howard county public school system fy 2017 operating

Howard County Public School System FY 2017 Operating Budget

Board of Education Work Session Follow-Up Requests from April 29, 2016

Included in this document is the Howard County Public School System’s response to questions posed at the County Council’s budget work session on April 29, 2016, for the Board of Education’s Operating Budget.

A. An updated copy of the deferred maintenance list in priority order with an indication of how long each project has been on the list

B. An update on the assignment of relocatable classroom

C. A detailed breakdown of the $26.8M placeholder for salary increases by each bargaining unit/unrepresented group and by salary/benefits

D. Source of funds for the first payment for the early retirement program (FY16)

E. Legal Services

1. Confirmation of the number of special education legal cases in which the Board’s decision was not upheld

2. Additional detail on legal services cost comparison with other jurisdictions to include:

• In-house or outside counsel

• Number of students in the system

• Number of students with IEPs

• Legal services cost as a percent of total system operating budget

3. The percentage of students with IEPs whose cases go to court

4. A breakdown of legal fees by type of cases (special education, public information requests, etc.)

F. Why is there money in the budget for an addition to Waverly ES which is <90% capacity through 2028-29 (and <80% thru 2024-25) when other schools are currently well-over 100% capacity now and projected to be for years? The redistricting in 2018 from Manor Woods described in the project description does not seem like it would contribute to an increase in capacity requiring an addition.



G. Capital projects:

• For funded projects: Which projects will add to student capacity in the schools? What is the current and projected capacity/enrollment for these schools?

• For projects that have no FY17 funding and were proposed to be funded in FY2017 (either in the FY16 approved budget or the HCPSS proposed FY17 budget): Which projects would have added to student capacity in the schools? What is the current and projected capacity/enrollment for these schools?

H. Public Input on HCPSS Budget

• What was the cost in staff time and funds to design, develop, and disseminate the input request?

• How will the results be tabulated and analyzed?

• What is the anticipated cost in staff time and funds to analyze, summarize, document, and disseminate the results from the public input?

• Who developed and who reviewed the content of the request before it was released?

I. By what percentage and dollar amount has the public relations/marketing office increased in size since FY2012 (by year)?

J. How many new administrative positions have been created each year beginning with the 2013-14 school year? How does this compare to the preceding three-year period 2010-11, 2011-12, and 2012-13?

K. New computers, laptops and peripherals. What is the replacements cycle? Was any assessment done to the remaining useful life on this equipment? What would be the cost savings of adding one or two years to the cycle?

L. New High School

1. Does the data support a high school in that location at this time?

2. Given the limited capital resources should that location be used for a high school, or should the priority be an elementary or middle school?

M. Adequate Pubic Facilities Ordinance Chart Board Report 05-12-2016.

N. Electronic copies of all handouts provided at the work session



O. Updated presentation on health fund balance and efforts to limit costs

P. Additional detail and cost estimates for the employer group waiver plan- Analysis Pending

Q. A comparison of the cost and benefits under that plan to the existing retiree health benefits- Analysis Pending

R. Teach for Tomorrow program:

• What is the cost for each cohort in this program? Provide a breakout of all of the costs (e.g., tuition, materials, travel, etc...).

• What are all of the sources of funds for the program?

• What is the cost in staff time and funds to advertise and administer the program?

S. Legal Services:

• What was the total number of requests, reviews, or cases that required review by outside counsel? How many proceeded to court or other judicial proceeding?

T. Assuming no additional funding, what moves is the Board requesting, if any, within the operating budget?

U. Assuming additional funding is found by cuts made to the County’s budget request, what is the order of prioritization of restoration of funding?

V. A Council Member would like to know the FY17 impact of the gas tax legislation on HCPSS.

W. Can you please provide an explanation for moving the start of this project from FY 17 to FY22 considering the anticipated overcrowding?

Additional Information Provided

Operating Budget

• Turnover Analysis • aetna Consultative Analytics and Impact Report presented 4-21-2016 • CareFirst Plan Review Meeting 01-06-2016 • Express Scripts – Your Collaborative Planning Guide 03/02/16

Capital Budget

• Updated Schedule of Projected Balances • Funding Letter from State.

Location Project DescriptionDeferred Project

Estimates

Priority

1-High

2-Med.

3-Low

Fiscal Year

Project

Deferred

Admin Bldg.- C.O. Cooling Tower Replacement NEW CONTROL (DDC) 100,000.00$ 2 2010

Admin Bldg.- C.O. Exterior / Interior Painting - partial UL & ML 215,000.00$ 3 2014

Admin Bldg.- C.O. Skylight in main hallway requires replacement 350,000.00$ 1 2012

Admin Bldg.- C.O. AHU's and Boiler 4,500,000.00$ 1 2010

ARL Replacement of heating plant & all rooftop units $ 12,500,000.00 1 2011

ARL Exterior Wall Panels $ 5,000,000.00 1 2011

ARL, Cradlerock ES,

Jeffers Hill ES, Triadelphia

Ridge ES Main distribution panel replacement 1,600,000.00$ 1 2014

Atholton HS, Clarksville

ES, Old Cedar Ln, Howard

HS-B Hall Replace galvanized piping 1,200,000.00$ 1 Prior to 2009

Bellows Spring ES Paint - Full School Interior/Exterior 113,000.00$ 3 2013

Bollman Bridge ES,

Elkridge Landing MS,

Forest Ridge ES, Mayfield

Woods ES, Mount View

MS Convert emergency generators to natural gas 150,000.00$ 2 Prior to 2009

Bonnie Branch MS Chiller plant $ 200,000.00 1 2015

Bonnie Branch MS Replacement of Boiler Plant - Boiler project FY17 Capital $ 513,000.00 1 2015

Centennial HS Stadium Concession Stand & Restrooms 250,000.00$ 3 2013

Clarksville ES Replacement of Interior Classroom Doors 375,000.00$ 2 2013

Cradlerock ES - Lake

Elkhorn MS Exterior Doors $ 140,000.00 2 2014


Elkhorn MS Science Room Renovation $ 165,000.00 1 2012


Elkhorn MS Boiler/Pumps etc. $ 550,000.00 1 2014

Dunloggin MS Site Lighting Replacement 65,000.00$ 2 2015

Dunloggin MS, Jeffers Hill

ES, Swansfield ES,

Waverly ES Generator replacement 1,012,500.00$ 1 2014

Ellicott Mills MS Exterior & Interior Painting $ 110,000.00 3 2015

Ellicott Mills MS Carpet & VCT Replacement $ 180,000.00 3 2015

Faulkner Ridge Center Electrical room renovation 500,000.00$ 3 2003

Faulkner Ridge Center Replace RTU 800,000.00$ 3 2003

Folly Quarter MS Carpet & VCT Replacement 160,000.00$ 3 2015

Fulton ES NEW CONTROL SYSTEM -DDC (replace Pneumatic ) 220,000.00$ 3 2014

Glenelg HS Demo Existing Water Storage Tank 350,000.00$ 3 Prior to 2009

Glenelg HS Replace rubber flooring in weight room 175,000.00$ 3 2012

Glenelg HS Replacement of Boilers with new energy efficient boilers 800,000.00$ 2 2014

Glenelg HS

Replace Remaining Interior & Exterior Doors, Frames &

Hardware. 975,000.00$ 3 2013

Harper's Choice MS Roof $ 3,200,000.00 1 2003

Harriet Tubman Cover Windows $ 1,500.00 3 Prior to 2009

Harriet Tubman Repoint BMU Walls $ 58,000.00 3 Prior to 2009

Harriet Tubman Replace Boiler/Steam Lines with Condensing Boilers $ 95,000.00 3 Prior to 2009

Harriet Tubman Paving $ 170,000.00 3 2010

Harriet Tubman Replace out dated MDP/Switch Gear $ 250,000.00 3 Prior to 2009

Lime Kiln MS, Cedar Lane Replace EMS System 1,000,000.00$ 1 2014

Howard HS

Replace (4) RTU's and Associated Components - JR ROTC

& Tech LAB 350,000.00$ 1 2010

Howard HS Sanitary Lines - Bathroom Renovations Phase 2 550,000.00$ 2 2011

Howard County Public School System

Systemic Renovation Projects

DEFERRED MAINTENANCE MASTER LIST

1 of 2

A

Location Project DescriptionDeferred Project

Estimates

Priority

1-High

2-Med.

3-Low

Fiscal Year

Project

Deferred


Systemic Renovation Projects


Jeffers Hill ES Replace exterior doors & frames 275,000.00$ 2 2010

Lime Kiln MS Efflorescence of Brick Exterior Walls 60,000.00$ 3 Prior to 2009

Lime Kiln MS Window Issues 140,000.00$ 2 2010

Lime Kiln MS OFFICE ROOFTOP & NEW CONTROL SYSTEM (DDC) 475,000.00$ 2 2015

Long Reach HS Window Leaks Heads & Jambs 47,800.00$ 2 2011

Mayfield Woods MS Replace two AC Units $ 15,000.00 3 Prior to 2009

Mayfield Woods MS Replace water heaters $ 65,600.00 1 2014

Mayfield Woods MS Roof Issues-Standing Seam Metal $ 100,000.00 1 2013

Mount View MS Replace window frame sealants $ 12,000.00 2 2013

Northfield ES Site Lighting $ 95,000.00 2 2015

Oakland Mills HS Replace interior doors $ 850,000.00 2 2009

Oakland Mills HS AHU's replacement $ 4,500,000.00 1 Prior to 2009

OLD Bushy Park Gas Conversion of Boiler burners $ 650,000.00 3 Prior to 2009

OLD Cedar Lane Replacement of HVAC Equipment $ 2,750,000.00 3 Prior to 2009

Patapsco MS HVAC Control Project $ 350,000.00 1 2011

Patapsco MS RTU replacement $ 2,650,000.00 1 2011

Pointers Run ES Replacement of Boilers with new energy efficient boilers $ 675,000.00 3 2014

Reservoir HS Repair window frame sealant $ 14,000.00 3 2013

Reservoir HS COOLING TOWER REPLACEMENT NEW CONTROL (DDC) $ 50,000.00 3 2016

River Hill HS Cooling Tower, Two New Chillers 925,000.00$ 1 2014

River Hill HS Masonry repairs 32,800.00$ 2 2013

Several Schools Covert EMS to Web based system for all schools 300,000.00$ 2 2015

St. John's Lane ES COOLING TOWER REPLACEMENT 75,000.00$ 3 2010

St. John's Lane ES (3) ROOFTOP UNIT REPLACEMENTS 750,000.00$ 2 Prior to 2009

Triadelphia Ridge ES Window thru wall flashings 50,000.00$ 1 2009

Various High Schools Replace emergency lighting 850,000.00$ 1 2012

Various Schools Exterior and Interior Door replacements 150,000.00$ 2 2014

West Friendship ES Replace total doors 95,000.00$ 2 2013

West Friendship ES Replacement of domestic water/well system $ 1,250,000.00 1 2010

Wilde Lake HS Masonry repairs $ 20,000.00 2 2009

Wilde Lake HS Regasket or wet seal convex windows on face of bldg. $ 150,000.00 2 Prior to 2009

Worthington ES Replace total doors $ 95,000.00 2 2013

Total 57,460,200.00$

PRIORITY KEY:

1 = Life Safety items or Failure

2 = Affects Instructional/Curriculum or probable failure

3 = Requires attention, but has useful life remaining

2 of 2

BOARD OF EDUCATION OF HOWARD COUNTYMEETING AGENDA ITEM

TITLE: Assignment of Relocatable Classrooms DATE: April 14, 2016

PRESENTER(S): Joel Gallihue, Manager, School Planning

VISION 2018 GOAL: Students Staff Families and Community Organization

OVERVIEW:Relocatable classrooms are used by the Howard County Public School System for short-term relief of overcrowding and to serve programming. This report represents an evaluation by staff using considerations of capacity, projected enrollment, current number of relocatable classrooms and additional programs housed at a school. School Planning and School Administration collaborated to determine which schools are most impacted by programs and enrollment growth. Three new single classroom units and one five classroom unit are recommended for placement by staff.

The five classroom modular building recommendation in this report supports provision of full day pre-kindergarten services to all children in the Oakland Mills Village area (Talbott Springs Elementary School and Stevens Forest Elementary School) from families with income at 300 percent of poverty or less. This strategy requires the installation of one five classroom modular building at Talbott Springs Elementary School and demolition of some older existing single classroom units. A five classroom modular permits the grouping of one grade (likely fourth or fifth) and includes bathrooms. The details of the pre-kindergarten strategy are provided in a separate report. The three attached tables show that no school will exceed 110 percent with existing or proposed relocatable classrooms. We have requested funding for relocatable classrooms next year and intend to return to other individual school needs this time next year.

RECOMMENDATION/FUTURE DIRECTION:Approve the recommendation for placement of units for the school year 2016 – 2017.

SUBMITTEDBY: APPROVAL/CONCURRENCE:

Joel Gallihue, Manager School Planning

Renee A. Foose, Ed.D. Superintendent

Camille B. Jones Chief Operating Officer

Bruce Gist Executive Director Facilities, Planning and Mgmt.

ACTION B

Recommendations:

New relocatable placements: St. Johns Lane ES +1 Talbott Springs ES +5 Thunder Hill ES +1 Long Reach HS +1 8 new units to be placed

Demolish: Talbott Springs ES -3 -3 units total to be demolished

Relocatable Classroom Assignments 2016-2017

Overview: The primary criterion for recommending installation of a relocatable classroom is to provide immediate relief from high enrollment. Projected capacity utilization percentages in school year 2016–2017 are based on the recently completed enrollment projections which will be used in the June 2016 Feasibility Study.

Recommendations and Justifications:

St. Johns Lane ES Proj. % Utilized

(no relocatables)Current

RelocatablesProj. % Utilized

w/Current RelocatablesProposed


w/Proposed Relocatables117.8% 6 94.6% 7 91.6%

Justification: Student enrollment projections at St. Johns Lane ES indicate that the growth at this school will continue to escalate. St. Johns Lane ES is projected to be at 117.8% utilization without existing relocatable classrooms. A new relocatable is needed to augment limited program area.

Talbott Springs ES Proj. % Utilized






Justification: Talbott Springs ES will be hosting full day pre-kindergarten services to all children in the Oakland Mills Village area (Talbott Springs ES and Stevens Forest ES) from families with income at 300% of poverty or less. The five classroom modular building recommendation in this report supports this new PreK program. Three older relocatables will be demolished.

Thunder Hill ES Proj. % Utilized






Justification: Thunder Hill ES is projected to be 114.9% utilization next school year without the existing relocatable classrooms. Thunder Hill ES hosts a Regional ASL program. The present units help, but redistricting in this area was recently completed and is not likely to be reviewed until ES #42 is opened. Even if redistricting is considered, it will more likely will be confined to the Rt. 1 area. Temporary space allows the administrator greater flexibility to manage population swings in the interim.

Long Reach HS Proj. % Utilized



w/CurrentRelocatables

ProposedRelocatables

Proj. % Utilized w/ProposedRelocatables

107.2% 3 102.0% 4 100.4%

Justification: Long Reach HS population is growing and presently has large classes for ESOL which exceed the rooms which have typically been allocated.

