Southeast Minnesota. Human Services. Redesign. Business Case Details. May Human Services. Empowering Services, Improving Lives

Transcription

1 Southeast Minnesota Human Services Redesign Business Case Details May 2012 Human Services Empowering Services, Improving Lives

2 Methodology High Level Model Current State Base Year: 2010 Dodge Rice Waseca Olmsted Transition Period Future State One Region-Wide System Fillmore Freeborn Steele Mower Goodhue Houston Winona Wabasha 12 Unique County Pictures Expenditures Revenues One Region-Wide View Includes all one time costs and activities to achieve operating model Dodge Rice Waseca Olmsted Expenditures Revenues 12 Unique County Pictures Fillmore Freeborn Steele Mower Goodhue Houston Winona Wabasha

3 Methodology Process The business case consists of three key sets of data, which answer the questions outlined below: 1 2 Current State Status Quo What does each county, as well as the region as a whole, spend on human services today? If the counties continue down their current path, how much will be spent on human services in the future? 3 Future State How much will the counties spend in the future, if they redesign their system and move to the Service Delivery Authority outlined in the Operating Model? 2

4 Current State Methodology 1 Current State: What does each county, as well as the region as a whole, spend on human services today? Starting Point Key Considerations Consistent, county-by-county expenditures and revenue sourced from 2010 DHS Cost Report Current State data developed at the county-bycounty level, then aggregated to develop a region-wide view Data is intended to be a proxy for county budgets, and includes components of State/Federal contributions, County levies and miscellaneous revenue generated by the counties 3

5 Current State Key Variables Variable Metric(s) Source(s) Expenditures Revenues Personnel expenditures Non-personnel expenditures County-purchased services All federal, state, county, and miscellaneous revenues 2010 DHS cost report 2010 DHS cost report 4

6 Current State Details Type 2010 Expenditures Federal and State $ 58,409,426 Counties $ 49,808,247 Dodge $ 1,718,978 Fillmore $ 1,268,673 Freeborn $ 4,547,988 Goodhue $ 3,174,161 Houston $ 976,635 Mower $ 3,522,496 Olmsted $ 23,746,898 Rice $ 3,139,429 Steele $ 1,846,858 Wabasha $ 1,314,481 Waseca $ 1,452,817 Winona $ 3,098,833 Miscellaneous $ 15,280,085 Total $ 123,497,758 5

7 Status Quo Methodology 2 Status Quo: If the counties continue down their current path, how much will be spent on human services in the future? Starting Point Key Considerations Projections utilize Current State data and extrapolated for the duration of the analysis Key variables used to project the Status Quo scenario include population growth estimates and increases in labor costs Analysis assumes that the counties continue to maintain their current level of service. If caseloads rise, counties will increase their costs accordingly rather than pushing additional work onto caseworkers Federal and State contribution rates remain the same for the duration of the analysis, though this can be adjusted within the model 6

8 Status Quo Key Variables Variable Metric(s) Application(s) Source(s) Caseload County population projections Personnel cost growth County-purchased services cost growth Assumes constant service levels MN state projections Cost Cost of labor adjustment Personnel cost growth County example (Dodge) State & Federal Contributions Historical contribution levels No change relative to county contribution except in the case of block grants (held constant) DHS cost report 7

9 Status Quo Details Caseload Population Projections Region-Wide 1.1% Dodge 2.2% Fillmore 1.0% Freeborn 0.3% Goodhue 1.2% Houston 1.1% Mower 0.3% Olmsted 1.5% Rice 1.6% Steele 1.6% Wabasha 1.2% Waseca 0.6% Winona -0.2% State/Federal Contributions State/Federal Funding Rate Total Federal 36% State 5% County 59% Social Services Federal 29% State 7% County 64% Support Services Federal 51% State 1% County 49% Cost Costs Rate Cost of Labor Adjustment 1.75% 8

10 Future State Methodology 3 Future State: How much will the counties spend in the future, if they redesign their system and move to the Service Delivery Authority outlined in the Operating Model? Starting Point Key Considerations County template submissions, conversations with county staff, industry standards, and final operating model used to estimate costs for the Future Organization Initial analysis produces an estimate for total costs across the region Each area of the regional cost model reflects the final operating model County data submissions were supplemented with industry standards and Accenture experience to estimate future regional costs Full model assumes full implementation of transition activities, and impact thereof, while benefits of full model phased in during first three years of future state Region-wide costs disaggregated across the 12 counties based on the funding formula developed by the Directors Cost Avoidance estimates based on difference between Status Quo and Future State 9

