor of four (62.5 / 15.5 = 4.05). The actual data, as mentioned above, include only Richmond and Concord homeless shelters and hence do not include other public or private shelter. On the annual basis, the savings are about $83,507, or $1,687 per client. C. Mental Health Services--Health Department Savings We used the actual Mental Health service utilization data for each Rubicon client and calculated the cost avoidance savings to the County. In Table 2, we show the annual average cost of Mental Health services used by the clients. We used the data on service use for each client before coming to Rubicon and on service use during their stay in the program. We computed annual average costs for all clients served between 1991 and 1994 in Figure 2. Table 2 Mental Health Cost Avoidance ' Mental Health Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $4,959 Average Annual Costs per Client in Rubicon Program $3,465 Average Annual Cost Avoidance / Savings per Client $1,494 Average Annual Cost Avoidance $73,953 Average Number of Clients Served 1991-941 49.5 ' Total Number of Clients Served, 1991-941 198 Source: Mental Health Division,Health Services Department. ' The Center for Applied Local Research 11 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM i Evaluation of Rubicon's SSI Advocacy and Money Management Program Figure 2 Average Annual Mental Health Costs and Benefits per Client-Year . . . ........ ............. Client[Year ............. .. ......... Cost Avoidance per Cost During Rubicon X.. ........ . .......... Program/Year .......... X XXX..XXX,. ...... . ......... ......... ... ......... .. ........ ... .......... Cost Before Joining Rubicon/Yea .... ............. ...... .......... ... .. ................ . ....... ........... .. . . ........ .... .....X x:,X, $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 The Mental Health data demonstrate that the annual average savings per client is about $1,494 or, $295,812 for 198 clients served between 1991 and 1994. Average annual savings for 49.5 clients equals $73,953. D. Hospital and Emergency Room Services--Health Department Savings For those services that actual data were not able, we used the estimates of service use from our survey of the active Rubicon clients. These estimates, in general, tend to under-estimate service use. In Table 3, we show that average use of hospital beds was 75.7 days for clients before joining Rubicon and 8.7 days while in the program. This amounts to savings of 66.9 days per year per client. The average annual saving of hospital days equals to 3,311.5 days (based on average of 49.5 clients per year). We estimate 50% ratio of recoupment of general funds to the county based on patients with MediCal or Medicare. According to Patient Accounting, room and board with doctor visit costs about $700 and Emergency Room visits cost about $444. Factoring in these rates, annual cost avoidance for using hospital room amounts to $1,159,042. In Figure 3, we show estimates of average annual costs per client. The Center for Applied Local Research 12 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program ' Table 3 Hospital-Bed Cost Avoidance Hospital Bed Costs and Benefits: 1 Average Annual Costs per Client Before Joining Rubicon $52,990 Average Annual Costs per Client During Rubicon Program $6,160 Average Annual Cost Avoidance / Savings per Client $46,830 Average Annual Cost Avoidance (50% ratio of recoupment) $1,159,042 Hospital Bed and Doctor Visit Cost per Da $700 ' Average Das of Hospital Use Before Joining Rubicon 75.70 Average Das of Hospital Use During Rubicon Program 8.80 ' Total Number of Clients Served, 1991-94 198 Source: Survey of Active Clients in Rubicon's Money Management Program;Patient Accounting. ' Figure 3 Average Annual Costs and Benefits of Hospital Use per Client-Year 1 Cost Av otdanceP e r i. C'en /Y f' - h t ear Cost During Rubicon P ram/ ro Year g Cost Before Joining g Rubicon/Year $0 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 ' We show In Table 4 cost avoidance for Emergency Room visits by Rubicon clients. Using the same methods, on the average, Rubicon clients had 5.5 Emergency Room Visits prior joining Rubicon compared to 3.38 visits while in the program. The net saving per year are 2.12 visits for each client. Factoring the same 50% ratio, the Emergency Room visit savings amount to $23,297 per year. In Figure 4, we show estimates of average annual cost's per client. ' The Center for Applied Local Research 13 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program 1 Table 4 Hospital Emergency Room Cost Avoidance Hospital Emergency Room Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $2,442 IAverage Annual Costs per Client During Rubicon Program $1,501 Average Annual Cost Avoidance / Savings per Client $941 ' Average Annual Cost Avoidance (50% recoupment) $23,297 ' Emergency Room Cost per Visit $444 Average E. R. Visits Before Joining Rubicon 5.50 Average E. R. Visits After Joining Rubicon 3.38 ' Average Number of Clients Served, 1991-94 49.5 Total Number of Clients Served, 1991-941 198 Source: Survey of Active Clients in Rubicon's Money Management Program;Patient Accounting. Figure 4 ' Average Annual Emergency Room Costs and Benefits per Client-Year Cost Avoidance per fH }' -:>.::,;::.;•::::..;:.;:<::.;:.:;.:.:::.:;Client/Year /f. S .? ;;::;:.;:.::;::.;•:.