Elementary

School Current Relocatables


% Util % w/ Relocatables

Program Notes

Atholton ES 3 3 99.1% 84.2% Pre-K, Preschool, MINCBellows Spring ES 5 5 93.3% 80.0% Pre-K, Preschool, MINC, EB, ES PLBollman Bridge ES 2 2 100.5% 93.4% Title I, Pre-K, Preschool, MINCBryant Woods ES 4 4 107.5% 84.2% Title I, ESM Full-day Pre-KBushy Park ES 0 0 75.0% 75.0% Pre-K, Preschool, MINCCentennial Lane ES 5 5 116.2% 97.4%Clarksville ES 1 1 72.4% 69.5%Clemens Crossing ES 3 3 99.8% 87.2%Cradlerock ES 3 3 110.6% 93.0% Title I, Pre-K, PreschoolDayton Oaks ES 0 0 77.0% 77.0% Pre-K, Preschool, MINC, EBDeep Run ES 6 6 102.5% 85.8% Title I, Pre-K, Preschool, MINCDucketts Lane ES 0 0 106.5% 106.5%Elkridge ES 4 4 106.3% 94.0% Pre-KForest Ridge ES 5 5 113.6% 95.7%Fulton ES 0 0 104.9% 104.9% Regional EDGorman Crossing ES 2 2 93.0% 86.8% Pre-K, Preschool, MINCGuilford ES 5 5 103.2% 81.4% Title I, Pre-KHammond ES 1 1 99.2% 95.6%Hollifield Station ES 3 3 105.6% 95.3% Pre-K, Preschool, MINCIlchester ES 3 3 99.1% 88.9% Pre-K, Preschool, MINC, ES PLJeffers Hill ES 2 2 109.0% 97.5%Laurel Woods ES 2 2 85.6% 79.4% Title I, ESM Full-day Pre-KLisbon ES 1 1 80.6% 77.0%Longfellow ES 0 0 86.7% 86.7% Title I, Pre-K, Preschool, MINCManor Woods ES 1 1 109.8% 105.9%Northfield ES 1 1 100.4% 97.0%Phelps Luck ES 7 7 92.7% 72.2% Title I, ESM Full-day Pre-KPointers Run ES 9 9 97.0% 74.5% Pre-K, Preschool, MINC, ES PL, ALSRockburn ES 1 1 95.1% 91.6% Pre-K, Preschool, MINCRunning Brook ES 3 3 98.1% 85.6% Title I, ESM Full-day Pre-K*, PreschoolSt Johns Lane ES 6 7 117.8% 91.6%Stevens Forest ES 5 5 107.0% 81.5% Title I, ESM Full-day Pre-K*, PreschoolSwansfield ES 12 12 117.5% 74.5% Title I, Pre-KTalbott Springs ES 8 10 118.8% 71.5% Title I, ESM Full-day Pre-KThunder Hill ES 2 3 114.9% 100.2% ALSTriadelphia Ridge ES 0 0 95.7% 95.7% EBVeterans ES 5 5 111.2% 95.9% EB, Pre-K, Preschool, MINCWaterloo ES 4 4 90.8% 78.9% Pre-K, Regional ED, Preschool, MINC Waverly ES 8 8 109.4% 83.3% Pre-K, ALS, Preschool, MINC, ES PLWest Friendship ES 0 0 73.9% 73.9%Worthington ES 1 1 89.3% 85.7%Total 133 137

ALS Regional Academic Life SkillsPreschool Preschool Program, including Parent Assisted Learning at SchoolsPre-K Income qualifying Pre-K program. Astrisk (*) indicates 300% poverty qualification.ESM Full-day Pre-K Elementary School Model Full-day Pre-K programEB Early Beginnings - SE services for very young childrenTitle 1 State approved based upon incomeRegional ED Regional Emotional Disabilities Program (draws from other schools)MINC Multiple Intensive Needs Classroom (Toddler, Preschool/K, and/or Early Learner)ES PL Elementary School Primary Learner Program

Proposed Changes Relocatable Classrooms




Program Notes

Bonnie Branch MS 2 2 109.8% 102.1%Burleigh Manor MS 1 1 105.3% 102.0%Clarksville MS 5 5 91.0% 76.2%Dunloggin MS 5 5 113.6% 93.0%Elkridge Landing MS 2 2 90.0% 84.6% ALSEllicott Mills MS 3 3 121.3% 109.0% Regional EDFolly Quarter MS 0 0 95.2% 95.2%Glenwood MS 6 6 100.4% 78.7%Hammond MS 3 3 98.8% 87.9%Harpers Choice MS 5 5 113.4% 91.0%Lake Elkhorn MS 1 1 76.4% 73.5%Lime Kiln MS 0 0 103.3% 103.3% ALSMayfield Woods MS 2 2 88.3% 83.1%Mount View MS 2 2 93.9% 88.3%Murray Hill MS 6 6 96.8% 78.9% Regional EDOakland Mills MS 0 0 91.9% 91.9%Patapsco MS 2 2 108.6% 100.7%Patuxent Valley MS 6 6 88.8% 74.2%Thomas Viaduct MS 0 0 91.0% 91.0%Wilde Lake MS 13 13 116.7% 68.8%Total 64 64




Program Notes

Atholton HS 0 0 103.0% 103.0%Centennial HS 4 4 111.1% 103.5%Glenelg HS 0 0 84.6% 84.6%Hammond HS 4 4 105.7% 97.7%Howard HS 15 15 130.6% 103.3%Long Reach HS 3 4 107.2% 100.4%Marriotts Ridge HS 0 0 75.4% 75.4%Mt Hebron HS 4 4 113.9% 106.3% Regional EDNew HS #13 0 0 0.0% 0.0%Oakland Mills HS 0 0 83.0% 83.0% ALSReservoir HS 5 5 96.6% 89.4% Regional EDRiver Hill HS 0 0 81.7% 81.7%Wilde Lake HS 0 0 90.2% 90.2%Total 35 36

Proposed Changes Relocatable ClassroomsMiddle

High

Howard County Public School SystemFY 2017 Operating Budget

Salary Increases by Bargaining Unit

Row Labels FY 2017 Impact of FY 2016

Negotiations

FY 2017 Superintendent's

Placeholder

FY 2017 BOE Placeholder

Total FY 2017 Salary Increase

AFSCME 672,161$ 712,445$ 712,595$ 2,097,201$ AMT 405,686 430,556 430,602 1,266,844 HCAA 813,131 821,025 823,732 2,457,888 HCEA 8,988,977 9,161,939 11,966,561 30,117,477 HCEAESP 1,789,263 1,798,901 2,409,621 5,997,785 HCFSA 57,832 56,725 56,889 171,446 Grand Total 12,727,050$ 12,981,591$ 16,400,000$ 42,108,641$ Increase in budgeted turnover* - - (2,600,000) (2,600,000) Total FY 2017 Salary Increase 12,727,050$ 12,981,591$ 13,800,000$ 39,508,641$

Note: Amounts listed above include FICA and Retirement estimates.

* Final negotiations with HCEA included compression of salary scales, the cost of which is included in theHCEA FY 2017 BOE Placeholder. However, this cost was incorporated into the budget through turnover.Please see Five-Year Turnover Analysis for details.

C

HCPSS

Source of Funding for ERP

Fiscal Year 2016

Fixed Charges Category

Appropriation Fiscal Year 2016 before transfer 151,805,740$

Plus amount transferred from Administration 50,000

Plus amount transferred from Mid-Level Administration 233,000

Plus amount transferred from Instructional Salaries and Wages 3,229,000

Plus amount transferred from Instructional Textbooks/Supplies 750,000

Plus amount transferred from Special Education 490,000

Plus amount transferred from Student Transportation Services 712,000

Plus amount transferred from Operation of Plant 1,766,000

Plus amount transferred from Capital Outlay 70,000

Total amount transferred to fund the Early Retirement Program 7,300,000

Appropriation Fiscal Year 2016 after transfer 159,105,740$

In FY 2016, the Board approved a mid-year step increase after approval of the Operating Budget. To fund

this increase, management instituted cost saving strategies and identified cost cutting such as reductions

in textbook purchases. An early retirement program offered in 2015 provided cost savings in FY 2016 of

$4.3 million, which helped fund this increase. The incentive payments, however, were not budgeted in the

Fixed Charges category in the FY 2016 budget. Therefore, transfers of salary savings from the early

retirement program and other cost savings to Fixed Charges are necessary.

The 2016 early retirement program payment will be accounted for as a fixed charge.

D


Legal Questions and Responses – County Council Work Session

• Confirmation of the number of special education legal cases in which the Board’sdecision was not upheld

During the 2014-2015 school year, there were no legal cases where HCPSS’ decision was not upheld.

• Additional detail on legal services cost comparison with other jurisdictions to include:HCPSS can respond only for our district; we do not have the requested information for other jurisdictions.

o In-house or outside counselHCPSS uses expert legal counsel exclusively.

o Number of students in the systemHCPSS enrollment is 54,870.

o Number of students with IEPsHCPSS is serving 5,158 students with IEPs.

o Legal services cost as a percent of total system operating budgetHCPSS legal services expenses represent 0.1% of the total operating budget.

• The percentage of students with IEPs whose cases go to court.During the 2014-2015 school year, the percentage of students with IEPs whose cases went to court is 0.08%.

• A breakdown of legal fees by type of cases (special education, public informationrequests, etc.)

HCPSS legal expenses by category for the 2014-2015 school year: Collective Bargaining $ 42,412 5.5% Facilities 3,939 0.5% Filing Fees 30,348 3.9% General Counsel 62,626 8.1% Legal Services Association 21,025 2.7% MD Public Information Act 6,106 0.8% Miscellaneous 27,079 3.5% Personnel 168,310 21.7% Policy 23,563 3.0% Procurement 64,566 8.3% Special Education 221,921 28.6% Student 96,615 12.4% Other 7,909 1.0% TOTAL $ 776,419 100.0%

E

Howard County Public School System FY 2017 Capital Budget

Waverly Elementary

Why is there money in the budget for an addition to Waverly ES which is <90% capacity through 2028-29 (and <80% thru 2024-25) when other schools are currently well-over 100% capacity now and projected to be for years? The redistricting in 2018 from Manor Woods described in the project description does not seem like it would contribute to an increase in capacity requiring an addition.

This is the third year of funding for Waverly ES which is also a State participated project. There are construction funds requested in the FY17 capital budget for an addition to Waverly ES because the results of the 2009 facility assessment concluded that Waverly ES had a 14.6 percent deficiency in educational program area of the 40 elementary schools operating at the time. The Waverly ES project will expand educational program spaces with 100 seats of new capacity and renovate the existing facility. This additional program space would better position Waverly ES to provide relief to other schools such as Manor Woods ES which is not on pubic sewer and for that reason is unlikely to be able to accommodate an expansion. See attached page 21 from the 2015 Feasibility Study which addresses adjacent school capacity needs.

F

2015 Feasibility Study Howard County Public School System

Middle Schools

Need: Enrollment exceeds 110 percent of regional capacity.

Strategy: Utilize temporary capacity until the replacement school is built at Wilde Lake MS in 2017.

The Columbia West Region capacity utilization is now above 110 percent. This supports the decision to replace Wilde Lake MS, a project that is scheduled to open in 2017. The new school is planned to be 293 seats larger than the existing one, and will stay within target utilization until 2024, based on the current projection. The pre- and post- measure charts show intermittent crowding at Harper’s Choice MS, which does not happen to occur in the selected years below. This will be monitored for relocatable classroom consideration.

Needs and Strategies Middle SchoolsPage 25

Columbia West Region

Table 4.8 Five year middle school utilization in the Columbia West Region

Middle schools of the Columbia West Region

Figure 4.8

G


Elementary Schools

Need: The region will have existing capacity through 2020 despite growth at Running Brook ES

Strategy: Provide interim capacity within the region using the addition at Swansfield ES. Maintain Faulkner Ridge site for a future elementary school.

Investment in a 100-seat addition at Running Brook ES, which opened last August, has been a key capital project for managing growth in this area. Even with this addition, Running Brook ES is expected to continue to grow. A 100-seat addition is also planned at Swansfield ES and will open in 2018. A study of Columbia schools attached to the 2014 Feasibility Study recommended the Faulkner Ridge site for a new school. The combination of the additional capacity at these two schools will help to delay the need for a new school with feasible redistricting.

Needs and Strategies Elementary SchoolsPage 19

Columbia West Region

Table 4.2 Five year elementary school utilization in the Columbia West Region

Elementary schools of the Columbia West Region

Figure 4.2


Elementary Schools

Need: Monitor growth at Manor Woods ES and St. John’s Lane ES.

Strategy: Complete the Waverly ES addition and plan for other new capacity.

Growth is projected at Manor Woods ES that will require redistricting and new capacity, depending upon the timing of the Turf Valley development. A key feature in capital planning for this development is the Phase II addition at Waverly ES. Constructing this addition in 2018 can help relieve overcrowding at Manor Woods ES. Previous feasibility studies have planned for a new elementary school in Turf Valley and considered the possibility that this could serve as a replacement for West Friendship ES. Considering the constraints to the capital budget, this plan should be adjusted. It remains a good idea to own land bank sites in the area, particularly a site in Turf Valley. In the interim West Friendship Elementary should be used to its fullest.


Northern Region

Table 4.4 Five year elementary school utilization in the Northern Region

Elementary schools of the Northern Region Figure 4.4


Elementary Schools

Need: There is adequate capacity in this region until 2017.

Strategy: Open Elementary School #42 in 2018.

Capacity utilization at Ducketts Lane ES will remain over 110 percent in 2020, even with the reassignment of regional programs to other locations. The region will exceed 115 percent utilization in 2021 and require close to 1,000 additional seats. The most elementary enrollment growth is in this region, east of Interstate 95. Accelerating the construction of Elementary School #42 to allow opening in 2018 was approved by the Board on March 26, 2015. This decision, with the change to the 788 seat model, helps respond to the growth trend.


Northeastern Region

Table 4.3 Five year elementary school utilization in the Northeast Region

Elementary schools of the Northeast Region Figure 4.3


For funded projects: Which projects will add to student capacity in the schools? What is the current and projected capacity/enrollment for these schools?

FY17 Projects Funded in the Executive Proposed Version

Project Name Increased Capacity

from Project

Current Capacity

Current Enrollment 9/30/15**

Projected Capacity

Projected Enrollment

2020 Wilde Lake MS Replacement School

760 467* 564 760 692

Patuxent Valley MS Renovation - 760 631 760 757 Swansfield ES Renovation/Addition

100 521 608 621 519

Waverly ES Renovation/Phase II Addition

100 638 707 738 572

New ES #42 788 N/A N/A 788 TBD

The capacity projects are supported by the strategies in the 2015 Feasibility Study. Review page 25 of the Feasibility Study for information regarding Wilde Lake MS Replacement, page 19 for Swansfield ES, page 21 for Waverly ES and page 20 for New ES #42. The strategies incorporate both projected enrollments and the new capacity created from capacity projects to position each school for possible redistricting to alleviate overcrowding at schools in the same region.

*Wilde Lake MS current capacity is from the current middle school.

For projects that have no FY17 funding and were proposed to be funded in FY2017 (either in the FY16 approved budget or the HCPSS proposed FY17 budget): Which projects would have added to student capacity in the schools? What is the current and projected capacity/enrollment for these schools?

FY17 Projects Not Funded in the Executive Proposed Version

Project Name Increased Capacity

from Project

Current Capacity

Current Enrollment 9/30/15**

Projected Capacity

Projected Enrollment

2020 Oakland Mills MS Renovation - 506 454 506 489 New HS #13 1600-1800 N/A N/A 1600-1800 TBD

**Students enrolled in Homewood School have been counted in their home school counts. Prekindergarten students excluded from both capacity and enrollment counts.

G


Survey Questions

1. What is cost of staff time and funds to design, develop, and disseminate the inputrequest?

Survey Tool The cost to purchase the use of the interactive survey tool was a total of $105 ($6 prorated for April and $99 monthly cost for May).

Survey Design and Dissemination Two staff members devoted approximately 7.6 hours, at a cost of $435.86, in researching a suitable solution for a survey tool and designing the layout of the survey as well as how it would collect data. An additional two hours of staff time, at a cost of $113.74, was devoted to draft the press release before dissemination.

Survey Development There was no additional cost associated with staff time to develop the data used in the survey as all data was already in development and would have occurred normally as part of the budget process.

How will the results be tabulated and analyzed? The survey tool provides the results by the number of respondents selecting a particular item as a suggested budget cut, and those respondents’ percentage of total participants in the survey.

The survey provides this information in an easily viewed format, allowing readers to see what suggested budget cuts received the greatest to least preference by respondents.

2. What is the anticipated cost in staff time and funds to analyze, summarize, document,and disseminate the results from public input?

The anticipated cost of staff time would be 1.5 hours at a cost of $75.93. The cost is minimal due to the fact that the data provided is formatted in an easily discernable format that can be used for review.

H


Survey Questions Analysis of the responses are not done by staff, as the purpose of the survey is to provide Board of Education members with feedback of the public’s input and their suggestions as to how best budget the funds provided by the county to the school system for FY 2017. This will be one source of input available to Board of Education members when making their final decisions on funding for the FY 2017 Operating Budget. 3. Who developed and who reviewed the content of the request before it was released?

The content of the survey was developed by Budget office staff in collaboration with other staff members. The final survey was previewed with the Superintendent, Deputy Superintendent, and all but one Board of Education member prior to its release.


Public Information

FY 2017

Fiscal YearPublic Information

Office Budget

Increase/(Decrease) to

Prior Year

Percent Increase to

Prior YearFTE

1,321,780 13.0

1,313,520 (8,260) -0.6% 13.0

1,637,100 323,580 24.6% 16.0

2,198,940 561,840 34.3% 20.0

FY 2016 2,329,324 130,384 5.9% 19.0

FY 2017 2,368,558 39,234 1.7% 18.0

Summary

FY 2014

FY 2015

The Public Information Office encompasses three distinct programs and serves three budget categories.

Family, Community, and Staff Communication (0302) fosters communication and collaboration among the

school system, staff, families, and the community, and leads HCPSS efforts in effective communications and

community outreach. Communications Technology (2701) provides the infrastructure underlying HCPSS

communications functions including system and school online site development, upgrade and maintenance;

staff communications site development, upgrade and maintenance; HCPSS News email and text alerts

application; mobile application development; and video production and operations. Other Communication

Services (9401) was divided and merged with 0302 and 2701 in the FY 2015 budget. The budgets for all three

programs in three categories are represented in the table below.