11 Future State Regional Cost Analysis Key Areas Cost Area Personnel Non-Personnel County-Purchased Services Approach Regional administrative personnel estimated top-down based on organizational chart Population-based service delivery personnel estimated bottom-up based on workload Salaries and benefits reflect current regional norms Estimated bottoms-up based on current costs, in-sourcing/outsourcing recommendations, and future needs Certain county-purchased services scaled in response to key areas of demonstrated regional need Remainder of county-purchased services transitioned as-is to future state *Refer to 2010 DHS Cost Report for more detailed definitions and descriptions of cost areas 10

12 Future State Personnel Key Variables Variable Metric(s) Source(s) Salary For primary positions, mixed rate of Olmsted (1/3) and non-olmsted average (2/3) For remaining positions, bottom-up estimate in line with current norms and primary position averages Association of Minnesota Counties (AMC) database County data submissions Benefit Average percentage of salary County data submissions FTE Regional administrative FTEs estimated topdown based on organizational chart Population-based service delivery FTEs estimated bottom-up based on workload County data submissions DHS data submissions County discussions Industry standards 11

13 Future State Salary/Benefit Details (1/2) Title Assumptions Salary Executive Director Higher pay for executive director $ 130,000 Equal pay for all deputy directors (incl. program), slightly more than Deputy Directors current average $ 100,000 Lead Attorney Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 100,000 Strategic Planning and Delivery Support Supervisor Supervisor level, adjusted for span of control magnitude $ 90,000 Managers Interim salary band between highest supervisor and director $ 85,000 Finance/Accounting Supervisor Higher adjustment for supervisor $ 85,000 Chief of Staff Manager level salary $ 85,000 Attorney Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 85,000 Finance/Accounting Worker Olmsted average salary $ 76,000 Fraud Worker Finance worker $ 76,000 HR Supervisor Higher adjustment for supervisor $ 75,000 Communications Supervisor Supervisor level $ 75,000 Risk Supervisor Supervisor level $ 75,000 Waiver Oversight Supervisor Supervisor level $ 75,000 Consumer Contact Supervisor Supervisor level $ 75,000 Social Work Supervisor Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 71,383 Data Privacy Worker Legal qualifications $ 65,000 Service Contract Management Worker Legal qualifications $ 65,000 One-third social worker supervisor and two-thirds financial supervisor Licensing Supervisor salary level $ 62,594 HR Worker Olmsted average salary $ 60,000 Financial Assistance Supervisor Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 58,199 Child Support Supervisor Financial Supervisor salary level $ 58,199 Social Worker Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 57,254 Quality Assurance Worker Social worker salary level $ 57,254 Court Services Social Worker Social worker salary level $ 57,254 Copyright Housing Needs 2012 Worker Accenture All Rights Reserved. Case aide Accenture, level its logo, and High Performance Delivered are trademarks $ of Accenture. 57,254 12

14 Future State Salary/Benefit Details (2/2) Title Assumptions Salary Licensing Worker One-third social worker and two-thirds financial worker salary level $ 49,437 Child Support Officer Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 48,290 Financial Worker Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 45,529 Case Aids Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 37,467 Risk Worker Case aide level $ 37,467 Program Evaluation and Research Worker Case aide level $ 37,467 Revenue Maximization Worker Case aide level $ 37,467 Data Analysis Worker Case aide level $ 37,467 Training Worker Case aide level $ 37,467 Grant Writing Worker Case aide level $ 37,467 Volunteer Driver Worker Case aide level $ 37,467 Donor Coordination Worker Case aide level $ 37,467 Father Support Worker Case aide level $ 37,467 Homelessness Worker Case aide level $ 37,467 Consumer Contact Worker Case aide level $ 37,467 Outreach Worker Case aide level $ 37,467 Clerical Support/Data Entry Salary weighted 1/3 Olmsted rate, 2/3 non-olmsted rate $ 32,051 Description Assumption Rate Employee benefits Equal benefits load across workforce 30% 13