>:..::::.::;:>:>::>:>:.::;:.;;:.;;:;:::: Cost DuringRubicon xi '`' is Program/Year /�` r/s, ss .. .;f` Cost Before Joining Rubicon/Year %/fs.€ • s{ va`,s s# 's.# #s r' sss/f### £ ,. 0 5001.000:>;#<»:: ytz <00 $2,000 •>;':::>.'2.. 00 1 The Center for Applied Local Research 14 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH®AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program E. Jail and Prison Cost Avoidance Table 5 shows that, based on the survey data, each client spent an average of 45.93 days in jail or prison before coming to Rubicon vs. 4.55 days while in the program. 1 Based on $56 cost per day (according to the Six Month Report by Hawkins/Rubicon), the average annual cost per client before coming to Rubicon amounts to $2,572 compared to $255 for clients in the program. The average annual cost avoidance per ' client is about $2,317, shown in Figure 5. For the average 49.5 clients per year, the total annual cost avoidance amounts to $114,705. ' Table 5 Jail and Prison Cost Avoidance ' Jait dPris n Costs and Benefits: Average Annual Costs per Client Before Joining Rubicon $2,572 Average Annual Costs per Client During Rubicon Program $255 Average Annual Cost Avoidance/ Savings per Client $2,317 Average Annual Cost Avoidance $114,705 Cost per Da $56 Average Das of Jail and Prison Before Joining Rubicon 45.93 ' Average Days of Jail and Prison During Rubicon Program 4.55 Average Number of Clients Served 1991-94 49.5 Total Number of Clients Served, 1991-941 198 Source: Survey of Active Clients in Rubicon's Money Management Program;Six Month Progress Report. 1 t The Center for Applied Local Research 15 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRBSCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Figure 5 Average Annual Jail and Prison Costs and Benefits per Client-Year ..... ...i...£...............................f. .... ...... ::.:.....:•::::::.:: « ... . ..... .Client/YearCost Avoidance er . . ........... . „ Cost DuringRubicon s Prog ram/Year Cost Before Ioinin SXX Rubicon/Yea r n $0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 F. Prevention of Return From SSI Back to GA Without Representative Payee Status In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients' returning from SSI to GA ranges from $346,560 (100% return) to $86,660 (25% return). These figures are preliminary estimates (based on GA $304 ' monthly payment) and more accurate estimates require further research. IV. Overa❑ Cost Avoidance of Services to the County and Projections for 1995 A. Cost Avoidance for Combined Services Based on the calculations in the previous section, we will estimate the overall financial benefits of cost avoidance to the County, shown in Table 6. The combined overall average annual cost avoidance per client is estimated at $29,384. Factoring 49.5 average clients per year, average annual cost avoidance amounts to $1,454,483. Adding the net recovery to the County due to shift from GA to SSI, the total average annual 1 cost avoidance is estimated at $2,034,479. ' The Center for Applied Local Research 16 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH 0 AOL.COM ' Evaluation of Rubicon's SSI Advocacy and Money Management Program , • Table 6 Overall Cost Avoidance of Services Services: ' Homeless Shelter Costs and Benefits Average Annual Cost Avoidance / Savings per Client $1,687 Average Annual Cost Avoidance $83,507 Mental Health Costs and Benefits Average Annual Cost Avoidance / Savings per Client $1,494 Average Annual Cost Avoidance $73,953 ' Hospital Bed Costs and Benefits Average Annual Cost Avoidance / Savings per Client ®50% $23,415 Average Annual Cost Avoidance $1,159,043 Hospital Emergency Room Costs and Benefits ' Average Annual Cost Avoidance / Savings per Client ®50% $471 Average Annual Cost Avoidance $23,297 ' Jail and Prison Costs and Benefits Average Annual Cost Avoidance / Savings per Client $2,317 Average Annual Cost Avoidance $114,705 Overall Services Benefits ' Average Annual Cost Avoidance for Overall Services per Client $29,384 Average Annual Cost Avoidance for Overall Services (49.5 $1,454,483 clients 1 Shift from GA to SSI Net Recovery $579,996 ' Total Cost Avoidance and Net Recovery $2,034,479 Source: Tables 1-5 B. Projection of Cost Avoidance for 1995 ' We will use these estimates to project the financial benefits to the County for 1995. Based on the contract of Rubicon Programs with the County, we will assume a total of 95 clients for 1995. In Table 7, we show overall cost avoidance projections for 1995. The annual average cost avoidance for overall services amounts to $29,384 per client. Projections for 95 clients in 1995 amount to $2,791,480. Adding the net recovery to The Center for Applied Local Research 17 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH®AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program the County due to shift from GA to SSI, the total projected figure for 1995 amounts to $3,371,476. ' 1 Table 7 1 Projection of Overall Cost Avoidance of Services for 1995 ' Services: Homeless Shelter Costs and Benefits ' Average Annual Cost Avoidance / Savings per Client $1,687 Average Annual Cost Avoidance $160,265 ' Mental Health Costs and Benefits Average Annual Cost Avoidance / Savings per Client $1,494 Average Annual