Two new positions were added; 1.0 Web Developer and 1.0 Public Information Coordinator. 1.0 Secretary was

transferred from Accountability (0502) to public information. In total, the office increased by 3.0 FTE in FY

2014. In addition, the Staff Hub was introduced to streamline access to information and online resources for

employees and the school system launched its social media presence.

One new position, 1.0 School System Editor position was added. A Specialist of 1.0 Family and Community

Outreach was transferred from Central Office Instructional Personnel (0304). A 1.0 Coordinator and 1.0 E-

Learning Facilitator were transferred from the Information and Network Technology Services (9714). In total,

the office increased by 4.0 FTE in FY 2015. In addition, the HCPSS News email service was upgraded to deliver

more dynamic, informative, and easily accessed updates on important system news and events. The

Superintendent's Blog was created to offer a new forum for community engagement. Expanded multimedia

communications to communicate issues of interest to stakeholders.

Goal 3 of Vision 2018: Fulfilling the Promise of Preparation is that "families and the community are engaged

and supported as partners in education." In support of this goal, the public information office contracted key

initiatives to build out the missing communication tools which could then be maintained by in-house staff.

Since 2011, only 3 new positions have been added and a net of 2 have been transferred into this office from

other programs.

FY 2012

FY 2013

FY 2014

FY 2015

Page 1

I


Public Information

FY 2017

FY 2016

FY 2017

One position was transferred out to Central Office Instructional Personnel (0304). In total, the office

decreased by 1.0 FTE. Additions to the budget include HCPSS Insight , a livestream video series, features

experts responding to questions submitted by community and staff members via Twitter or email. In FY 2016,

school websites were migrated to a consistent, user-friendly platform. The district website was migrated to a

modern content management system that has a mobile responsive design.

The office decreased by 1.0 FTE. This position was transferred out to other programs. The FY 2017 budget

request would enable the public information office to upgrade school website infrastructure, enhance HCPSS

News functionality, enhance the Staff Hub infrastructure, improve the mobile app functionality, and develop

Staff Hub communities to facilitate communication within and between employee groups and key

organizational functions.

Page 2


Administration Category Staff

FY 2016

Fiscal Year Total FTEFTE Increase/ (Decrease)

due to New Positions

FTE Increase/

(Decrease) due to

Repurposed Positions

Net FTE ChangePercent of

Change

FY 2014 96.2 0.8 (1.0) (0.2) -0.2%

FY 2015 98.9 1.7 1.0 2.7 2.8%

FY 2016 102.5 - 3.6 3.6 3.7%

Total 3-Year FTE Change (FY14-FY16) 2.5 3.6 6.1 6.3%

Prior 3-Year FTE Change (FY11-FY13) 3.3 2.0 5.3 5.8%

Summary

Adminstration includes the activities associated with the general regulations, direction, and control of the LEA. Such activities as

establishing and administering LEA operating policy, providing fiscal and internal services necessary for operating the LEA,

supporting each of the other instructional and supporting services programs, and assisting the instructional staff with the content

and process of providing learning experiences for students are included in Administration. In the 3-year period from FY 2014 to FY

2016, a total of 6.1 positions were added to this category. Of these positions, a net of 2.5 were newly created, a decrease from

3.3 created in the prior 3-year period.

Strategy 4.3.1 of Vision 2018, "Implement a zero-based budgeting process to invest in strategic priorities," was executed with the

FY 2015 Budget. Through the analysis of staff functions and allocated resources, the School System has been able to redirect

positions to more efficiently meet the growing needs of the system.

J

Computer Replacement Cycle and Timeline Howard County Public School System

Replacement Cycle Timeline Time

Desktop Computers* 4 years Laptop Computers* 4 years Peripherals (e.g. Printers)* 4 years

*Purchased with a four-year warranty

Replacement Cost Fiscal Year Units Cost Units

Deferred Cost

Deferred RP 1.0 – ES & MS Mobile Lab Laptops FY 2015 5,820 $5.2M 1,830 $2.2M RP 1.5 – Teacher Laptops FY 2016 5,000 $4.9M RP 1.5 – HS Lab Desktops/Laptops FY 2016 1,610 $1.6M RP 2.0 – Computers, Printers, Multi-functional Devices FY 2017 4,666 $5.0M

RP 2.0 – School Curriculum Program Computers FY 2017 3,947 $4.4M

RP 2.0 – MAP Testing Computers FY 2017 3,720 $2.1M Total Deferred Beyond Normal Four-Year Replacement Cycle 11,107 $10.2M

Maintenance Cost • Warranties expire after four years, creating an anticipated increase in maintenance cost for extended

warranties or repairs as needed.• Repairs would take place as needed, assuming employees can be without this equipment while it is being

repaired.• Assuming no additional computer replacement deferrals, the FY 2017 budget to repair equipment is

$257,400. (Additional replacement deferrals could easily double ($514,800), if not triple ($772,200) repaircosts.)

• Other considerations with additional deferrals include:o Dated hardware may not support new operating systems and application software versions that

frequently change.o Impact on instruction if staff and students are without these computers and other devices during

maintenance and repair.

Other Considerations: • Servers and switches in all schools (except new or renovated schools) are 9 years old and need to be

replaced.• The replacement cycle is longer for network equipment (5–10 years)• The older switches cannot pass the higher data rates needed and available over the network.• Old server hardware have the same problem as computers supporting new operating systems and

application software versions that don’t change as frequently.

K


FY 2017 Capital Budget

The following questions are regarding the new high school property.

Does the data support a high school in that location at this time?

The projections indicate Howard High School, which already exceeds 110 percent of its capacity, is expected to be at 142 percent capacity by 2020. Long Reach High School, the remaining high school in the northeastern region of the county, will be at 137 percent of its capacity. Hammond HS, the sole high school in the southeastern region of the county, will be 127 percent of its capacity in 2020. (Please reference pages 32 and 34 as well as pre and post measures charts from the 2015 Feasibility Study.)

Given the limited capital resources, should that location be used for a high school, or should the priority be an elementary or middle school?

The pre measures charts show that by 2024, all school levels are projected to exceed 110 percent capacity utilization. The largest share of enrollment growth is in the east. A small amount of capacity in nearby schools is not sufficient to balance these needs. For these reasons the annual feasibility study models long range capital projects of ES #43 for the southeast, HS #13 for the east, and MS #21 for the east. Land banking has been recommended. The fact that this site can host multiple schools in a location of crowding supports further development of capital proposals which will gain state funding approval. Determining which project is the highest priority will occur in the state submission process as additional capital budgets are developed and future funding constraints become clearer.

Please provide backup data for both.

http://www.hcpss.org/f/schoolplanning/2015-feasibility-study.pdf

L

http://www.hcpss.org/f/schoolplanning/2015-feasibility-study.pdf


TITLE: Adequate Public Facilities Ordinance (APFO) Chart DATE: May 12, 2016



OVERVIEW:The Adequate Public Facilities Ordinance (APFO) chart is utilized as part of the residential growth management process of Howard County. County code requires that the school system provide this report each year. The attached APFO chart lists schools as "closed" if the enrollment projection developed for the FY 2017 Capital Budget and Capital Improvement Program/Redistricting Process exceeds 115 percent of capacity as listed and funded in the most recent Capital Improvement Program. Closed schools are indicated in the chart with the letter “C” and open schools are left blank.

Individual elementary (Grades K-5) or middle schools (Grades 6-8) that show a capacity utilization of less than 115 percent are considered "open" for future residential development. Those schools with greater than 115 percent capacity utilization are considered "closed" for future residential development. At the elementary level, regions that demonstrate capacity utilization above 115 percent are considered “closed” to future residential development.

The “OCIP” notation has been used to denote a school which is open, even when its capacity utilization percentage is over 115 percent, because an approved capital project and feasible redistricting will make the area open. This notation has been applied to this chart for schools involved in redistricting plans associated with additions at Waverly ES and Swansfield ES, as well as the opening of New Elementary School #42.

RECOMMENDATION/FUTURE DIRECTION:Approve the APFO chart for submittal to the Howard County Council for their adoption.

SUBMITTED BY: APPROVAL/CONCURRENCE:Joel GallihueManager, School Planning

Renee A. Foose, Ed. D.Superintendent

Camille B. Jones Chief Operating Officer

Bruce Gist, Executive Director Facilities, Planning and Mgmt.

ACTION

M

May 2016

Columbia - East 2019 2020 2021 2022 Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util.Cradlerock ES 398 398 398 398 369 92.7 386 97.0 383 96.2 379 95.2 395 99.2 406 102.0 422 106.0 436 109.5 441 110.8 445 111.8Jeffers Hill ES 421 421 421 421 447 106.2 444 105.5 447 106.2 445 105.7 453 107.6 464 110.2 470 111.6 477 113.3 482 114.5 491 116.6 CPhelps Luck ES 616 616 616 616 535 86.9 539 87.5 546 88.6 547 88.8 549 89.1 548 89.0 553 89.8 559 90.7 567 92.0 575 93.3Stevens Forest ES 399 399 399 399 397 99.5 419 105.0 423 106.0 429 107.5 424 106.3 425 106.5 429 107.5 433 108.5 438 109.8 442 110.8Talbott Springs ES 377 377 377 377 427 113.3 424 112.5 426 113.0 430 114.1 438 116.2 C 453 120.2 C 458 121.5 C 466 123.6 C 474 125.7 C 482 127.9 CThunder Hill ES 509 509 509 509 595 116.9 C 580 113.9 586 115.1 C 598 117.5 C 605 118.9 C 616 121.0 C 623 122.4 C 631 124.0 C 639 125.5 C 648 127.3 CRegion Totals 2720 2720 2720 2720 2770 101.8 2792 102.6 2811 103.3 2828 104.0 2864 105.3 2912 107.1 2955 108.6 3002 110.4 3041 111.8 3083 113.3

Columbia - WestBryant Woods ES 361 361 361 361 345 95.6 342 94.7 343 95.0 347 96.1 351 97.2 358 99.2 363 100.6 369 102.2 370 102.5 376 104.2Clemens Crossing ES 521 521 521 521 520 99.8 530 101.7 526 101.0 523 100.4 519 99.6 504 96.7 504 96.7 506 97.1 509 97.7 511 98.1Longfellow ES 512 512 512 512 432 84.4 436 85.2 439 85.7 438 85.5 447 87.3 457 89.3 464 90.6 469 91.6 478 93.4 484 94.5Running Brook ES 515 515 515 515 674 130.9 OCIP 735 142.7 OCIP 807 156.7 OCIP 878 170.5 C 938 182.1 C 995 193.2 C 1041 202.1 C 1077 209.1 C 1115 216.5 C 1142 221.7 CSwansfield ES A 621 621 621 621 514 82.8 519 83.6 516 83.1 524 84.4 529 85.2 526 84.7 534 86.0 541 87.1 548 88.2 555 89.4Region Totals 2530 2530 2530 2530 2485 98.2 2562 101.3 2631 104.0 2710 107.1 2784 110.0 2840 112.3 2906 114.9 2962 117.1 C 3020 119.4 C 3068 121.3 C

NortheasternBellows Spring ES 751 751 751 751 844 112.4 886 118.0 C 915 121.8 C 918 122.2 C 905 120.5 C 885 117.8 C 874 116.4 C 843 112.3 817 108.8 799 106.4Deep Run ES 772 772 772 772 884 114.5 903 117.0 C 911 118.0 C 905 117.2 C 895 115.9 C 898 116.3 C 906 117.4 C 917 118.8 C 928 120.2 C 939 121.6 CDucketts Lane ES 770 770 770 770 1224 159.0 OCIP 1354 175.8 OCIP 1441 187.1 OCIP 1531 198.8 OCIP 1588 206.2 C 1601 207.9 C 1617 210.0 C 1627 211.3 C 1636 212.5 C 1658 215.3 CElkridge ES 760 760 760 760 833 109.6 840 110.5 854 112.4 866 113.9 883 116.2 C 914 120.3 C 930 122.4 C 964 126.8 C 963 126.7 C 965 127.0 CIlchester ES 653 653 653 653 624 95.6 618 94.6 624 95.6 630 96.5 659 100.9 699 107.0 720 110.3 731 111.9 746 114.2 741 113.5New ES #42 NS 788 788 788 788Rockburn ES 653 653 653 653 580 88.8 600 91.9 639 97.9 683 104.6 712 109.0 739 113.2 788 120.7 C 830 127.1 C 858 131.4 C 876 134.2 CVeterans ES 788 788 788 788 836 106.1 836 106.1 811 102.9 822 104.3 843 107.0 851 108.0 869 110.3 875 111.0 883 112.1 897 113.8Waterloo ES 663 663 663 663 576 86.9 594 89.6 603 91.0 610 92.0 609 91.9 620 93.5 636 95.9 644 97.1 649 97.9 659 99.4Worthington ES 590 590 590 590 472 80.0 473 80.2 475 80.5 497 84.2 510 86.4 525 89.0 524 88.8 519 88.0 516 87.5 519 88.0Region Totals 7188 7188 7188 7188 6873 95.6 7104 98.8 7273 101.2 7462 103.8 7604 105.8 7732 107.6 7864 109.4 7950 110.6 7996 111.2 8053 112.0

NorthernCentennial Lane ES 647 647 647 647 769 118.9 C 769 118.9 C 774 119.6 C 780 120.6 C 783 121.0 C 789 121.9 C 803 124.1 C 814 125.8 C 822 127.0 C 832 128.6 CHollifield Station ES 694 694 694 694 809 116.6 C 834 120.2 C 866 124.8 C 892 128.5 C 913 131.6 C 938 135.2 C 946 136.3 C 931 134.1 C 911 131.3 C 893 128.7 CManor Woods ES 681 681 681 681 1100 161.5 OCIP 1257 184.6 OCIP 1376 202.1 OCIP 1475 216.6 OCIP 1573 231.0 OCIP 1597 234.5 OCIP 1565 229.8 OCIP 1508 221.4 OCIP 1451 213.1 OCIP 1392 204.4 OCIP

Northfield ES 700 700 700 700 717 102.4 731 104.4 746 106.6 756 108.0 770 110.0 776 110.9 808 115.4 C 816 116.6 C 822 117.4 C 830 118.6 CSt Johns Lane ES 612 612 612 612 732 119.6 C 721 117.8 C 721 117.8 C 720 117.6 C 720 117.6 C 719 117.5 C 724 118.3 C 726 118.6 C 744 121.6 C 756 123.5 CWaverly ES A 738 738 738 738 586 79.4 572 77.5 575 77.9 584 79.1 595 80.6 602 81.6 612 82.9 633 85.8 649 87.9 659 89.3Region Totals 4072 4072 4072 4072 4713 115.7 C 4884 119.9 C 5058 124.2 C 5207 127.9 C 5354 131.5 C 5421 133.1 C 5458 134.0 C 5428 133.3 C 5399 132.6 C 5362 131.7 C

SoutheasternAtholton ES 424 424 424 424 396 93.4 399 94.1 405 95.5 406 95.8 412 97.2 420 99.1 426 100.5 433 102.1 440 103.8 446 105.2Bollman Bridge ES 666 666 666 666 778 116.8 OCIP 796 119.5 OCIP 816 122.5 OCIP 829 124.5 OCIP 839 126.0 C 847 127.2 C 862 129.4 C 868 130.3 C 879 132.0 C 893 134.1 CForest Ridge ES 669 669 669 669 794 118.7 OCIP 846 126.5 OCIP 875 130.8 OCIP 912 136.3 OCIP 954 142.6 C 979 146.3 C 995 148.7 C 1001 149.6 C 995 148.7 C 990 148.0 CGorman Crossing ES 700 700 700 700 775 110.7 764 109.1 749 107.0 729 104.1 720 102.9 700 100.0 687 98.1 679 97.0 679 97.0 684 97.7Guilford ES 465 465 465 465 557 119.8 C 553 118.9 C 556 119.6 C 563 121.1 C 567 121.9 C 573 123.2 C 574 123.4 C 580 124.7 C 583 125.4 C 585 125.8 CHammond ES 653 653 653 653 720 110.3 728 111.5 767 117.5 C 786 120.4 C 817 125.1 C 843 129.1 C 846 129.6 C 850 130.2 C 859 131.5 C 874 133.8 CLaurel Woods ES 640 640 640 640 553 86.4 552 86.3 563 88.0 563 88.0 566 88.4 582 90.9 589 92.0 591 92.3 597 93.3 604 94.4Region Totals 4217 4217 4217 4217 4573 108.4 4638 110.0 4731 112.2 4788 113.5 4875 115.6 C 4944 117.2 C 4979 118.1 C 5002 118.6 C 5032 119.3 C 5076 120.4 C

WesternBushy Park ES 788 788 788 788 602 76.4 602 76.4 590 74.9 600 76.1 598 75.9 606 76.9 611 77.5 619 78.6 631 80.1 640 81.2Clarksville ES 612 612 612 612 427 69.8 430 70.3 430 70.3 435 71.1 435 71.1 432 70.6 436 71.2 435 71.1 437 71.4 437 71.4Dayton Oaks ES 788 788 788 788 605 76.8 591 75.0 578 73.4 578 73.4 566 71.8 567 72.0 566 71.8 566 71.8 569 72.2 573 72.7Fulton ES 788 788 788 788 861 109.3 878 111.4 875 111.0 884 112.2 866 109.9 865 109.8 870 110.4 876 111.2 873 110.8 859 109.0Lisbon ES 527 527 527 527 444 84.3 447 84.8 446 84.6 460 87.3 471 89.4 465 88.2 468 88.8 471 89.4 474 89.9 477 90.5Pointers Run ES 744 744 744 744 826 111.0 855 114.9 898 120.7 C 923 124.1 C 918 123.4 C 904 121.5 C 891 119.8 C 864 116.1 C 832 111.8 805 108.2Triadelphia Ridge ES 581 581 581 581 614 105.7 620 106.7 621 106.9 614 105.7 601 103.4 570 98.1 561 96.6 556 95.7 558 96.0 563 96.9West Friendship ES 414 414 414 414 241 58.2 236 57.0 242 58.5 242 58.5 250 60.4 253 61.1 257 62.1 258 62.3 264 63.8 271 65.5Region Totals 5242 5242 5242 5242 4620 88.1 4659 88.9 4680 89.3 4736 90.3 4705 89.8 4662 88.9 4660 88.9 4645 88.6 4638 88.5 4625 88.2Countywide Totals 25969 25969 25969 25969 26034 100.3 26639 102.6 27184 104.7 27731 106.8 28186 108.5 28511 109.8 28822 111.0 28989 111.6 29126 112.2 29267 112.7

NS: New school scheduled to open in August 2018.