15 Future State Consumer Contact FTE Details Description Assumptions Value FTE Source Supervisors 1:12 span of control, assume financial supervisor rate 12 5 Industry standard Access Center/I&R/Low- Intensity Intake Call center handles all I&R, refers to appropriate intake workers Operating model Call center operates 24/7 Operating model Average total calls per day 1800 Rice County total calls extrapolated to per capita region total Percentage of calls during busy hour 18% Industry estimate Call handled during busy hour 324 Calculation Call handle time (min) - includes call time and aftercall work time 8 Industry estimate SLA for calls completed within 120 seconds 70% Industry standard The number of agents is driven by SLAs and handle time Industry standard Number of agents required based on handle time 43 Industry standard Adjustment for SLA rate 15% Industry standard Number of agents total 50 Industry standard Agents are case aides Base case Facility reception staff are included in these estimates Operating model Outreach Includes community education and training, case aide salary 5 Operating model 14

16 Future State Social Services FTE Methodology Key Question Starting Point How many social services FTEs do we need in the fully-implemented regional model? County data submissions, conversations with county staff, industry standards, and final operating model Key Considerations Sizing estimates are driven by caseload Cases/worker developed through range of current county ranges and leading practices (e.g., TCM rate optimization) Span of control numbers developed through range of current county ranges and leading practices Sizing estimates are averages Specializations of different workforces are likely to fall above or below the average In-office workers and telecommuters are likely to fall above or below the average Estimates are not meant to imply workload distribution or dispatch these processes will still be managed in the field based on complexity and acuity of case (among other factors) 15

17 Inputs FTEs Future State CYF Services FTE Details Area Description Value Source Child Behavioral Health Total regional cases annually 802 Extrapolated based on population percentage from Olmsted 2010 cases Child Protection Total regional cases annually 1213 Extrapolated based on population percentage from Olmsted 2010 cases Child DD / Disabilities / Waiver Total regional cases annually 792 Extrapolated based on population percentage from Olmsted 2010 cases Child Behavioral Health Cases per worker 15 County data submissions, leading practice adjustments Child Protection Cases per worker 12 County data submissions, leading practice adjustments Child DD / Disabilities / Waiver Cases per worker 50 County data submissions, leading practice adjustments Child Behavioral Health Workers per supervisor 12 County data submissions, leading practice adjustments Child Protection Workers per supervisor 7 County data submissions, leading practice adjustments Child DD / Disabilities / Waiver Workers per supervisor 15 County data submissions, leading practice adjustments Average adjustment for current Child Behavioral Health services provided by providers 40% County data submissions Title Assumption FTE Source Manager(s) Managers based on 1:12 ratio for supervisors 2 Industry standard Social Work Supervisors Child Behavioral Health Case workers and span of control 3 Calculation Social Work Supervisors Child Protection Case workers and span of control 14 Calculation Social Work Supervisors Child DD / Disabilities / Waiver Case workers and span of control 1 Calculation Social Workers Child Behavioral Health Cases/worker and cases 32 Calculation Social Workers Child Protection Cases/worker and cases 101 Calculation Social Workers Child DD / Disabilities / Waiver Cases/worker and cases 16 Calculation 16

18 Inputs FTEs Future State Adult Services FTE Details Area Description Value Source Adult Behavioral Health Total regional cases annually 1828 Extrapolated based on population percentage from Olmsted 2010 cases Adult Protection Total regional cases annually 597 Extrapolated based on population percentage from Olmsted 2010 cases Adult DD / Disabilities / Waiver Total regional cases annually 2,496 Extrapolated based on population percentage from Olmsted 2010 cases Adult Behavioral Health Cases per worker 30 County data submissions, leading practice adjustments Adult Protection Cases per worker 18 County data submissions, leading practice adjustments Adult DD / Disabilities / Waiver Cases per worker 50 County data submissions, leading practice adjustments Adult Behavioral Health Workers per supervisor 15 County data submissions, leading practice adjustments Adult Protection Workers per supervisor 12 County data submissions, leading practice adjustments Adult DD / Disabilities / Waiver Workers per supervisor 15 County data submissions, leading practice adjustments Average adjustment for current Adult Behavioral Health services provided by providers 35% County data submissions Title Assumption FTE Source Manager(s) Managers based on 1:12 ratio for supervisors 0 Industry standard Social Work Supervisors Adult Behavioral Health Case workers and span of control 3 Calculation Social Work Supervisors Adult Protection Case workers and span of control 3 Calculation Social Work Supervisors Adult DD / Disabilities / Waiver Case workers and span of control 3 Calculation Social Workers Adult Behavioral Health Cases/worker and cases 40 Calculation Social Workers Adult Protection Cases/worker and cases 33 Calculation Social Workers Adult DD / Disabilities / Waiver Cases/worker and cases 50 Calculation 17