Cost Avoidance $141,930 1 Hospital Bed Costsd Benefits s ' Avera a Annual Cost Avoidance / Savings per Client ®50% $23,415 Average Annual Cost Avoidance $2,224,425 Hospital Emergency Room Costs and Benefits Average Annual Cost Avoidance / Savings per Client ®50% $471 Average Annual Cost Avoidance $447698 Jail and Prison Costs and Benefits ' Average Annual Cost Avoidance / Savings per Client $27317 Average Annual Cost Avoidance $220,115 1 Overall Services Benefits Average Annual Cost Avoidance for Overall Services per Client $29,384 ' Average Annual Cost Avoidance for Overall Services 95 clients $2,7912480 Shift from GA to SSI Net Recovery $579,996 1 Total Cost Avoidance and Net Recovery $3,371,476 Source: Tables 1-6 i 1 ' The Center for Applied Local Research 18 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program V. Summary and Conclusions ' Both the actual and the survey data show that when people are in Rubicon's Money• . Management Program they tend to use less of County services (in all service 1 categories). These data demonstrate the benefits of the Rubicon's Program to clients and to the County. Clients' life situations seemed to become more stabilized and hence their needs for services tend to decrease. The reduction in service utilization directly ' translates to financial benefits to the County. We estimated the financial benefits of the SSI Advocacy and Money Management ' Program to the County in two ways: (1) The direct savings resulted from shifting people from the General Assistance (GA) to SSI and staying on SSI, and (2) The cost avoidance or, "multiplier" savings, resulted from reduction in utilization of the County ' services by the people in the Money Management Program. Below, we summarize the estimated financial benefits to the County: ' A. Shift from GA to SSI • Based on the data provided by the Hawkins Center, the annual net recovery to the County after reimbursement of attorneys fees is about $579,996. B. Homeless Shelters--Social Services Department Savings • The data from Richmond and Concord shelters indicate that, on the average, clients spent 82.9 days before coming to Rubicon and only 20.5 day during their stay in the program. With the average $27 per night, the average cost per client is about ' $2,241 before joining Rubicon and about $553.5 per client during their stay in the program. • On the annual basis, the savings are about $83,507 (for 49.5 clients). C. Mental Health Services--Health Department Savings • The Mental Health data demonstrate the average savings per client per year is about $1,494 or, $295,812 for 198 clients served between 1991 and 1994. • Average annual savings per year equal $73,953 (for 49.5 clients). D. Hospital and Emergency Room Services--Health Department Savings ' • The ]average use of hospitals was 75.7 days for clients before joining Rubicon and g P Y g 8.7 days while in the program. This amounts to savings of 66.9 days per year per The Center for Applied Local Research 19 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH Q AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program client. The average annual saving of hospital days equals 3,043.9 days (based on average of 45.5 clients per year). We estimate 50% ratio of recoupment of general- funds to the county based on patients with MediCal or Medicare. According to Patient Accounting, room and board with doctor visit costs about $700 and ' Emergency Room visits cost about $444. • Factoring in these rates, average annual cost avoidance for using hospital room ' amounts to $1,159,043. • Using the same methods, on the average, Rubicon clients had 5.5 Emergency Room ' Visits prior joining Rubicon compared to 3.38 visits while in the program. The net saving per year are 2.12 visits for each client or, 96.45 visits for all clients. ' • Factoring the same 50% ratio, the annual average Emergency Room visit savings amount to $23,297. t • Combined hospital use and Emergency Room visit cost avoidance total to $1,182,332 per year. E. Jail and Prison 1 • On the average, each client spent 45.9 days in jail or prison before coming to Rubicon vs. 4.5 days while in the program. Based on $56 average cost per day, the annual average cost for clients before coming to Rubicon amounts to $116,980 compared to $11,800 for clients in the program. • The average savings to the County on the annual basis equals $114,705. ' F. Prevention of Return From SSI Back to GA Without Rresentative Payee Status • In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients returning from SSI to GA ranges from $346,560 (100% return) to $86,660 (25% return). These figures are preliminary estimates and more accurate estimates require further research. Therefore, we will not these figures in our estimates. ' G. Overall Cost Avoidance o The overall annual average cost avoidance / savings to the County is estimated at $2,034,479 ($1,454,483 + $579,480; items A-E, excluding F). ' The Center for Applied Local Research 20 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH®AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program 1 . Below, we summarize the projected Cost Avoidance savings to the County for 1995: ' A. Shift from GA to SSI • Based on the data provided by the Hawkins Center, the annual net recovery to the County after reimbursement of