2024-25

A: capacity includes additions as reflected in FY 2017 Capital Budget for Grades K-5 in 2017.

2025-26 2026-27 2028-29Capacity 2021-22

ELEMENTARY SCHOOLS - MAY 2016 APFO Test Capacity Utilization Rates with Board of Education's Approved FY 2017 Capital Budget Projects

Chart reflects May 2015 Projections, Board of Education's Requested FY 2017 capacities, and proposed redistricting associated with Capital Projects.2019-20 2020-21 2023-242022-23 2027-28

May 2016

Columbia - East 2019 2020 2021 2022 Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util. Proj % Util.Lake Elkhorn MS 643 643 643 643 564 87.7 557 86.6 572 89.0 563 87.6 557 86.6 549 85.4 548 85.2 568 88.3 581 90.4 585 91.0Oakland Mills MS 506 506 506 506 474 93.7 489 96.6 477 94.3 472 93.3 478 94.5 478 94.5 484 95.7 482 95.3 493 97.4 498 98.4Region MS Totals 1149 1149 1149 1149 1038 90.3 1046 91.0 1049 91.3 1035 90.1 1035 90.1 1027 89.4 1032 89.8 1050 91.4 1074 93.5 1083 94.3

Columbia - WestHarpers Choice MS 506 506 506 506 574 113.4 542 107.1 566 111.9 549 108.5 549 108.5 553 109.3 555 109.7 564 111.5 559 110.5 565 111.7Wilde Lake MS R 760 760 760 760 705 92.8 692 91.1 697 91.7 710 93.4 763 100.4 819 107.8 869 114.3 888 116.8 C 895 117.8 C 908 119.5 CRegion MS Totals 1266 1266 1266 1266 1279 101.0 1234 97.5 1263 99.8 1259 99.4 1312 103.6 1372 108.4 1424 112.5 1452 114.7 1454 114.8 1473 116.4

NortheasternBonnie Branch MS 662 662 662 662 734 110.9 690 104.2 652 98.5 657 99.2 663 100.2 681 102.9 686 103.6 696 105.1 703 106.2 716 108.2Elkridge Landing MS 779 779 779 779 677 86.9 672 86.3 685 87.9 697 89.5 714 91.7 712 91.4 731 93.8 743 95.4 781 100.3 796 102.2Ellicott Mills MS A 662 662 662 662 909 137.3 C 904 136.6 C 899 135.8 C 861 130.1 C 856 129.3 C 826 101.0 851 104.0 867 106.0 896 109.5 912 111.5Mayfield Woods MS 798 798 798 798 827 103.6 858 107.5 906 113.5 920 115.3 C 968 121.3 C 1000 125.3 C 993 124.4 C 981 122.9 C 984 123.3 C 993 124.4 CThomas Viaduct MS 701 701 701 701 806 115.0 C 865 123.4 C 959 136.8 C 998 142.4 C 1088 155.2 C 1170 166.9 C 1253 178.7 C 1307 186.4 C 1338 190.9 C 1365 194.7 CRegion MS Totals 3602 3602 3602 3602 3953 109.7 3989 110.7 4101 113.9 4133 114.7 4289 119.1 4389 116.8 4514 120.1 4594 122.2 4702 125.1 4782 127.2

NorthernBurleigh Manor MS 779 779 779 779 860 110.4 868 111.4 899 115.4 C 953 122.3 C 997 128.0 C 1059 135.9 C 1092 140.2 C 1106 142.0 C 1091 140.1 C 1100 141.2 CDunloggin MS A 565 662 662 662 656 116.1 C 660 99.7 672 101.5 678 102.4 679 102.6 687 103.8 683 103.2 697 105.3 697 105.3 714 107.9Patapsco MS 643 643 643 643 738 114.8 756 117.6 C 779 121.2 C 784 121.9 C 781 121.5 C 778 121.0 C 789 122.7 C 804 125.0 C 834 129.7 C 855 133.0 CRegion MS Totals 1987 2084 2084 2084 2254 113.4 2284 109.6 2350 112.8 2415 115.9 2457 117.9 2524 121.1 2564 123.0 2607 125.1 2622 125.8 2669 128.1

SoutheasternHammond MS 604 604 604 604 648 107.3 710 117.5 C 717 118.7 C 743 123.0 C 759 125.7 C 804 133.1 C 814 134.8 C 829 137.3 C 834 138.1 C 845 139.9 CMurray Hill MS 662 662 662 662 760 114.8 792 119.6 C 811 122.5 C 770 116.3 C 768 116.0 C 769 116.2 C 771 116.5 C 761 115.0 C 760 114.8 740 111.8Patuxent Valley MS 760 760 760 760 735 96.7 757 99.6 726 95.5 736 96.8 753 99.1 766 100.8 790 103.9 829 109.1 868 114.2 899 118.3 CRegion MS Totals 2026 2026 2026 2026 2143 105.8 2259 111.5 2254 111.3 2249 111.0 2280 112.5 2339 115.4 2375 117.2 2419 119.4 2462 121.5 2484 122.6

WesternClarksville MS 643 643 643 643 562 87.4 562 87.4 552 85.8 548 85.2 552 85.8 572 89.0 584 90.8 590 91.8 588 91.4 585 91.0Folly Quarter MS 662 662 662 662 678 102.4 675 102.0 684 103.3 673 101.7 686 103.6 710 107.3 707 106.8 688 103.9 659 99.5 654 98.8Glenwood MS 545 545 545 545 559 102.6 578 106.1 590 108.3 559 102.6 567 104.0 570 104.6 596 109.4 590 108.3 579 106.2 580 106.4Lime Kiln MS 701 701 701 701 754 107.6 765 109.1 783 111.7 787 112.3 805 114.8 814 116.1 C 807 115.1 C 799 114.0 789 112.6 792 113.0Mount View MS 798 798 798 798 824 103.3 823 103.1 820 102.8 833 104.4 858 107.5 910 114.0 938 117.5 C 984 123.3 C 992 124.3 C 999 125.2 CRegion MS Totals 3349 3349 3349 3349 3377 100.8 3403 101.6 3429 102.4 3400 101.5 3468 103.6 3576 106.8 3632 108.5 3651 109.0 3607 107.7 3610 107.8Countywide Totals 13379 13476 13476 13476 14044 105.0 14215 105.5 14446 107.2 14491 107.5 14841 110.1 15227 111.7 15541 114.0 15773 115.7 15921 116.8 16101 118.1

R: Replacement school scheduled to open August 2017.

2025-26 2027-28

MIDDLE SCHOOLS - MAY 2016 APFO TestCapacity Utilization Rates with Board of Education's Approved FY 2017 Capital Budget Projects

Chart reflects May 2015 Projections, Board of Education's Requested FY 2017 capacities, and proposed redistricting associated with Capital Projects.Capacity

A: capacity includes additions as reflected in FY 2017 Capital Budget for Grades 6-8 between 2017 and 2024.

2019-20 2020-21 2028-292021-22 2026-272022-23 2023-24 2024-25

Legal Services Analysis

Budget Work Session III

February 16, 2016

Howard County Public School SystemLegal Services Expenditures

The transition to an expert legal model has not increased legal fees as a percentage of the operating budget.


Legal Services Expenditures

FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 FY 2016 FY 2017

Inhouse Legal Model 429,085$ 434,139$ 183,018$ -$ -$ -$ -$

Expert Legal Model 235,609 295,641 435,947 843,187 776,419 795,000 825,000

Total Legal Costs 664,694$ 729,779$ 618,965$ 843,187$ 776,419$ 795,000$ 825,000$

Cost as a % of our operating budget 0.1% 0.1% 0.1% 0.1% 0.1% 0.1% 0.1%

Inhouse Model Expert Model

Howard County Public School SystemLegal Services Cost Comparison

A comparison of the FY 2015, FY 2016 and FY 2017 legal costs of MCPS, AACPS, BCPS, and PGCPS to HCPSS highlights some commonalities. As the five largest school districts in Maryland, they are all growing school districts located in the Baltimore-Washington metro area that are projecting increasing budgets for legal fees in line with increasing operating budgets. The rising legal fees for HCPSS, viewed in this light, appear to be reasonable.


Legal Services Cost Comparison*

Actual

Approved

Budget

Proposed

Budget

FY 2015 FY 2016 FY 2017

HCPSS $776,419 $795,000 $825,000

MCPS $851,782 $1,239,050 $1,679,020

AACPS $866,659 $950,695 $1,036,658

BCPS $978,719 $1,081,383 $1,082,007

PGCPS $2,769,634 $3,673,835 $3,327,965

Howard County Public School SystemSpecial Education Projected Cost Savings

1 Yr Saving

Total

Projected

Saving* 1 Yr Saving

Total

Projected

Saving* 1 Yr Saving

Total

Projected

Saving* 1 Yr Saving

Total

Projected

Saving*

Tuition 109,432$ 552,800$ 203,214$ 976,533$ 264,825$ 2,592,869$ 421,640$ 2,227,793$

Transport 53,542 285,558 53,542 321,252 89,237 1,017,299 71,389 660,352

Cost avoided HCPSS 162,974$ 838,358$ 256,756$ 1,297,785$ 354,061$ 3,610,168$ 493,029$ 2,888,145$

Total Legal Costs 729,779$ 618,965$ 843,187$ 776,419$

* Total projected saving is inclusive of 1 year saving.


Special Education Projected Cost Savings

FY 2015FY 2012 FY 2013 FY 2014

Inhouse Model Expert Model

The expert legal model has resulted in greater savings in the form of current

and future avoided costs. The review of the cost and effectiveness of the

current legal model supports continuation of this approach by the Board.

10910 Clarksville Pike Ellicott City, MD 21042 410-313-6600 www.hcpss.org

LEGAL SERVICES ANALYSIS

Overview

The Board transitioned to an expert legal model during FY 2013. An expert legal model allows the Board to direct legal matters to counsel with the strongest subject matter expertise. The prior model employed in-house counsel who provided legal advice. Under the in-house model, heavy reliance on outside counsel existed. However, most were handled by in-house counsel who could not provide the level of expertise in legal matters as outside counsel who specialize in individual areas. As the Board evaluates the FY 2017 Superintendent’s Proposed Operating Budget, it provides an opportunity to analyze the results of the change to an expert legal model.

HCPSS Cost of Legal Services The table below analyzes five years of actual legal costs from FY 2011 through FY 2015 with FY 2016 approved budget and FY 2017 proposed budget. Costs under the in-house legal model include salaries, benefits, and supply costs related to in-house staff as well as legal fees paid to external counsel. These costs were accounted for in a number of different programs. Under the expert legal model, all costs are legal fees paid to outside counsel. The transition to an expert legal model has not increased legal fees as a percentage of the operating budget. Howard County Public School System

Legal Services Expenditures

FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 FY 2016 FY 2017

In-house Legal Model 429,085$ 434,139$ 183,018$ -$ -$ -$ -$

Expert Legal Model 235,609 295,641 435,947 843,187 776,419 795,000 825,000

Total Legal Costs 664,694$ 729,779$ 618,965$ 843,187$ 776,419$ 795,000$ 825,000$

Cost as a % of our operating budget 0.1% 0.1% 0.1% 0.1% 0.1% 0.1% 0.1%

In-house Legal Model Expert Legal Model

Actual legal costs increased from FY 2011 to FY 2015 and are projected to continue to increase in the FY 2016 approved budget and FY 2017 proposed budget. However, as a proportion of our operating budget, legal fees have remained constant. It should be noted that the transition to an expert legal model has not increased legal fees as a percentage of the operating budget. HCPSS Legal Costs Comparison Many factors influence legal cost incurred by a school system which makes benchmarking this area challenging. Nonetheless, it can be helpful to compare legal costs with neighboring school systems. A comparison of the FY 2015, FY 2016 and FY 2017 legal costs of MCPS, AACPS, BCPS, and PGCPS to HCPSS highlights some commonalities. As the five largest school districts in Maryland, they are all growing school districts located in the Baltimore-Washington metro area that are projecting increasing budgets for legal fees in line with increasing operating budgets. The rising legal fees for HCPSS, viewed in this light, appear to be reasonable.


Legal Services Cost Comparison*

Actual

Approved

Budget

Proposed

Budget

FY 2015 FY 2016 FY 2017

HCPSS $776,419 $795,000 $825,000

MCPS $851,782 $1,239,050 $1,679,020

AACPS $866,659 $950,695 $1,036,658

BCPS $978,719 $1,081,383 $1,082,007

PGCPS $2,769,634 $3,673,835 $3,327,965 *Costs taken from FY 2017 proposed budgets books.

Value of the Expert Legal Model The value of the expert legal model is that HCPSS receives the best legal advice for the various types of matters that arise. Expert legal advice in the areas of contracts ensures the Board enters into contracts with terms that protect the Board. In the areas of personnel, student appeals, and general counsel matters, it ensures the Board receives the best advice. In the area of special education in particular, with the assistance of expert legal services, the school system is able to ensure it places students appropriately. The HCPSS is committed to ensuring each student is provided with an appropriate education that will lead to their success and makes decisions regarding placement with that priority in mind. Under the in-house legal model, nonpublic placement requests were often granted without adequate legal review despite special educator and classroom teacher recommendations for local services. Under the expert legal model, each request is evaluated carefully with heavy emphasis on teacher input to determine whether the HCPSS can provide the services. HCPSS approves all requests of nonpublic placement if it is determined that the nonpublic placement is appropriate. However, if HCPSS has the capability to provide the services, these requests are challenged. Ensuring students are placed appropriately has a cost impact as nonpublic placements cost three times more per year, on average, than placement in an HCPSS school. Under the expert legal model, the taxpayers of Howard County are saving significantly more through avoided costs than under the in-house model. Savings through avoided costs are more than three times higher than the legal costs for the entire school system.

1 Yr Saving

Total

Projected

Saving* 1 Yr Saving

Total

Projected

Saving* 1 Yr Saving

Total

Projected

Saving* 1 Yr Saving

Total

Projected

Saving*

Tuition 109,432$ 552,800$ 203,214$ 976,533$ 264,825$ 2,592,869$ 421,640$ 2,227,793$

Transport 53,542 285,558 53,542 321,252 89,237 1,017,299 71,389 660,352

Cost avoided HCPSS 162,974$ 838,358$ 256,756$ 1,297,785$ 354,061$ 3,610,168$ 493,029$ 2,888,145$

Total Legal Costs 729,779$ 618,965$ 843,187$ 776,419$

* Total projected saving is inclusive of 1 year saving.


Special Education Projected Cost Savings

FY 2015FY 2012 FY 2013 FY 2014

In-house Legal Model Expert Legal Model

The avoided cost savings calculated is based upon the assumptions that when a case was brought against HCPSS for a specific non-public placement and was resolved, tuition is saved until the student reaches 21 years of age. Only the HCPSS portion of the tuition costs are included in the total projected savings. Transportation savings are based on FY2017 cost per student to transport to non-public placement. Conclusion The cost analysis performed shows that the transition to the expert legal model did not result in higher legal costs for the school system, as a percentage of the operating budget. HCPSS, similar to other large, growing metropolitan Maryland school districts, has rising legal costs, in proportion with the growth in its budget. These legal costs would likely be rising under either the in-house legal model or expert legal model. The expert legal model, however, has resulted in greater savings in the form of current and future avoided costs. The review of the cost and effectiveness of the current legal model supports continuation of this approach by the Board.