19 Future State Specialized Services FTE Details Title Assumption FTE Source Scale Olmsted model (coordination, not provision of Volunteer Driver Coordination rides/drivers), case aide level 2 Olmsted scaling estimate Donor Coordination Scale Olmsted model, case aide level 1 Olmsted scaling estimate Housing Needs Coordination Scale Olmsted model (coordination), social worker level 1 Olmsted scaling estimate Court Services Worker Scale Olmsted model, social worker level 3 Olmsted scaling estimate Fathers Support Programs Develop initial presence, scale with grants (case aide level) 2 None - base case Homelessness Programs Scale Olmsted model (case aide level) 6 Olmsted scaling estimate 18

20 Future State Support Services FTE Methodology Key Question Starting Point How many support services FTEs do we need in the fullyimplemented regional model? County data submissions, conversations with county staff, industry standards, and final operating model Key Considerations Sizing estimates are driven by caseload Span of control numbers developed through range of current county ranges and leading practices Sizing estimates are averages Specializations of different workforces are likely to fall above or below the average In-office workers and telecommuters are likely to fall above or below the average Estimates are not meant to imply workload distribution or dispatch these processes will still be managed in the field based on complexity and acuity of case (among other factors) No cases trends/case mix changes are assumed in these calculations. Current State cases/mix = Future State cases/mix. Income support includes all financial assistance, health care, and food stamps Licensing includes average of child care, child foster care, and adult foster care There are negligible no contracted/provider services for support services 19

21 Inputs FTEs Future State Support Services FTE Details Area Description Value Source Income/Food/Medical Support Current FTEs 129 County data submissions Child Support Current FTEs 86 County data submissions Licensing Current FTEs 25 County data submissions Impact of technology and process All support services changes 12% Industry standard County data submissions, impact of technology/process changes, Income/Food/Medical Support Cases per worker 278 discussions with county directors Child Support Cases per worker 311 County data submissions, impact of technology/process changes, discussions with county directors Licensing Cases per worker 188 County data submissions, impact of technology/process changes, discussions with county directors Income/Food/Medical Support Future state productivity increase 17.8% Calculation Child Support Future state productivity increase 20.5% Calculation Licensing Future state productivity increase 20.5% Calculation Income/Food/Medical Support Supervisory span of control 12 Industry standard Child Support Supervisory span of control 12 Industry standard Licensing Supervisory span of control 12 Industry standard Title Assumption FTE Source Manager(s) Managers based on 1:12 ratio for supervisors 2 Industry standard Financial Supervisors Case workers and span of control 9 Calculation Child Support Supervisors Case workers and span of control 6 Calculation Licensing Supervisors Case workers and span of control 2 Calculation Financial Workers Cases/worker and cases 106 Calculation Child Support Officers Cases/worker and cases 68 Calculation Licensing Workers Cases/worker and cases 20 Calculation 20

22 Future State Summary Sizing Cases/Worker Workers/Supervisor Program/Area Income / Food / Medical Support Current Range Future Sizing (incl. tech./process changes) Current Range Future Sizing (incl. tech./process changes) :6 1:17 1:12 Child Support :2 1:29 1:12 Licensing Varies, often supervised within other units 1:12 Child Behavioral Health :4 1:16 1:12 Child Protection :4 1:13 1:7 Child DD / Disabilities / Waiver Adult Behavioral Health :3 1:16 1: :3 1:24 1:15 Adult Protection :3 1:15 1:12 Adult DD / Disabilities / Waiver :3 1:16 1:15 Note: ranges reflect county data-submission templates 21