attorneys fees is about $579,996. ' B. Homeless Shelters--Social Services Department Savings ' • Projected savings for 1995 are estimated at $160,265 (based on 95 clients). C. Mental Health Services--Health Department Savings ' • Projected savings for 1995 are estimated at $141 (based on 95 clients g �930 � .) D Hospital and Emergency Room Services--Health Department Savings ' • Projected savings for combined hospital use and Emergency Room visit for 1995 are estimated at $2,269,122. E. Jail and Prison • Projected jail/prison cost avoidance / savings for 1995 are estimated at $220,115. F. Prevention of Return From SSI Back to GA Without Representative Payee Status 1 • In the absence of the Rubicon Money Management Program, an actuarial estimate of Rubicon's clients returning from SSI to GA ranges from $346,560 (100% return) ' to $86,660 (25% return). These figures are preliminary estimates and more accurate estimates require further research. Therefore, we will not these figures in our estimates. G. Overall Cost Avoidance ' The total projected cost avoidance and savings to the County for 1995 amount to $3,371,476 (based on 95 clients, $2,791,480 + $579,480; items A-E, excluding item F). ' The Center for Applied Local Research 21 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH Cgs AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Acknowledgments ' We would like to thank the staff of Mental Health Division, Health Services Department, Social Services Department, and the Housing Authority for their cooperation with this evaluation. i 1 1 1 The Center for Applied Local Research 22 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM i Evaluation of Rubicon's SSI Advocacy and Money Management Program � e ' APPENDIX The Center for Applied Local Research 23 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM ' Evaluation of Rubicon's SSI Advocacy and Money Management Program Rubicon Programs Inc. CLIENT INTERVIEW This interview will help us to find out how well the Rubicon's Money Management Program is serving its clients. We will not ask your name, and no one will know ' how you answered the questions. We will ask you question about possible changes in your housing condition, personal safety, and security concerns before joining the Rubicon's program and afterwards. Finally, we would like to know how do you ' feel about our program. Gender: M F Ethnicity: White African American Latino Asian Native American Other Age: ' How long have been in the Rubicon's Money Management Program? Years Months How many times have you moved in the six months BEFORE joining Rubicon? How many times have you moved in the six months AFTER joining Rubicon? How many nights have you used homeless shelters in the six months BEFORE joining Rubicon ? How many nights have you used homeless shelters in the six months AFTER 1 joining Rubicon ? How many DAYS have you stayed in hospitals in the six months BEFORE joining Rubicon? How many DAYS have you stayed in hospitals in the six months AFTER joining Rubicon? How many visits to hospital emergency rooms did you have in the six months BEFORE joining Rubicon? ' How many visits to hospital emergency rooms did you have in the six months AFTER joining Rubicon? How many months did you stay in a Drug Treatment Program in the six months BEFORE joining Rubicon? The Center for Applied Local Research 24 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM • Evaluation of Rubicon's SSI Advocacy and Money Management Program 49 How many months did you stay in a Drug Treatment Program in the six months AFTER joining Rubicon? ' How many times have you lots money, or your money was stolen, during the six months BEFORE joining Rubicon? How many times have you lots money, or your money was stolen, during the six months AFTER joining Rubicon? ' How many DAYS have you been in Jail, or prison, in the six months BEFORE joining Rubicon? ' How many DAYS have you been in jail in the six months AFTER joining Rubicon? ' How many times have you been arrested in the six months BEFORE joining Rubicon? How many times have you been arrested in the six months AFTER joining Rubicon? ' How many times have you been taken advantage of, or your property stolen in the six months BEFORE joining Rubicon? How many times have you been taken advantage of, or your property stolen in the ' six months AFTER joining Rubicon? 1 How many days did your monthly payment last in the six months BEFORE joining Rubicon? How many days your monthly payment lasts AFTER joining Rubicon? Do you feel safer with Monthly or Weekly payments? LET ME ASK YOU ABOUT HOW YOU FEEL ABOUT RUBICON PROGRAMS. How your life situation has changed after you came to Rubicon. NO Change Changed for BETTER Changed for WORSE On the scale of 1 to 10 (1=least satisfied, and 10=most satisfied), how satisfied are you with Rubicon Programs? ' The Center for Applied Local Research . 25 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH @ AOL.COM Evaluation of Rubicon's SSI Advocacy and Money Management Program Which of the Rubicon services was most helpful to you? " Why do you say that? What can we do to improve our services? 1 1 i 1 i 1 i ' The Center for Applied Local Research 26 120 Broadway,Suite 21 Richmond,California 94804 Telephone:(510)970-7520 FAX:(510)970-7526 Internet: CALRESCH Q AOL.COM i