TITLE: Assignment of Relocatable Classrooms DATE: April 14, 2016



OVERVIEW:Relocatable classrooms are used by the Howard County Public School System for short-term relief of overcrowding and to serve programming. This report represents an evaluation by staff using considerations of capacity, projected enrollment, current number of relocatable classrooms and additional programs housed at a school. School Planning and School Administration collaborated to determine which schools are most impacted by programs and enrollment growth. Three new single classroom units and one five classroom unit are recommended for placement by staff.

The five classroom modular building recommendation in this report supports provision of full day pre-kindergarten services to all children in the Oakland Mills Village area (Talbott Springs Elementary School and Stevens Forest Elementary School) from families with income at 300 percent of poverty or less. This strategy requires the installation of one five classroom modular building at Talbott Springs Elementary School and demolition of some older existing single classroom units. A five classroom modular permits the grouping of one grade (likely fourth or fifth) and includes bathrooms. The details of the pre-kindergarten strategy are provided in a separate report. The three attached tables show that no school will exceed 110 percent with existing or proposed relocatable classrooms. We have requested funding for relocatable classrooms next year and intend to return to other individual school needs this time next year.

RECOMMENDATION/FUTURE DIRECTION:Approve the recommendation for placement of units for the school year 2016 – 2017.

SUBMITTED BY: APPROVAL/CONCURRENCE: Joel Gallihue, Manager

School Planning Renee A. Foose, Ed.D.

Superintendent Camille B. Jones

Chief Operating Officer

Bruce Gist Executive Director Facilities, Planning and Mgmt.

ACTION

Recommendations:

New relocatable placements: St. Johns Lane ES +1 Talbott Springs ES +5 Thunder Hill ES +1 Long Reach HS +1 8 new units to be placed

Demolish: Talbott Springs ES -3 -3 units total to be demolished

Relocatable Classroom Assignments 2016-2017

Overview: The primary criterion for recommending installation of a relocatable classroom is to provide immediate relief from high enrollment. Projected capacity utilization percentages in school year 2016–2017 are based on the recently completed enrollment projections which will be used in the June 2016 Feasibility Study.

Recommendations and Justifications:

St. Johns Lane ES Proj. % Utilized






Justification: Student enrollment projections at St. Johns Lane ES indicate that the growth at this school will continue to escalate. St. Johns Lane ES is projected to be at 117.8% utilization without existing relocatable classrooms. A new relocatable is needed to augment limited program area.

Talbott Springs ES Proj. % Utilized






Justification: Talbott Springs ES will be hosting full day pre-kindergarten services to all children in the Oakland Mills Village area (Talbott Springs ES and Stevens Forest ES) from families with income at 300% of poverty or less. The five classroom modular building recommendation in this report supports this new PreK program. Three older relocatables will be demolished.

Thunder Hill ES Proj. % Utilized






Justification: Thunder Hill ES is projected to be 114.9% utilization next school year without the existing relocatable classrooms. Thunder Hill ES hosts a Regional ASL program. The present units help, but redistricting in this area was recently completed and is not likely to be reviewed until ES #42 is opened. Even if redistricting is considered, it will more likely will be confined to the Rt. 1 area. Temporary space allows the administrator greater flexibility to manage population swings in the interim.

Long Reach HS Proj. % Utilized



w/CurrentRelocatables


Proj. % Utilized w/ProposedRelocatables

107.2% 3 102.0% 4 100.4%

Justification: Long Reach HS population is growing and presently has large classes for ESOL which exceed the rooms which have typically been allocated.

Elementary




Program Notes

Atholton ES 3 3 99.1% 84.2% Pre-K, Preschool, MINCBellows Spring ES 5 5 93.3% 80.0% Pre-K, Preschool, MINC, EB, ES PLBollman Bridge ES 2 2 100.5% 93.4% Title I, Pre-K, Preschool, MINCBryant Woods ES 4 4 107.5% 84.2% Title I, ESM Full-day Pre-KBushy Park ES 0 0 75.0% 75.0% Pre-K, Preschool, MINCCentennial Lane ES 5 5 116.2% 97.4%Clarksville ES 1 1 72.4% 69.5%Clemens Crossing ES 3 3 99.8% 87.2%Cradlerock ES 3 3 110.6% 93.0% Title I, Pre-K, PreschoolDayton Oaks ES 0 0 77.0% 77.0% Pre-K, Preschool, MINC, EBDeep Run ES 6 6 102.5% 85.8% Title I, Pre-K, Preschool, MINCDucketts Lane ES 0 0 106.5% 106.5%Elkridge ES 4 4 106.3% 94.0% Pre-KForest Ridge ES 5 5 113.6% 95.7%Fulton ES 0 0 104.9% 104.9% Regional EDGorman Crossing ES 2 2 93.0% 86.8% Pre-K, Preschool, MINCGuilford ES 5 5 103.2% 81.4% Title I, Pre-KHammond ES 1 1 99.2% 95.6%Hollifield Station ES 3 3 105.6% 95.3% Pre-K, Preschool, MINCIlchester ES 3 3 99.1% 88.9% Pre-K, Preschool, MINC, ES PLJeffers Hill ES 2 2 109.0% 97.5%Laurel Woods ES 2 2 85.6% 79.4% Title I, ESM Full-day Pre-KLisbon ES 1 1 80.6% 77.0%Longfellow ES 0 0 86.7% 86.7% Title I, Pre-K, Preschool, MINCManor Woods ES 1 1 109.8% 105.9%Northfield ES 1 1 100.4% 97.0%Phelps Luck ES 7 7 92.7% 72.2% Title I, ESM Full-day Pre-KPointers Run ES 9 9 97.0% 74.5% Pre-K, Preschool, MINC, ES PL, ALSRockburn ES 1 1 95.1% 91.6% Pre-K, Preschool, MINCRunning Brook ES 3 3 98.1% 85.6% Title I, ESM Full-day Pre-K*, PreschoolSt Johns Lane ES 6 7 117.8% 91.6%Stevens Forest ES 5 5 107.0% 81.5% Title I, ESM Full-day Pre-K*, PreschoolSwansfield ES 12 12 117.5% 74.5% Title I, Pre-KTalbott Springs ES 8 10 118.8% 71.5% Title I, ESM Full-day Pre-KThunder Hill ES 2 3 114.9% 100.2% ALSTriadelphia Ridge ES 0 0 95.7% 95.7% EBVeterans ES 5 5 111.2% 95.9% EB, Pre-K, Preschool, MINCWaterloo ES 4 4 90.8% 78.9% Pre-K, Regional ED, Preschool, MINC Waverly ES 8 8 109.4% 83.3% Pre-K, ALS, Preschool, MINC, ES PLWest Friendship ES 0 0 73.9% 73.9%Worthington ES 1 1 89.3% 85.7%Total 133 137

ALS Regional Academic Life SkillsPreschool Preschool Program, including Parent Assisted Learning at SchoolsPre-K Income qualifying Pre-K program. Astrisk (*) indicates 300% poverty qualification.ESM Full-day Pre-K Elementary School Model Full-day Pre-K programEB Early Beginnings - SE services for very young childrenTitle 1 State approved based upon incomeRegional ED Regional Emotional Disabilities Program (draws from other schools)MINC Multiple Intensive Needs Classroom (Toddler, Preschool/K, and/or Early Learner)ES PL Elementary School Primary Learner Program

Proposed Changes Relocatable Classrooms




Program Notes

Bonnie Branch MS 2 2 109.8% 102.1%Burleigh Manor MS 1 1 105.3% 102.0%Clarksville MS 5 5 91.0% 76.2%Dunloggin MS 5 5 113.6% 93.0%Elkridge Landing MS 2 2 90.0% 84.6% ALSEllicott Mills MS 3 3 121.3% 109.0% Regional EDFolly Quarter MS 0 0 95.2% 95.2%Glenwood MS 6 6 100.4% 78.7%Hammond MS 3 3 98.8% 87.9%Harpers Choice MS 5 5 113.4% 91.0%Lake Elkhorn MS 1 1 76.4% 73.5%Lime Kiln MS 0 0 103.3% 103.3% ALSMayfield Woods MS 2 2 88.3% 83.1%Mount View MS 2 2 93.9% 88.3%Murray Hill MS 6 6 96.8% 78.9% Regional EDOakland Mills MS 0 0 91.9% 91.9%Patapsco MS 2 2 108.6% 100.7%Patuxent Valley MS 6 6 88.8% 74.2%Thomas Viaduct MS 0 0 91.0% 91.0%Wilde Lake MS 13 13 116.7% 68.8%Total 64 64




Program Notes

Atholton HS 0 0 103.0% 103.0%Centennial HS 4 4 111.1% 103.5%Glenelg HS 0 0 84.6% 84.6%Hammond HS 4 4 105.7% 97.7%Howard HS 15 15 130.6% 103.3%Long Reach HS 3 4 107.2% 100.4%Marriotts Ridge HS 0 0 75.4% 75.4%Mt Hebron HS 4 4 113.9% 106.3% Regional EDNew HS #13 0 0 0.0% 0.0%Oakland Mills HS 0 0 83.0% 83.0% ALSReservoir HS 5 5 96.6% 89.4% Regional EDRiver Hill HS 0 0 81.7% 81.7%Wilde Lake HS 0 0 90.2% 90.2%Total 35 36

Proposed Changes Relocatable ClassroomsMiddle

High

FY 2017 HCPSS Operating Budget by Category

Category FY 2017 Board Requested

County Executive's Proposal

Variance

Administration 13,547,269 12,894,327 (652,942) Mid‐Level Administration 61,962,957 61,056,955 (906,002) Instruction 354,578,248 352,261,890 (2,316,358) Special Education 98,973,242 98,973,242 ‐ Student Services 3,389,823 3,302,029 (87,794) Student Health Services 8,341,981 7,928,482 (413,499) Student Transportation Services 38,959,280 38,959,280 ‐ Operation of Plant 44,883,600 44,124,441 (759,159) Maintenance of Plant 28,123,388 24,601,916 (3,521,472) Fixed Charges 195,881,017 156,484,715 (39,396,302) Community Services 6,933,687 6,933,687 ‐ Capital Outlay 866,892 866,892 ‐ Total 856,441,384 808,387,856 (48,053,528)

Note: The County's Executive's funding assumes the additional $2.3 million from the state which has not been approved by the governor.

1 of 2

Location Project Description Deferred Project Estimates

Admin Bldg.- C.O. Cooling Tower Replacement NEW CONTROL (DDC) 100,000.00$ Admin Bldg.- C.O. Exterior / Interior Painting - partial UL & ML 215,000.00$ Admin Bldg.- C.O. Skylight in main hallway requires replacement 350,000.00$ Admin Bldg.- C.O. AHU's and Boiler 4,500,000.00$ ARL Replacement of heating plant & all rooftop units $ 12,500,000.00 ARL Exterior Wall Panels $ 5,000,000.00 ARL, Cradlerock ES, Jeffers Hill ES, Triadelphia Ridge ES Main distribution panel replacement 1,600,000.00$ Atholton HS, Clarksville ES, Old Cedar Ln, Howard HS-B Hall Replace galvanized piping 1,200,000.00$ Bellows Spring ES Paint - Full School Interior/Exterior 113,000.00$

Bollman Bridge ES, Elkridge Landing MS, Forest Ridge ES, Mayfield Woods ES, Mount View MS Convert emergency generators to natural gas 150,000.00$ Bonnie Branch MS Chiller plant $ 200,000.00 Bonnie Branch MS Replacement of Boiler Plant - Boiler project FY17 Capital $ 513,000.00 Centennial HS Stadium Concession Stand & Restrooms 250,000.00$ Clarksville ES Replacement of Interior Classroom Doors 375,000.00$ Cradlerock ES - Lake Elkhorn MS Exterior Doors $ 140,000.00 Cradlerock ES - Lake Elkhorn MS Science Room Renovation $ 165,000.00 Cradlerock ES - Lake Elkhorn MS Boiler/Pumps etc. $ 550,000.00 Dunloggin MS Site Lighting Replacement 65,000.00$ Dunloggin MS, Jeffers Hill ES, Swansfield ES, Waverly ES Generator replacement 1,012,500.00$ Ellicott Mills MS Exterior & Interior Painting $ 110,000.00 Ellicott Mills MS Carpet & VCT Replacement $ 180,000.00 Faulkner Ridge Center Electrical room renovation 500,000.00$ Faulkner Ridge Center Replace RTU 800,000.00$ Folly Quarter MS Carpet & VCT Replacement 160,000.00$ Fulton ES NEW CONTROL SYSTEM -DDC (replace Pneumatic ) 220,000.00$ Glenelg HS Demo Existing Water Storage Tank 350,000.00$ Glenelg HS Replace rubber flooring in weight room 175,000.00$ Glenelg HS Replacement of Boilers with new energy efficient boilers 800,000.00$

Glenelg HS Replace Remaining Interior & Exterior Doors, Frames & Hardware. 975,000.00$

Harper's Choice MS Roof $ 3,200,000.00 Harriet Tubman Cover Windows $ 1,500.00


Howard County Public School SystemSystemic Renovation Projects

2 of 2

Location Project Description Deferred Project Estimates


Howard County Public School SystemSystemic Renovation Projects

Harriet Tubman Repoint BMU Walls $ 58,000.00 Harriet Tubman Replace Boiler/Steam Lines with Condensing Boilers $ 95,000.00 Harriet Tubman Paving $ 170,000.00 Harriet Tubman Replace out dated MDP/Switch Gear $ 250,000.00 Lime Kiln MS, Cedar Lane Replace EMS System 1,000,000.00$

Howard HSReplace (4) RTU's and Associated Components - JR ROTC & Tech LAB 350,000.00$

Howard HS Sanitary Lines - Bathroom Renovations Phase 2 550,000.00$ Jeffers Hill ES Replace exterior doors & frames 275,000.00$ Lime Kiln MS Efflorescence of Brick Exterior Walls 60,000.00$ Lime Kiln MS Window Issues 140,000.00$ Lime Kiln MS OFFICE ROOFTOP & NEW CONTROL SYSTEM (DDC) 475,000.00$ Long Reach HS Window Leaks Heads & Jambs 47,800.00$ Mayfield Woods MS Replace two AC Units $ 15,000.00 Mayfield Woods MS Replace water heaters $ 65,600.00 Mayfield Woods MS Roof Issues-Standing Seam Metal $ 100,000.00 Mount View MS Replace window frame sealants $ 12,000.00 Northfield ES Site Lighting $ 95,000.00 Oakland Mills HS Replace interior doors $ 850,000.00 Oakland Mills HS AHU's replacement $ 4,500,000.00 OLD Bushy Park Gas Conversion of Boiler burners $ 650,000.00 OLD Cedar Lane Replacement of HVAC Equipment $ 2,750,000.00 Patapsco MS HVAC Control Project $ 350,000.00 Patapsco MS RTU replacement $ 2,650,000.00 Pointers Run ES Replacement of Boilers with new energy efficient boilers $ 675,000.00 Reservoir HS Repair window frame sealant $ 14,000.00 Reservoir HS COOLING TOWER REPLACEMENT NEW CONTROL (DDC) $ 50,000.00 River Hill HS Cooling Tower, Two New Chillers 925,000.00$ River Hill HS Masonry repairs 32,800.00$ Several Schools Covert EMS to Web based system for all schools 300,000.00$ St. John's Lane ES COOLING TOWER REPLACEMENT 75,000.00$ St. John's Lane ES (3) ROOFTOP UNIT REPLACEMENTS 750,000.00$ Triadelphia Ridge ES Window thru wall flashings 50,000.00$ Various High Schools Replace emergency lighting 850,000.00$ Various Schools Exterior and Interior Door replacements 150,000.00$ West Friendship ES Replace total doors 95,000.00$ West Friendship ES Replacement of domestic water/well system $ 1,250,000.00 Wilde Lake HS Masonry repairs $ 20,000.00 Wilde Lake HS Regasket or wet seal convex windows on face of bldg. $ 150,000.00 Worthington ES Replace total doors $ 95,000.00 Total 57,460,200.00$