23 Future State Delivery Support FTE Details Area Assumption(s) FTE Source(s) Strategic Planning and Delivery Support Supervisors 1:15 span of control 2 Industry standard Quality Assurance Scale Olmsted model, to include pure QA, process improvement, and strategic planning/development 4 Olmsted scaling estimate Program Evaluation and Research Scale Olmsted model, slight increase in staff but larger increase in data to analyze 3 Olmsted scaling estimate Revenue Maximization Dependent on deployment to program -scale from Olmsted to deploy appropriately 14 Olmsted scaling estimate Fraud Investigation Scale current 6-county program to 12 counties (1 -> 2) workers 2 Regional scaling estimate Data Privacy Scale Olmsted model 2 Olmsted scaling estimate Data Analysis Scale Olmsted model 4 Olmsted scaling estimate Scale Olmsted model, expanded scope includes non-waiver Service Contract Management contracts and increased provider relationship management 4 Olmsted scaling estimate Training Scale Olmsted model, includes orientation, technology/skills, and HS concepts for internal FTEs 3 Olmsted scaling estimate Grant Writing Scale Olmsted model, includes both existing and new grants 1 Olmsted scaling estimate 22

24 Future State Mgmt and Admin FTE Details Area Assumption(s) FTE Source(s) Executive Director One executive director, higher pay than deputies 1 Organizational model Deputy Director Equal pay for all deputy directors (incl. program), slightly more than current average 5 Organizational model Chief of Staff Reports to Executive Director 1 Organizational model Clerical Support Based on 5% of total organization sizing 32 Base case 23

25 Future State General Admin FTE Details Title Assumption(s) FTE Source HR supervisor Ratio of HR supervisors to workers is 1:15 0 Industry standard HR worker Ratio of HR workers to size of organization is 1:120 employees 6 Industry standard Finance supervisor 1:12 span of control 2 Industry standard Finance worker Workers based on 1:45 employees ratio, with addition of specialized financial support 20 Industry standard Communications / PR / Media Coordination requires one person 1 Base case Waiver Oversight Coordination of the optimization process requires one person 1 Base case Risk Mgmt and Insurance Supervisor Coordination of insurance and risk management requires 2 people 1 Base case Risk Mgmt and Insurance Worker Coordination of insurance and risk management requires 2 people 1 Base case Lead Attorney Supervisor ratio of 1:6 1 Olmsted scaling estimate Attorney These legal personnel will support fundamental and "typical" areas for human services 6 Olmsted scaling estimate 24

26 Future State Non-Personnel Details Area Assumption(s) Value Cost Source Information Technology State covers all costs for state system support County data submissions Contract with a 3rd party provider (including all services/people) Operating model Overall person organization Operating model Overall 40-50% of workforce remote for some portion of their time Operating model 260 days per year of support on average 260 Industry estimate $900/day on average (blended onshore/offshore) $900 Industry estimate 25 people on average 25 Industry estimate Total future state costs $ 5,850,000 Calculation HR and Finance systems is an exception to this sizing; these two systems will be sourced through Olmsted's current CGI-AMS system Operating model Future state maintenance costs $ 487,000 Olmsted estimate Legal Specialized legal advice will be contracted as needed with attorneys not employed by the co-op $ 500,000 Estimate Insurance Estimated $321K for Property & Liability and $215K for Workers Comp $ 536,000 Industry estimate Contracted leasing $ 250,000 Estimate Contracted leasing $ 100,000 Estimate Infrastructure and Facilities Number of personnel in future-state co-op 705 Operating model 50% of workforce will need facility space at any one time, assuming telecommuting and facilities optimization 50% Industry standard Number of personnel who need facility space in future state co-op 352 Calculation Square feet per person 270 Olmsted metric Cost per square foot (including maintenance and utilities) $17.95 Olmsted metric Cost for facilities $ 1,707,495 Calculation 25

27 Future State County-Purchased Services Details Area Regional Cost Source Olmsted BRASS contract data across populations scaled to regional demand, Interpreters $ 103,465 adjustments for scale purchasing and existing contracts Olmsted BRASS contract data across populations scaled to regional demand, Child Psychiatry $ 353,909 adjustments for scale purchasing and existing contracts Olmsted BRASS contract data across populations scaled to regional demand, In-Home Family Counseling Services $ 566,680 adjustments for scale purchasing and existing contracts Olmsted BRASS contract data across populations scaled to regional demand, Guardianship Program $ 1,042,461 adjustments for scale purchasing and existing contracts Current county-purchased services projected into the future with no other All other programs/services No change changes, apart from standard cost projections 26