Fixed ChargesExpenditure Description

FY 2015 Actual Expenditures

FY 2016 ApprovedFY 2017 Board Requested

Employee Assistance Program 57,964$ 66,000$ ‐$ Insurance‐Unemployment 83,877 200,000 100,000 Contingency ‐ 100,000 100,000 Insurance‐Vehicles 210,000 230,000 241,500 Insurance‐Liability 470,000 570,000 598,500 Accrued Leave Pay‐out 1,239,762 725,000 750,000 Life Insurance 1,100,067 1,075,000 1,150,000 Tuition Reimbursement 1,852,154 1,800,000 1,900,000 Insurance‐Workers Compensation 2,915,000 2,272,980 2,300,000 Early Retirement Program ‐ ‐ 7,153,152 Retirement 20,432,354 23,330,820 32,652,030 Social Security 37,470,387 38,935,940 41,519,135 Employee Health Insurance 80,831,427 82,500,000 107,416,700 Total Fixed Charges 146,662,992$ 151,805,740$ 195,881,017$

HCPSS Operating BudgetFixed Charges Category

FY 2017

Explanation of CostFY 2017 Board Requested

FY 2017 Salaries and Wages 532,215,149$ Less: Pre‐tax reductions under Flex Spending (19,933,988) Add: Benefit credits 3,797,490 Add: Excess life insurance 422,701 Total Taxed Salaries and Wages 516,501,352$

FICA cost (7.65% of total Salaries and Wages) 39,512,353$ Less: OASDI adjustment (224,253) Total FICA on positions in the Superintendent's Budget 39,288,100 FICA on Superintendent Proposed placeholder for negotiations 1,101,900 FICA on Superintendent Proposed new positions 115,000 FICA on Board Requested placeholder for negotiations 821,707 FICA for Board Requested new positions 192,428 Total Social Security Cost 41,519,135$

HCPSS Operating BudgetSocial Security Costs

FY 2017

Explanation of CostFY 2017 Board Requested

Teachers' Retirement & Pension systems, estimate 2016(source: State Retirement Agency, Department of Legislative Services) 21,295,257$ Employees' Retirement & Pension systems 4,644,954 Additional pension cost for FY 2016 pay increases, not included in FY 2016 budget 1,742,296 Teachers' Retirement & Pension Administrative fees 1,099,664 Employees' Retirement and Pension Administrative fees 154,392

28,936,563$ Additional pension cost for Superintendent Proposed placeholder 1,482,602 Additional pension cost for Board Requested positions 389,132 Additional pension cost for Board Requested placeholder 1,843,733

Total Pension Cost 32,652,030$

HCPSS Operating BudgetPension Costs

FY 2017

HCPSSHealth & Dental Budget

4/28/2016

Approved BoardActual Budget Estimated Requested

FY 2015* FY 2016 FY 2016 FY 2017Sources of FundsUse of Fund Balance ‐$ 5,347,445$ 17,575,540$ ‐$

Employee withholdings 16,627,796 17,868,440 16,041,667 18,404,493 Retiree payments 5,008,063 5,700,000 6,000,218 5,700,000 COBRA, leave, refunds, etc. 429,154 300,000 343,877 360,500 Payment from Food Services 2,068,497 2,020,000 2,070,000 2,080,600 Payment from Transportation 693,216 691,000 232,592 711,730 Payment from General Fund–Budgeted 78,000,000 82,500,000 82,500,000 107,416,700 Add'l General Fund Contributions 1,331,427 ‐ ‐ ‐ Year End Transfer 1,500,000 1,500,000 ‐ 1,500,000 Rebates 4,825,824 3,800,000 6,641,621 3,914,000 Miscellaneous Revenue 267,564 100,000 135,781 110,700 Payment from Grants 1,505,353 1,700,000 865,620 1,751,000 Subtotal User Charges 112,256,894 116,179,440 114,831,376 141,949,723

Total Sources of Funds 112,256,894$ 121,526,885$ 132,406,916$ 141,949,723$

Uses of FundsNon‐Election Benefits 3,826,893$ 3,920,000$ 3,598,726$ 3,800,000$ Administrative Fees 5,665,421 7,356,550 6,617,605 7,021,918 Incr/Decr to fund reserve 1,061,315 ‐ 921,415 ‐ Payment of claims 108,182,030 106,281,060 117,239,357 121,982,511 PPACA Fees 1,133,264 647,830 624,496 226,058 Wellness Program 1,948,586 1,991,110 2,052,101 2,006,000 Other Expenses 1,865,667 1,330,335 1,353,216 1,334,506 Recovery of Fund Balance ‐ ‐ ‐ 5,578,730

Total Uses of Funds 123,683,176$ 121,526,885$ 132,406,916$ 141,949,723$

Annual SummaryBeginning Fund Balance $ 13,031,657 $ 232,862 1,605,375$ (15,970,165)$

Excess (Deficit) Revenue Over Expenditures (11,426,282) (5,347,445) (17,575,540) 5,578,730

Ending Fund Balance 1,605,375$ (5,114,583)$ (15,970,165)$ (10,391,435)$

Ending Fund Balance SummaryUnrestricted 1,605,375 (5,114,583) (15,970,165) (10,391,435)

Total Ending Fund Balance 1,605,375$ (5,114,583)$ (15,970,165)$ (10,391,435)$ **FY 2016 Approved Budget beginning fund balance based upon Spring 2016 projections. FY 2016 Estimated

beginning fund balance based upon FY 2015 Actual ending fund balance.

Budgetary Basis

* Actual revenues do not include revenue from fund balance which is included in the budgetary basis of accounting.

Fund Balance**

Project

State Contribution

Local Bonds/Ttax

Total FY17 Request

State Contribution

Local Bonds/Ttax

Total FY17 Request

Difference from Total

FY17 Request Impact of FY17 Executive Proposed CutsWilde Lake MS Replacement School 2,056$ 14,229$ 16,285$ 2,056$ 12,229$ 14,285$ (2,000)$ Through realigned cash flow to FY18, this cut can be managedPatuxent Valley MS Renovation - 10,890 10,890 - 9,890 9,890 (1,000) Through realigned cash flow to FY18, this cut can be managedSwansfield ES Renovation/Addition 7,539 5,183 12,722 7,539 3,183 10,722 (2,000) Through realigned cash flow to FY18, this cut can be managedWaverly ES Renovation/Phase II Addition 2,000 7,589 9,589 6,000 1,589 7,589 (2,000) Through realigned cash flow to FY19, this cut can be managedNew ES #42 8,855 7,671 16,526 8,855 5,671 14,526 (2,000) Through realigned cash flow to FY19, this cut can be managedOakland Mills MS Renovation - 9,131 9,131 - - - (9,131) Forces delay of project one yearNew HS #13 - 3,300 3,300 - - - (3,300) Forces delay of project one year

- - Systemic Renovations/Modernizations 1,600 17,668 19,268 1,600 4,138 5,738 (13,530) Forces delay of five projects* Roofing Projects - - - - - - -

- - Playground Equipment - 300 300 - 300 300 -

- - Relocatable Classrooms - 1,500 1,500 - 1,500 1,500 - Site Acquisition & Construction Reserve - - - - - - - Technology - 5,000 5,000 - 5,000 5,000 - School Parking Lot Expansions - - - - - - - Planning and Design - 300 300 - 300 300 - Barrier Free - 200 200 - 200 200 -

TOTALS 22,050$ 82,961$ 105,011$ 26,050$ 44,000$ 70,050$ (34,961)$

* Talbott Springs ES Renovation, Oakland Mills Village Area Pre-K Expansion, Glenwood MS Boiler/Water Heater, Energy Projects and reduces funding for Systemic Maintenance and Emergency Repairs by $5.5M.

BOE Requested 2/23/2016 FY17 Executive Proposed

FY17 Capital BudgetComparison of BOE Requested as of 2/23/16 and Executive Proposed

(In Thousands)

Project

State Contribution Local Bonds/Ttax Total FY17

RequestState

Contribution Local Bonds/Ttax Total FY17 Request

Required from Howard County Government to Fund BOE

RequestWilde Lake MS Replacement School 2,056$ 12,229$ 14,285$ 2,056$ 14,229$ 16,285$ 2,000$ Patuxent Valley MS Renovation - 9,890 9,890 - 10,890 10,890 1,000 Swansfield ES Renovation/Addition 7,539 3,183 10,722 7,539 5,183 12,722 2,000 Waverly ES Renovation/Phase II Addition 9,589 1,589 11,178 9,589 - 9,589 (1,589) New ES #42 12,000 5,671 17,671 12,000 4,526 16,526 (1,145) Oakland Mills MS Renovation - - - - 9,131 9,131 9,131 New HS #13 - - - - 3,300 3,300 3,300

- - - Systemic Renovations/Modernizations 2,072 4,138 6,210 2,072 17,196 19,268 13,058 Roofing Projects - - - - - - -

- - - Playground Equipment - 300 300 - 300 300 -

- - - Relocatable Classrooms - 1,500 1,500 - 1,500 1,500 - Site Acquisition & Construction Reserve - - - - - - - Technology - 5,000 5,000 - 5,000 5,000 - School Parking Lot Expansions - - - - - - - Planning and Design - 300 300 - 300 300 - Barrier Free - 200 200 - 200 200 -

TOTALS 33,256$ 44,000$ 77,256$ 33,256$ 71,755$ 105,011$ 27,755$

FY17 Executive Proposed w/Updated State Funding BOE Requested Scenario 4/28/2016

FY17 Capital BudgetComparison of Executive Proposed and BOE Requested Scenario as of 4/28/16

(In Thousands)

Project

State Contribution Local Bonds/Ttax Total FY17

RequestState

Contribution Local Bonds/Ttax Total FY17 Request Realignment of Howard

County Government BondsWilde Lake MS Replacement School 2,056$ 12,229$ 14,285$ 2,056$ 12,229$ 14,285$ -$ Patuxent Valley MS Renovation - 9,890 9,890 - 9,890 9,890 - Swansfield ES Renovation/Addition 7,539 3,183 10,722 7,539 3,183 10,722 - Waverly ES Renovation/Phase II Addition 9,589 1,589 11,178 9,589 - 9,589 (1,589) New ES #42 12,000 5,671 17,671 12,000 2,526 14,526 (3,145) Oakland Mills MS Renovation - - - - - - - New HS #13 - - - - - - -

- - - Systemic Renovations/Modernizations 2,072 4,138 6,210 2,072 8,872 10,944 4,734 Roofing Projects - - - - - - -

- - - Playground Equipment - 300 300 - 300 300 -

- - - Relocatable Classrooms - 1,500 1,500 - 1,500 1,500 - Site Acquisition & Construction Reserve - - - - - - - Technology - 5,000 5,000 - 5,000 5,000 - School Parking Lot Expansions - - - - - - - Planning and Design - 300 300 - 300 300 - Barrier Free - 200 200 - 200 200 -

TOTALS 33,256$ 44,000$ 77,256$ 33,256$ 44,000$ 77,256$ -$

FY17 Executive Proposed w/Updated State Funding BOE Requested Scenario 4/28/2016

FY17 Capital BudgetProject Change Scenarios

(In Thousands)


FY 2017 Operating Budget

Teacher for Tomorrow Program

What is the cost for each cohort in this program? Provide a breakout of all of the costs (e.g., tuition, materials, travel, etc...).

Estimated costs are approximately $144,000 per cohort.

What are all of the sources of funds for the program?

The Teachers for Tomorrow program is funded through grants and contributions.

R


Assuming no additional funding, what moves will the Board request, if any, within the operating budget?

The Board held a public hearing on Thursday, May 12th and is scheduled for a work session with the County Council on Wednesday, May 18th followed by a Board of Education work session Thursday, May 19th. The Board has also gathered public input through an interactive survey tool which is available through May 17th. The Board will have a better idea of decisions as input is received through this process.

Assuming additional funding is found by cuts made to the County’s budget request, what is the order of prioritization of restoration of funding?

It is likely any restored funds will be most needed in the Fixed Charges Category as it was cut by $39.5 million.

Subsequent to budget adoption and depending upon the amount of funds restored by the County Council, the Board may need to return to the county to request categorical transfers.


Gas Tax What would be the FY17 impact of the gas tax legislation on HCPSS? HCPSS does not own a fleet of buses, it contracts bus services through competitive bids. This federal fuel refund goes to the owners of the buses which in the case of HCPSS are the bus contractors. When we issue our next bids, we should see bus contractors bid more competitively because they have federal fuel refunds offsetting some of their costs. We typically bid our routes in October/November and again in February/March for the following school year. As a result, we would not see an immediate impact for next school year since the contracts have already been awarded. Our Transportation Office will continue to monitor this.


Ellicott Mills MS

Can you please provide an explanation for moving the start of the Ellicott Mills Middle School project from FY 17 to FY22 considering the anticipated overcrowding?

The CIP in the capital budget request had been self-constrained to present realistic future year funding requests. We are capturing two classrooms (50 seats) from an internal space which will help offset the increased student population.

W

HCPSS

Health Fund

Fund Balance Analysis

FY 2011 - FY 2015

Fiscal

Year

Approved

Budgeted

Ending Fund

Balance

Actual Ending

Fund BalanceDifference

(Increase)/

Decrease in

Difference of

FB

Explanation For Difference Between Budget and Actual

FY 2011 -$ 21,642,934$ (21,642,934)$ (5,551,530)$

The FY 2011 beginning fund balance was projected to be

$5986,070 while the actual beginning fund balance was

$11,537,600. This difference was due to savings HCPSS achieved

through an employee eligibility audit and the year end transfer of

funds.

(8,645,831)

HCPSS utilized an ARRA Education Jobs Fund Grant to fund $8.6

million in teacher claims reducing claims charged to the Health

Fund by $8.6 million. Notification of grant came after year began.

(4,663,336)

HCPSS claims were lower than projected, in part due to the

change in employee contribution rate from 13% to 15% resulting

in $2.4 million in savings.

(1,210,954)

HCPSS made an additional $1.2 million in General Fund

contribution to the Health Fund at year end as prefunding.

(1,571,283)

HCPSS received $1.6 million more in Medicare Part D rebates than

expected.

(21,642,934)$

FY 2012

166,640$ 16,342,111$ (16,175,471)$ (11,959,604)$ The FY 2012 beginning fund balance was projected to be

$9,683,330 while the actual beginning fund balance was

$21,642,934. This difference iwas due to the ARRA funds, the year

end transfer, and the additional rebate revenues.

(642,005)$ HCPSS achieved approximately $4.5 million in savings through

competitively bidding the health plans which resulted in

consolidating the health plans, reducing administrative fees, hiring

a Prescription Benefit Manager (PBM) and implementing their

savings programs. This savings was offset by higher claims of

approximately $3.9 million more than projected.

HCPSS

Health Fund


FY 2011 - FY 2015

Fiscal

Year

Approved

Budgeted

Ending Fund

Balance

Actual Ending


(Increase)/

Decrease in

Difference of

FB


(3,836,511) HCPSS made an additional $3.8M in General Fund contribution at

year end.

262,649 HCPSS received actual revenues from retiree payments, COBRA,

Food Services Fund etc. that were lower than budgeted by $262K

(16,175,471)$

FY 20133,864,674$ 12,527,992$ (8,663,318)$ 838,713$ The budgeted beginning fund balance was $17,180,284 while the

actual beginning fund balance was $16,342,111.

(2,802,148) HCPSS made an additional $2.8 million in General Fund

contributions to the Health Fund at year end.

(4,008,124) HCPSS converted CareFirst from a funding reserve approach to an

auto debit funding approach which resulted in one time savings of

$6.7 million which was offset by hiring claims of $2.7 million.

(2,578,289) HCPSS recevied an increase in rebate revenue of $2.6M.

(113,470) HCPSS had a net increase of revenue from transportation, grants,

etc.

(8,663,318)$

FY 2014

(9,635,526)$ 13,031,657$ (22,667,183)$ (6,651,758)$ The budgeted beginning fund balance was $5,876,234 while the

actual beginning fund balance was 12,527,992. The difference is

primarily due to the CareFirst one time savings.

(5,297,316) HCPSS prefunded the Health Fund with additional funds to offset

future costs through a TAO at the beginning of the fiscal year.

(3,000,000) HCPSS made an additional $3.0M in General Fund contributions to

the health fund at year end.

(2,985,476) HCPSS received approximately $3 million more in rebate revenue

than expected.

HCPSS

Health Fund


FY 2011 - FY 2015

Fiscal

Year

Approved

Budgeted

Ending Fund

Balance

Actual Ending


(Increase)/

Decrease in

Difference of

FB


(247,531) HCPSS recevied a net increase of revenue from retiree payments,

COBRA, grants, etc.

(4,485,102) HCPSS had lower claims than budgeted by $4.5M which was due

to very good claims experience and the positive impact of the

employee wellness program.

(22,667,183)$

FY 2015

(1,169,728)$ 1,605,375$ (2,775,103)$ (1,792,605)$ The budgeted beginning fund balance was $11,239,052 while the

actual beginning fund balance was 13,031,657. The difference is

attributable to the increased rebate revenue received in FY 2014.

(1,831,427)

HCPSS made an additional General Fund contribution at year end

to prefund health care contributions.

(2,525,824) HCPSS received an Increase in rebate revenue beyond the budget.

(95,906)

HCPSS had a net increase of revenue from employee

withholdings, retiree payments, COBRA, etc.

3,470,659

HCPSS had an increase in claims experience of approximately $3.5

million more than projected.

(2,775,103)$

Board of Education

FY 2016 Budget

Health Benefits Restricted

Fund(Health Fund)

Operated solely to administer and support

employee health coverage, prescription

coverage, and employee voluntary benefits

such as dental, vision and disability.

Funds are used exclusively for these

purposes.

2

Reasons for Rising Costs in the

Health Fund

Costs in the Health Fund are rising primarily for the following reasons:

• Medical and Prescription Inflation – trending upward

• New enrollees – new hires and previous hires electing our benefit coverage for the first time

• Increase in retirees covered

• Impact of Patient Protection and Affordable Care Act

• Participants electing additional voluntary benefits

3

Health Fund Plan Participation - 2016

4

Enrollees Participants

Number

of

Enrollees

% Increase

over past 6

years

Number of

Participants

% Increase

over past 6

years

Employees 6,921 3.3% 17,206 9.5%

Retirees 2,342 39.8% 2,547 42.8%

Total 9,263 9.1% 19,753 12.0%

Health Fund Cost Containment

Strategies Implemented

HCPSS has successfully implemented numerous health

cost reducing strategies. From 2007–2011, some of the

significant changes included:

• Self-insured the health plans, saved $2.8 million

• Elected to grandfather health plans under Patient

Protection and Affordable Care Act (PPACA), saved

$2 million

• Auditing dependent eligibility, saved $1.4 million

• Changing employee contribution rate, saving $2.4

million

5

Health Fund Cost Containment

Strategies Implemented

In 2012–2016, HCPSS has continued to garner savings through a variety of approaches.

• Achieved savings through vendor consolidation and hiring a PBM - ~$4.5 M

• Implemented an award-winning employee wellness program, Commit To Be Fit, that has achieved a positive ROI each year

• Implemented and expanded mail order Rx program• Put various fraud/abuse programs into place in

both medical and prescription plans• Expanded disease management/case management

programs to achieve better outcomes at lower cost6

HCPSS Analysis of Actual Health

Claim Trends by Fiscal Year

7

Year Average

Participants

Per Month

Per

Member

Per Month % Change

Industry

Average*

FY 2011 17,245 352.58 3.3% 9.0%

FY 2012 17,662 388.54 10.2% 8.5%

FY 2013 18,335 391.41 0.7% 7.5%

FY 2014 18,939 409.76 4.7% 6.5%

FY 2015 19,437 418.25 2.1% 6.8%

*Calendar Year data from PwC Health Research Institute

CY 2015 Claims per Member

per Month (PMPM) Comparison

8

*Harford County Schools maintain lower costs by shifting more cost to the participants in

their PPO plan. This is achieved by requiring an in-network deductible and only covering

90% of in-network claims after co-pay. Harford PPO plan has 20% of their enrollees. HCPSS

PPO has no in-network deductible and pays 100% after co-pays in-network.

400

420

440

460

480

500

520

540

HCPSS HowardCounty

Government

BaltimoreCountySchools

HarfordCounty

Schools*

Carroll CountySchools

434.02

452.84

521.82

438.08

469.79

Health Fund – General Fund & Fund Balance Revenues

9*FY 2016 projected as of the FY 2017 Board of Education’s Requested Operating Budget.

-

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

2009 2010 2011 2012 2013 2014 2015 2016*

59.3 60.7 68.7 67.5 67.3

75.9 78.0 82.5

0.8 1.3

1.2 3.1 2.8

8.2 2.8

3.1

6.5 5.3 3.8

11.4 13.6

Ge

ne

ral F

un

d a

nd

Fu

nd

Ba

lan

ce R

eve

nu

es

(Mill

ion

s)

General Fund (Budgeted) Year End Funds Fund Balance

Health Fund Ending Fund BalancesActual/Projected

10

11,538

21,643

16,342

12,528 13,032

1,605

(12,030) (15,000)

(10,000)

(5,000)

-

5,000

10,000

15,000

20,000

25,000

2010 2011 2012 2013 2014 2015 2016*

En

din

g F

un

d B

ala

nce

(M

illio

ns)

*FY 2016 projected as of the FY 2017 Board of Education’s Requested Operating Budget.

Health FundFund Balance Fluctuations

FY 2009 – $18M • Prior year, we self insured and had great claims

experience.

FY 2010 – $11.5M• Kept GF contribution similar, used $6.5M of

excess Health fund balance for 2010 claims costs.

FY 2011 – $21.6M• Charged $8.6M of teacher claims costs to

ARRA Education Jobs Fund Grant. Notification of grant came after year began.

11


FY 2012 - $16.3M • Used $5.3M of excess Health fund balance for claims,

kept GF contribution similar to PY. Had lower claims costs with new plans in place and very good claims experience.

FY 2013 - $12.5M• Used $3.8M of excess Health fund balance for current

year claims, reduced GF contribution in 2013 which made GF contribution lower than 2012. Left funding in GF to fund negotiated salary increases.

FY 2014- $13.0M• Contributed add’l funds to the health fund, had lower

claims costs than expected, and an increase in rebate revenue from the prescription program, no reduction in fund balance.

12


FY 2015 - $1.6M • Used $11.4M fund balance to cover increased

claims costs.

FY 2016 – ($12.0M)• The deficit is caused by an increase in claims

costs that exceeds the actuarial projections.

13

Health Fund Fund Balance Fluctuations

The Fund Balance of the Health Fund has

fluctuated year to year for the following

reasons: • Cost containment strategies• One time opportunities – in FY 2011, ARRA

Educations Jobs Fund Grant that was applied to teacher health claims

• Contribution of year end funds to the Health Fund

14

Health FundNeed For Prudent Fund Balance

Government Finance Officers Assn. (GFOA)

recommends a prudent fund balance to

mitigate current and future risk. • HCPSS is self-insured and as such is obligated

to pay every allowable claim incurred.• Claims experience is subject to fluctuations so

the budget is only an estimate. • Auditors do not look favorably on deficit fund

balances. Recommended fund balance level is between 5%-10% of annual claims costs - $6M-$12M.

15

Interagency Committee on School ConstructionFY 2017 Public School Construction Capital Improvement ProgramSummary of Requests, Board of Public Works Approvals and IAC 100% Recommendations for Planning and Funding as of April 21, 2016($000) omitted

Howard County

The funding recommendations shown for individual major projects may be adjusted due to a number of factors, including the final determination of the area that is eligible for State participation, subtraction of State funding for projects previously approved in an existing facility, and the actual contract cost in some cases. These adjustments will be shown in the worksheets that will accompany the Final FY 2017 Capital Improvement Program as submitted to the Board of Public Works in May 2016.

Also note, while approval of planning is a commitment on the part of the State to fund a project, this commitment is made pending continuing eligibility of the project and the availability of funds. Approval of planning cannot guarantee that future State construction funding will be available at the time that it is requested. Since the current fiscal situation indicates that future year State capital funding will be highly constrained, it is advisable to proceed with a full understanding that local funding may be necessary in order for a project to proceed on schedule.

Notes:(1) Projects recommended by the IAC but not yet approved for funding by the BPW are shown with a status of "A" and an amount of funding within the "90% IAC Recommendations 3-1-16"

and "100% IAC Recommendations 4-21-16" columns.(2) Projects are shown in priority order.

Prior FY 2017 CIP Approvals &

Recommendations100% IAC Recommendations

4-21-16Total EGRC Allocations

Priority - Project Name Project Type

Total FY 2017

CIP

FY 2017 CIP

4-21-16

CombinedTotal

Allocation

FY 2017 EGRC

CIP

FY 2016 EGRC

CIPStatewide

Contg.

LEA Reserved & LEA ACI

Contg.

90% IAC Recomm.

3-1-16FY 2017

CIP

BPW Approval1-27-16FY 2017

CIP

FY 2017 RequestsPlanning/Funding

PriorStateFunds

NetState FundsStatus

1 - Wilde Lake Middle Replacement A $15,359 $13,303 $2,056 $2,056 $2,056 b$2,0562 - Swansfield Elementary Renovation/Addition A $7,696 LP LPLP3 - Swansfield Elementary Renovation/Addition A $7,696 $7,539 $7,539 $7,539 p1$7,5394 - Waverly Elementary Renovation/Addition A $11,650 $9,589 $2,000 $4,000 $1,988 $312 $1,289 $9,589 p1$8,3005 - Northeastern Elementary

School #42New A $18,290 $12,000 $6,805 $334 $2,050 $2,811 $12,000 p1$7,139

6 - Bonnie Branch Middle SR:HVAC/Ceilings/Lighting A $1,100 $1,100 $800 $300 $1,100 e$1,1007 - Manor Woods Elementary SR:HVAC/Ceilings/Lighting A $972 $972 $800 $172 $972 e$972

$13,303 $33,256 $20,000 $4,000 $2,794 $312 $27,106 $2,050 $4,100 $33,256Totals

Abbreviations:K - KindergartenSR - Systemic Renovations

Funding Code:b Balance of multi-year fundsp Partial fundse Entire funding for project

Approval Status:A - IAC Recommendation for approval of planning or funding pending approval of the BPW.B - deferred, but eligible for local planning or construction funding.C - Deferred, and not currently eligible for planning or funding approval.D - Denied, and not eligible for planning or funding approval.

FY 2017 CIP Summary of Requests, Board of Public Works Approvals and IAC 100% Recommendations for Planning and Funding as of April 21, 2016($000) omitted

Major ProjectsKindergartenSystemic RenovationRelocatables

Totals

$31,184

$2,072

$33,256

$18,400

$1,600

$4,000

$4,000$20,000

$2,322

$472

$2,794

$312

$312

$31,184

$2,072

$33,256

$2,050

$2,050

$4,100

$4,100

$25,034

$2,072

$27,106

Howard County Summary by Project Type Total EGRCAllocations

FY 2017 CIP

Total Allocation

FY 2017 EGRC

CIP

FY 2016 EGRC

CIP

LEA Reserved & LEA ACI

Contg.

Combined Total

FY 2017 CIP

Statewide Contg.

FY 2017 CIP

4-21-16

90% IAC Recomm

3-1-16FY 2017

CIP

BPW Approval1-27-16FY 2017

CIP

FY 2017 RequestsPlanning/Funding

10

1

# ofPlanningRequests

10

1

# ofFunding

Requests

4020

6

4020

6

# ofPlanning

Approvals

# of Funding

ApprovalsProject Types:

100% IAC Recommendations4-21-16

Abbreviations:K - KindergartenSR - Systemic Renovations

Funding Code:b Balance of multi-year fundsp Partial fundse Entire funding for project

Approval Status:A - IAC Recommendation for approval of planning or funding pending approval of the BPW.B - deferred, but eligible for local planning or construction funding.C - Deferred, and not currently eligible for planning or funding approval.D - Denied, and not eligible for planning or funding approval.

The Howard County Public School SystemCapital Projects Financial Report

Period Ending April 30, 2016

Total Actual Total Accounting Construction ProjectedProject Project Cost Project Project Cost Percentage Percentage Project Uncommitted

Project Budget To Date Encumbrances To Date Complete Complete Commitments Funds Status

0973 - Waverly Elementary 7,968,459 3,967,647 2,238,939 6,206,586 77.89% 1,761,873 - Planning Phase0980 - Systemic Renovations 228,703,937 211,923,506 3,783,323 215,706,829 94.32% Various 12,997,108 - Ongoing Maintenance Projects0989 - Barrier Free 5,427,500 4,785,329 12,450 4,797,779 88.40% 48,900 580,821 Rolling ongoing project0990 - Playground Equipment 2,380,000 2,321,570 - 2,321,570 97.54% 58,430 - Rolling ongoing project0993 - Relocatable Classrooms 17,410,000 16,627,592 45,498 16,673,090 95.77% 736,910 - Rolling ongoing project0994 - Roofing Projects 45,840,829 37,782,915 2,415,354 40,198,269 87.69% 5,642,560 - Rolling ongoing project0995 - Contingency/Site Acquisition 20,836,241 17,963,163 - 17,963,163 86.21% 1,425,000 1,448,078 Rolling ongoing project0999 - Facility Modernization 6,400,000 6,400,000 - 6,400,000 100.00% - - Closing at end of FY161007 - FY2007 Running Brook 6,266,205 6,254,051 - 6,254,051 99.81% 100.00% 12,154 - Construction Completed1012 - Parking Lot Expansion 4,200,370 3,580,765 - 3,580,765 85.25% 325,000 294,605 Rolling ongoing project1015 - Atholton High Renovation 60,712,620 58,059,851 2,536,407 60,596,258 99.81% 99.00% 116,362 - Construction Phase1020 - Ducketts Lane ES 34,388,625 33,445,698 393,295 33,838,993 98.40% 100.00% 549,632 - Construction Phase1021 - Technology 34,486,000 32,939,396 565,907 33,505,303 97.16% 980,697 - Ongoing Replacement Plan1022 - Gorman Crossing ES 5,337,232 5,337,232 - 5,337,232 100.00% 100.00% - - Closing at end of FY161023 - New Middle School #20 30,983,746 30,800,528 44,046 30,844,574 99.55% 100.00% 139,172 - Construction Completed1026 - Phelps Luck ES 17,869,719 17,869,719 - 17,869,719 100.00% 100.00% - - Closing at end of FY161027 - Longfellow ES Renovation 17,630,000 16,390,087 989,103 17,379,190 98.58% 99.00% 250,810 - Construction Phase1028 - New ES #42 2,807,000 1,830,211 976,789 2,807,000 100.00% - - Planning Phase1030 - Deep Run ES Reno/Add 24,010,960 16,342,887 5,693,305 22,036,192 91.78% 85.00% 1,974,768 - Construction Phase1031 - Wilde Lake MS Reno/Add 29,092,000 20,918,122 8,173,878 29,092,000 100.00% 56.00% - - Construction Phase1032 - Laurel Woods ES Addition 8,823,000 8,650,665 151,594 8,802,259 99.76% 99.00% 20,741 - Construction Phase1033 - Patuxent Valley MS Renovation 18,145,000 14,077,138 4,067,862 18,145,000 100.00% 65.00% - - Construction Phase1034 - Swansfield ES Reno/Add 11,773,000 1,945,225 9,827,775 11,773,000 100.00% - - Planning Phase1038 - Planning and Design 300,000 51,000 17,000 68,000 22.67% 232,000 - Rolling ongoing project

Total 641,792,443$ 570,264,297$ 41,932,525$ 612,196,822$ 27,272,117$ 2,323,504$

Accounting Percentage CompleteAccounting percentage complete is a mathematic calculation based on total project cost to date divided by the total project budget.Total cost is as of the date of the report. There are timing differences between when physical work is completed and when wereceive, approve, process and record payment of project costs. In addition, all of our projects have retention ranging from5%-10% depending on the stage of completion of the project. Retention is not fully paid out until a contractor meets 100% completionof his contract.

Construction Percentage Complete Construction percentage complete is defined as the physical stage of completion of the project. The determination of construction percentage complete is made independent of what stage of accounting payment the project has reached. Consequently, it is not unusual for a project to have a construction percentage complete of 99% but only have an accounting percentage complete of 89%,particularly if we have not paid out retention on a number of contracts.

Consultative Analytics and Impact Report

Copyright © 2016 Aetna, Inc. DOCUMENT CONTAINS CONFIDENTIAL HEALTH INFORMATION. REDISCLOSURE IS STRICTLY PROHIBITED EXCEPT WITH THE WRITTEN PERMISSION OF AETNA INC.

Presentation Date: April 21, 2016

HOWARD COUNTY PUBLIC SCHOOL SYSTEM

Prior Reporting Period: 01-01-2014 - 12-31-2014

Current Reporting Period: 01-01-2015 - 12-31-2015

Key Measures Summary

Key Program Savings PEPM

Precertification $1.43

Concurrent Review $10.36 Claims and Policies $54.89 Care Considerations $20.17

Current YoY Trend

Medical PEPM $780.93 -0.7%

PEPM without HCC $636.80 2.7%

Medical PMPM $323.67 -1.5%

PMPM without HCC $263.94 1.9%

Total Paid Change PPO Select Medical $35.8M 4.8% $24.2M $11.5M

% Utilizing Members 96.8% -1.1 97.5% 96.0%

Membership

Employee 3,816 5.6% 2,348 1,467

Members 9,206 6.5% 5,594 3,613

% Female 55.6% -0.3 55.7% 55.4%

Cost Sharing Current Change

Aetna BoB

Employer Cost Share 93.5% - 1.1 83.3%

Employee Cost Share 3.8% 0.0 14.5%

COB Cost Share % 2.7% 1.0 2.2%

-1.9%

-2.3%

2.7%

-0.1%

0.0%

Non-Par

High Cost Claimants

All Other Medical

Demographics

Geography

Trend Cost Drivers : YOY change


01-01-2015 - 12-31-2015

2

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/mmsavings_HCPSS_2015M12_report.xls



//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/acttop20_HCPSS_2015M12y_Standard.xls








Member and Employee Characteristics

Member Characteristics

Members Continuously Enrolled (≥12 months) Relationship Distribution & Cost

Employee Gender

Current Change Aetna

BoB

Membership 9,206 6.5% N/A

Average Member Age

34.8 0.0% 36.5

Family Size 2.4 0.8% 1.7

Membership Female

55.6% -0.3 50.9%

% of Total

PMPM Change

Employee 41.4% $414 5.8%

Spouse 21.8% $347 -12.2%

Children 36.8% $207 -4.2%

Prior 90.0%

Current 91.1%

Aetna BoB

76.7%

Current Change

Average Employee Age

46.4 0.7%

Male

20.9% Female

79.1%


01-01-2015 - 12-31-2015

Key Observations: • Population is predominantly female, 55.6%. • A more female population is more likely to drive maternity, mental health, medical

pharmacy and emergency room spend. They are also more engaged and more likely to incur expensive heart disease treatment, autoimmune diseases, migraines.