28 Future State Cost Analysis Phase In Area Percentage Change Against Status Quo Source Cost Analysis Phase In (Year 1) 20% Initial implementation considerations Cost Analysis Phase In (Year 2) 80% Initial implementation considerations Cost Analysis Phase In (Year 3) 100% Initial implementation considerations Cost Analysis Phase In (Year 4) 101% Continuous improvement, industry standard Cost Analysis Phase In (Year 5) 102% Continuous improvement, industry standard 27

29 Future State Funding Formula Key Variables % of Region / SDA HS Spend (2010) Funding Dodge $ 1,733, % Fillmore $ 1,285, % Freeborn $ 4,575, % Goodhue $ 3,204, % Houston $ 986, % Mower $ 3,559, % Olmsted $ 23,867, % Rice $ 3,170, % Steele $ 1,872, % Wabasha $ 1,330, % Waseca $ 1,467, % Winona $ 3,139, % Region $ 50,195, % *Transitions Costs were not included in the modeling 28

30 Future State Cost Avoidance Key Variables Variable Status Quo Future State Cost Avoidance Description Projection of human services spend into the future if redesigned operating model is not implemented Projection of human services spend assuming full implementation of redesigned operating model Difference between the future state and status quo projections *Transitions Costs were not included in the modeling 29

31 Future State Cost Avoidance County Summary Total Cost to Counties ($M) 60 Total FTE Estimate: Status Quo (Counties) 50 Total Cost Avoidance: $34.8M (13%) Future State (Counties) 40 Today Year 1 Year 2 Year 3 Year 4 Year 5 *Note: current-state FTE count not available due to differences in use of providers, shared county administrative positions, and county collaborations between human services and other departments (e.g., public health) 30

32 Future State Cost Avoidance County Details Cost Avoidance by Year (Based on Status Quo Spend) County Year 1 Year 2 Year 3 Year 4 Year 5 Total Dodge $ 65,992 $ 251,339 $ 336,957 $ 369,982 $ 404,675 $ 1,428,944 Fillmore $ 31,944 $ 160,157 $ 207,990 $ 215,895 $ 224,080 $ 840,066 Freeborn $ 98,583 $ 521,633 $ 638,024 $ 610,686 $ 582,662 $ 2,451,589 Goodhue $ 67,919 $ 407,062 $ 544,929 $ 583,918 $ 624,272 $ 2,228,100 Houston $ 28,055 $ 122,786 $ 157,488 $ 161,525 $ 165,753 $ 635,607 Mower $ 57,540 $ 378,790 $ 468,943 $ 447,272 $ 425,067 $ 1,777,612 Olmsted $ 913,056 $ 3,360,171 $ 4,339,642 $ 4,583,680 $ 4,838,942 $ 18,035,492 Rice $ 127,519 $ 481,517 $ 641,416 $ 704,669 $ 770,507 $ 2,725,629 Steele $ 67,491 $ 278,038 $ 375,253 $ 415,421 $ 457,150 $ 1,593,355 Wabasha $ 37,081 $ 169,713 $ 220,091 $ 229,242 $ 238,791 $ 894,918 Waseca $ 31,741 $ 170,561 $ 216,766 $ 217,090 $ 217,420 $ 853,578 Winona $ 24,464 $ 300,746 $ 365,626 $ 331,576 $ 296,746 $ 1,319,157 Region $ 1,551,384 $ 6,602,513 $ 8,513,125 $ 8,870,956 $ 9,246,067 $ 34,784,046 *Cost Avoidance based on Funding Formula using 2010 spending percentage as distributing factors for county contribution 31

33 Future State Cost Avoidance Total Summary Total Cost ($M) Total Cost Avoidance: $61M (9%) Status Quo (Total) Future State (Total) County Cost Avoidance: $34.8M (13%) Status Quo (Counties) Future State (Counties) 30 Today Year 1 Year 2 Year 3 Year 4 Year 5 32

34 Future State Cost Avoidance Total Details 5 Year Total Status Quo Future State Cost Avoidance Percent Federal $ 217,881,782 $ 194,457,136 $ 23,424, % State $ 107,523,128 $ 105,094,531 $ 2,428, % Counties $ 269,706,393 $ 234,922,347 $ 34,784, % Dodge $ 9,540,909 $ 8,111,965 $ 1,428, % Fillmore $ 6,857,596 $ 6,017,531 $ 840, % Freeborn $ 23,866,117 $ 21,414,528 $ 2,451, % Goodhue $ 17,226,949 $ 14,998,850 $ 2,228, % Houston $ 5,253,228 $ 4,617,621 $ 635, % Mower $ 18,438,831 $ 16,661,219 $ 1,777, % Olmsted $ 129,739,135 $ 111,703,644 $ 18,035, % Rice $ 17,565,474 $ 14,839,845 $ 2,725, % Steele $ 10,357,986 $ 8,764,631 $ 1,593, % Wabasha $ 7,123,862 $ 6,228,944 $ 894, % Waseca $ 7,722,121 $ 6,868,543 $ 853, % Winona $ 16,014,184 $ 14,695,026 $ 1,319, % Miscellaneous $ 61,431,553 $ 61,431,553 $ 0 0.0% Total $ 656,542,855 $ 595,905,567 $ 60,637, % 33

35 Transition Activities Overview Area Description Estimated Cost Source(s) Process Business process analysis and standardization $ 4,500,000 Accenture experience Call center implementation Technology Electronic document management system Upgraded equipment $ 5,400,000 Accenture experience Facilities Space utilization Facility placement $ 800,000 Accenture experience Procurement Strategic sourcing / provider reforms $ 50,000 Accenture experience Human Resources Wage and benefits normalization Organizational design and transition $ 700,000 Accenture experience Transition Team Additional Transition Costs Executive team Project team Program management office Pay back initial investments (Bush Foundation and counties) $ 3,555,575 Contingency 20% contingency $ 3,196,915 Total $ 19,181,490 Operating model cost assumptions; Accenture experience $ 979,000 County discussions 34

36 Future State Additional Regional Opportunities Area CAC/CADI/BI waivers DD waivers Child care assistance program Metric Average under-utilization of available funding Average under-utilization of available funding Average under-utilization of available funding Annual Financial Opportunity Potential $17.3M (5.4%) in direct allocation $8.7M (1.5%) in direct allocation $1.7M in direct allocation 35

37 Financial Impact Dodge Total Cost to Dodge ($M) $2.10 $2.00 $1.98 $2.05 Status Quo (Dodge) $1.90 $1.84 $1.91 $1.80 $1.77 Total Cost Avoidance: $1.4M (15.0%) $1.70 $1.60 $1.71 $1.59 $1.57 $1.61 $1.64 Future State (Dodge) $1.50 Today Year 1 Year 2 Year 3 Year 4 Year 5 36

38 Financial Impact Fillmore Total Cost to Fillmore ($M) $1.45 $1.41 $1.44 Status Quo (Fillmore) $1.40 $1.37 $1.35 $1.34 $1.30 $1.25 $1.20 $1.30 $1.27 Total Cost Avoidance: $840K (12.3%) $1.22 Future State (Fillmore) $1.15 $1.18 $1.16 $1.19 $1.10 Today Year 1 Year 2 Year 3 Year 4 Year 5 37

39 Financial Impact Freeborn Total Cost to Freeborn ($M) $5.00 $4.90 $4.85 $4.92 Status Quo (Freeborn) $4.80 $4.70 $4.60 $4.50 $4.40 $4.30 $4.61 $4.51 $4.71 $4.78 Total Cost Avoidance: $2.5M (10.3%) $4.24 $4.34 Future State (Freeborn) $4.20 $4.10 $4.19 $4.14 $4.00 Today Year 1 Year 2 Year 3 Year 4 Year 5 38

40 Financial Impact Goodhue Total Cost to Goodhue ($M) $3.70 $3.60 $3.55 $3.66 Status Quo (Goodhue) $3.50 $3.45 $3.40 $3.34 $3.30 $3.20 $3.22 Total Cost Avoidance: $2.2M (12.9%) $3.10 $3.00 $3.16 Future State (Goodhue) $2.90 $2.80 Today Year 1 $2.93 Year 2 $2.90 Year 3 $2.97 Year 4 $3.04 Year 5 39

41 Financial Impact Houston Total Cost to Houston ($M) $1.15 $1.10 $1.08 $1.10 Status Quo (Houston) $1.05 $1.03 $1.05 $1.00 $0.95 $0.90 $1.00 $0.97 $0.90 Total Cost Avoidance: $636K (12.1%) $0.91 $0.89 $0.94 Future State (Houston) $0.85 $0.80 Today Year 1 Year 2 Year 3 Year 4 Year 5 40

42 Financial Impact Mower Total Cost to Mower ($M) $3.85 $3.75 $3.69 $3.75 $3.80 Status Quo (Mower) $3.65 $3.64 $3.55 $3.45 $3.56 $3.51 Total Cost Avoidance: $1.8M (9.6%) $3.35 $3.38 Future State (Mower) $3.25 $3.15 Today Year 1 $3.26 Year 2 $3.22 Year 3 $3.30 Year 4 Year 5 41

43 Financial Impact Olmsted Total Cost to Olmsted ($M) $28.00 $27.00 $26.69 $27.47 Status Quo (Olmsted) $26.00 $25.94 $25.21 $25.00 $24.00 $24.42 Total Cost Avoidance: $18.0M (13.9%) $23.00 $22.00 $21.00 Today Year 1 $23.51 Year 2 $21.85 $21.60 Year 3 $22.11 Year 4 $22.63 Year 5 Future State (Olmsted) 42

44 Financial Impact Rice Total Cost to Rice ($M) $3.80 $3.70 $3.64 $3.78 Status Quo (Rice) $3.60 $3.50 $3.40 $3.38 $3.51 $3.30 $3.20 $3.25 Total Cost Avoidance: $2.7M (15.5%) $3.10 $3.00 $3.12 $3.01 Future State (Rice) $2.90 $2.80 Today Year 1 $2.90 Year 2 $2.87 Year 3 $2.94 Year 4 Year 5 43

45 Financial Impact Steele Total Cost to Steele ($M) $2.30 $2.20 $2.15 $2.23 Status Quo (Steele) $2.10 $2.07 $2.00 $1.90 $1.91 $1.99 Total Cost Avoidance: $1.6M (15.4%) $1.80 $1.84 $1.78 Future State (Steele) $1.70 $1.71 $1.70 $1.73 $1.60 Today Year 1 Year 2 Year 3 Year 4 Year 5 44

46 Financial Impact Wabasha Total Cost to Wabasha ($M) $1.60 $1.55 $1.50 $1.45 $1.42 $1.46 $1.50 Status Quo (Wabasha) $1.40 $1.35 $1.30 $1.25 $1.35 $1.31 $1.39 Total Cost Avoidance: $895K (12.6%) $1.26 Future State (Wabasha) $1.20 $1.15 $1.22 $1.20 $1.23 $1.10 Today Year 1 Year 2 Year 3 Year 4 Year 5 45

47 Financial Impact Waseca Total Cost to Waseca ($M) $1.65 $1.60 $1.58 $1.61 Status Quo (Waseca) $1.55 $1.51 $1.55 $1.50 $1.45 $1.40 $1.35 $1.30 $1.48 $1.45 $1.34 Total Cost Avoidance: $894K (11.1%) $1.36 $1.33 $1.39 Future State (Waseca) $1.25 Today Year 1 Year 2 Year 3 Year 4 Year 5 46

48 Financial Impact Winona Total Cost to Winona ($M) $3.30 $3.20 $3.18 $3.21 $3.24 $3.27 Status Quo (Winona) $3.12 $3.10 $3.09 Total Cost Avoidance: $1.3M (8.2%) $3.00 $2.98 Future State (Winona) $2.90 $2.87 $2.91 $2.80 Today Year 1 Year 2 $2.84 Year 3 Year 4 Year 5 47

49 Financial Impact Federal Total Cost to Federal ($M) $46.00 $44.42 $45.28 Status Quo (State/Fed) $44.00 $43.58 $42.76 $42.00 $41.85 $40.00 $40.79 Total Cost Avoidance: $23.4M (10.8%) $38.00 $38.30 $37.84 $38.45 $39.08 Future State (State/Fed) $36.00 Today Year 1 Year 2 Year 3 Year 4 Year 5 48

50 Financial Impact State Total Cost to State ($M) $21.90 $21.70 $21.62 $21.74 Status Quo (State/Fed) $21.50 $21.39 $21.51 $21.30 $21.10 $20.90 $21.26 $21.16 Total Cost Avoidance: $2.4M (2.3%) $21.00 $20.93 $20.91 $21.09 Future State (State/Fed) $20.70 $20.50 Today Year 1 Year 2 Year 3 Year 4 Year 5 49