• Family size is 2.4 and above our BoB. • Employee cost increased 5.8% and is 41.4% of total medical spend.

3


//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/acttop20_HCPSS_2015M12y_Advanced.xls













Cost Category PMPM Current Change Aetna BoB

Inpatient Facility $63 -14.9% $67

Ambulatory Facility $51 -2.3% $29

Emergency Room $13 10.4% $16

PCP $16 0.3% N/A

Radiology $21 2.4% $17

Laboratory $20 5.9% $11

Home Care $6 34.0% $7

Medical Pharmacy $25 14.5% $21

Outpatient Mental Health $9 -1.0% $3

Utilization Current Change Aetna BoB Admits/1000 56.3 -2.3% 40.6

Average Length of Stay 4.4 -8.4% 4.8

30 Day Readmission Rate 4.6% 0.2 N/A

ER Visits/1000 181.3 -0.4% 179.5

Specialist Visits/1000 2,596.6 2.8% 1,365.1

PCP Visits/1000 2,110.2 -0.6% 1,385.0

Lab Services/1000 8,242.8 0.2% 5,695.3

Radiology Services/1000 2,188.8 0.2% N/A

MRI/1000 136.1 16.4% 76.9

CT Scans/1000 121.5 -20.6% 104.8

Radiation Oncology/1000 51.9 5.4% 38.7

Financial and Utilization

Key Observations: • ER visits/1000 increased 12.1% in the Select plan and decreased 7.1% in the PPO. • Inpatient Facility PMPM decreased 14.9% over the prior period and is below the BoB. • The number of PCP visits/1000 have decreased slightly; however remain above the BoB. • Specialist and Lab services increased and are above the BoB.

Total Medical Paid PMPM Current Change Aetna BoB

With High Cost Claimants $324 -1.5% $234

Without High Cost Claimants $264 1.9% $161


01-01-2015 - 12-31-2015

4























Diagnostic Categories

Total Medical Spend by Diagnosis Category

Top 5 Diagnoses by Relationship

Percent of Total Spend 19.3% 9.6% 7.3% 7.2% 6.8% 6.2% 6.0% 4.0% 3.9% 3.7%

Employees Spouses Children

Unspecified Morbidity Unspecified Morbidity Unspecified Morbidity

Osteoarthritis Neurologic Disorders - Other Newborn - Uncomp Birth

Mechanical Joint Disorders Back Pain/Degenerative Dx Substance Related Disorders

Back Pain/Degenerative Dx Mechanical Joint Disorders Alcohol Abuse

Breast Cancer Synovium/Tendon/Bursa Dx Newborn - Complicated Birth


01-01-2015 - 12-31-2015

$0

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

$7,000,000

$8,000,000

Musculoskelet

alDisorde

rs

Digestive

Disorders

Nonspecific

Disorders

MentalHealth

Disorders

Oncologic

Disorders

Obstetric Care

Neurologic

Disorders

CardiacDisorde

rs

Gynecologic

Disorders

SkinDisorde

rs

High Cost Claimants $1.0M $389K $300K $950K $1.2M $11K $633K $237K $37K $30K

Non-High Cost Claimants $5.9M $3.0M $2.3M $1.6M $1.2M $2.2M $1.5M $1.2M $1.4M $1.3M

Top Diagnosis Categories (ICD) by Total Paid, Current

Key observations: • Musculoskeletal Disorders has the highest percent of total paid and is almost always ranked

#1. • Continue to focus wellness programs on increasing physical activity to promote health body

and healthy weight.

5

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/diag_HCPSS_2015M12.xls


































Population Health

Key Observations: • Hypertension, Hyperlipidemia and Low Back Pain prevalence decreased over the prior

period. • Diabetes and Depression saw slight increases. • Continue focusing on wellness activities and incentives that address lifestyle behaviors. • All Preventive Services metrics are above the BoB.


BoB

Hypertension 14.2% 16.3 8.1%

Hyperlipidemia 15.5% 15.6 7.4%

Gastritis 8.5% 13.3 4.0%

Diabetes 4.0% 21.2 2.9%

Depression 9.2% 26.0 3.1%

Low Back Pain 9.4% 18.9 3.2%

% of Eligible

Change Bench mark

Breast Cancer Screen (HEDIS)

75.9% -1.0 >62%

Cervical Cancer Screen (HEDIS)

73.2% 11.2 >71%

Colon Cancer Screen (HEDIS)

52.4% 4.9 >38%

Child Immunizations under age 2 (HEDIS)

77.4% 7.5 53%

Child Preventive Visits under age 2 (Non-HEDIS)

77.9% 4.0 59%

Child Preventive Visits age 2-19 (Non-HEDIS)

66.2% -0.6 21%

Adult Preventative Visits (Non-HEDIS)

27.1% 2.4 8%


BoB

Financial Prediction Score

8.1 -1% 7.6

Member Illness Burden

1.40 ____- 1.21

Employee Illness Burden

1.75 - N/A

Inpatient Severity Index

1.2 -5.5% 1.8

Predictive Modeling & Risk

Key Chronic Conditions Preventive Services


01-01-2015 - 12-31-2015

6














//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/pg_HCPSS_all_2015M12.xls

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/rb_HCPSS_all_2015M12.xls


acttop20_HCPSS_2015M12y_Advanced.xls

Key Statistics Current Change Aetna

BoB

Number of HCC 48 6.7% N/A

HCC per 1,000 Members

5.2 0.2% 4.3

% of Total Paid 18.5% -2.7 28.7%

Avg Paid per HCC $137,485 -14.4% $261,777

HCC Demographics

Average Age 45.4 2.2% 51.3

Female 50.0% 5.6 54.2%

Relationship

Subscriber 47.9% 12.4 60.1%

Spouse/ Partner 27.1% -6.3 26.6%

Children 25.0% -6.1 13.2%

Utilization for HCCs Current Change Aetna

BoB

Admits/HCC 2.1 23.8% 1.6

ALOS 8.7 -36.1% 9.7

ER visits/HCC 1.3 8.2% 1.4

Readmissions 11.8% -2.9 15.2%

Financials Current Change

Medical Paid per Member

$3,884 -1.5%

Medical Paid per Member NET of

HCC $3,167 1.9%

Member Tenure


BoB

Enrolled < 12 months

8.3% 1.7 26.9%

Top Medical Diagnostic Categories

Count % HCC % Paid

Cancer 12 25.0% 26.8%

Musculoskeletal 11 22.9% 23.2%

Behavioral Health 7 14.6% 20.3%

Neurology 4 8.3% 7.2%

Gastroenterology 3 6.3% 4.1%

Major Categories

Count Paid/ HCC

% of Total

Change

Cancer 12 $137,080 4.6% -2.1

Neonate 2 $160,364 0.9% 0.0

Chronic 34 $136,282 13.0% -1.4

Acute 0 $0 0.0% 0.0

High Cost Claimants Key Statistics HOWARD COUNTY PUBLIC

SCHOOL SYSTEM

01-01-2015 - 12-31-2015

Key Observations: • High Cost Claimants (HCC) have total paid claims >$75,000 in the plan year. • The PPO plan has 34 HCC’s and the Select plan has 14. • The number of high cost claimants increased; however, total membership increased as well. • HCC per 1000 remained flat at 5.2 • Medical spend per HCC Inpatient Days decreased 21.3%. 7

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/hcceval_HCPSS_2015M12.xls











































• Attention to maternity services with a focus on delivery outcomes and intervention program activity that impact spend.

Maternity Experience

N/A

Key Observations:

Deliveries Current Change

Total Deliveries (including multiples) 117 -6.4%

Total High Risk and At Risk Deliveries 18 -48.6%

Births Total Newborns* 124 Total NICU admissions 4

Beginning Right Participation Mothers Enrolled 20.5% -2.7

Deliveries – Normal Risk Enrolled Mother

37.5% -7.3

* Newborn count can be understated due to normal newborns claims being rolled up into mother’s claims or newborn being covered under another plan so there are no claims for newborn.


01-01-2015 - 12-31-2015

8

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/acttop20_HCPSS_2015M12_Care_Activity.xls

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/br_summary_HCPSS_2015M12.xls





Case Management Current Change Members Identified (of total eligible members) 0.4% -0.2

Engaged Members of Outreach Completed 45.5% -2.4

Disease Management Members Identified (of total eligible members) 21.3% -0.8

Members Nurse Engaged (of total identified) 2.3% -6.5

Members UTR (of total identified) 0.4% -0.4

Care Considerations Volume Compliance Total Care Considerations

Severity 1 49 63.3% Severity 2 1,704 40.8% Severity 3 638 29.2%

Program Savings PEPM Disease Management $3.31 Care Considerations $20.17

Case/Disease Management Experience HOWARD COUNTY PUBLIC

SCHOOL SYSTEM

01-01-2015 - 12-31-2015

Key Observations:

• Case Management and Disease Management programs continue to be under utilized. • Consider adding Aetna InTouch Care to proactively identify those members at risk or

who have opportunities to improve their health.

9






Network Management

Key Measures


BoB

Admissions in Network

99.5% 1.6 96.7%

Physician Visits in Network

97.6% -0.2 96.4%

Claims Paid in Network

87.9% 1.7 91.3%

Ambulatory Facility Claims

Paid out of Network

$965K -31.5% N/A

Current Change

IOQ Opportunity Savings $280K 39%

Total IOQ Cases 67 40%

Currently Using IOQ 22% -12%

Cost per Lab Procedure In Network

$22.44 -0.9%

Cost per Lab Procedure Out of Network

$71.44 16.2%

Lab Procedure Out of Network

13.8% -4.7

Cancer Out of Network 0.0% 0.0


01-01-2015 - 12-31-2015

Key Observations:

• Out of Network lab procedures, ambulatory facility claims and mental health services have decreased over the prior period.

• Cost of care tools can help members make informed decisions regarding care.

10





//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/IOQOPP_HCPSS_2016M3W4.xls






Key Statistics Current Change

Total BH Paid Amount $1,677,766 -12.3%

BH Paid Amount Per Employee

$440 -16.9%

BH Paid Amount Per Member

$182 -17.6%

% of Members Accessing BH Services

12.1% -0.3

Paid Per Member for Mental Health

$134 -7.2%

Paid Per Member for Substance Abuse

$49 -37.0%

BH Paid Amount for Large Claimants (> $25,000)

$268,666 -55.6%

Number of Catastrophic Claimants*

3 -50.0%

MH Large Claimants 3 -50.0%

SA Large Claimants 2 -66.7%

Claimants per 1,000 0.3 -57.1%

Total BH Inpatient Current Change

Paid per Member $38 -41.6%

Avg paid/Admission $8,400 -37.8%

BH Admissions/1,000 4.6 -6.1%

Days of Care/1,000 31.9 -40.5%

Avg Length of Stay 7.0 -36.6%

% Admissions Out of Network

2.4% -11.9

Total BH Outpatient

Paid PMPM $144 -7.5%

Paid per Claimant $1,188 -5.3%

Visits/1,000 1288.0 -1.3%

*large claimants may have both a mental health and substance abuse component

Behavioral Health

$221

$66

$156 $182

$38

$144

BH Paid AmountPer Member

Inpatient PaidAmount Per

Member

Outpatient PaidAmount Per

Member

Comparison of Behavioral Health Paid Amount Per Member

Prior Current

18.8%

2.3%

0.7%

8.2%

9.9%

30.4%

29.9%

% of Total Paid by Service InpatientTreatmentResidentialTreatmentPartial Hospital

IntensiveOutpatientPsychiatric Visits

Therapist Visits

Key Observations: • Behavioral Health total paid amount decreased over the prior period in all metrics. • This could be a leveling off of the impact Mental Health Parity and ACA (health care

reform’s action to allow up to 26 year olds on their parent’s coverage). • Continue to promote EAP services as the first line of service when appropriate.


01-01-2015 - 12-31-2015

11

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/BHLvlB_HCPSS_2015M12.xls




















Key Utilization Metrics Current Change Aetna BoB

Aggregate Metrics, Excludes maternity except as noted

Days / 1,000 211.9 -9.2% 175.2

Avg. Cost per Day $2,528 -8.6% $3,796

ALOS 4.9 2.0% 5.4

Admissions/1,000 43.1 -1.8% 32.7

Admissions/1,000 w/ Maternity

56.3 -2.3% 40.6

Inpatient Hospital Current Change Aetna BoB

Orthopedic Surgery Cost PMPM $8.44 37.7% $8.64

Cardio Thoracic Surgery Cost PMPM $1.28 -72.7% $5.83

Bariatric Surgery Cost PMPM $0.68 -45.6%

$0.67

ICU Cost PMPM $1.87 -74.0% $4.24

NICU Cost PMPM $0.58 141.7% N/A

Psychiatric and Substance Abuse

Admits/1000 5.4 -8.5% 3.2

Days/1000 41.6 -42.3% 25.4

In-Network Use % Admits In-Network 99.5% 1.6 96.7%

Sample Company

Jan 01, 2015 - Dec 31, 2015 Inpatient Facility Drill Down Key Stats HOWARD COUNTY PUBLIC

SCHOOL SYSTEM

01-01-2015 - 12-31-2015

12













acttop20_HCPSS_2015M12y_Standard.xls

Inpatient Facility Drill Down Conditions

Top 5 Non-Maternity Conditions by Cost Current

Major joint replacement $419,241

Psychoses $370,850

Limb reattach/hip/femur trauma $217,412

Craniotomy/endovascular procedure $180,673

Extreme immaturity or RSD $150,257

Top 5 Non-Maternity Inpatient Conditions by Admits

Psychoses 29

Neonate with other significant problem 25

Major joint replacement 24

Full term neonate w major problem 13

Alcohol/drug w/o rehab 11

Top 5 Non-Maternity Inpatient Conditions by ALOS

Circulatory dis ex AMI w cath 40

Endocrine disorders 36

Coronary bypass w catheter 34

Neurological eye disorders 31

Limb reattach/hip/femur trauma 29


01-01-2015 - 12-31-2015

13











Alternative Care Settings

Retail Clinics Urgent Clinics

Current Aetna

BoB Current

Aetna BoB

Total Visits 962 N/A 3,094 N/A

Visits/1,000 104.5 28.3 336.1 115.8

Utilizing Members

739 N/A 1,889 N/A

Avg Allowed per Visit

$65 $63 $122 $150

Avg Paid per Visit

$52 $40 $100 $97

Employee Cost Sharing

19.5% 38.3% 16.6% 36.6%

Key Utilization Metrics Prior Current Aetna

BoB

Total ER Visits 1,574 1,669 N/A

ER Visits /1,000 182.0 181.3 179.5

Utilizing Members 1,027 1,071 N/A

Avg Visits per Utilizing Member

1.5 1.6 1.5

PCP to ER Visit Ratio 11.6 11.6 8.6

Overview of Cost Prior Current Aetna

BoB

Avg Allowed per Visit $1,180 $1,241 $1,851

Avg Paid per Visit $1,129 $1,190 $1,461

Employee Cost Sharing 3.3% 3.2% 19.5%

Paid Per Member Per Year

$206 $216 $255

Top Diagnosis Groups

Age 0-19 Allowed Visits % of Total

Accidental Injury $749 67 14.3%

Throat Disorders $505 37 7.9%

Gastroenteritis $881 25 5.3%

Abdominal Pain $1,058 24 5.1%

Fractures $1,079 22 4.7%

Age >=20 Allowed Visits % of Total

Angina/Chest Pain $1,537 104 8.7%

Accidental Injury $1,066 88 7.3%

Abdominal Pain $1,588 73 6.1%

Sprains/Strains $824 37 3.1%

Gastroenteritis $1,406 36 3.0%

# %

Non-Urgent ER Visits 517 31.0%

Members with > 4 ER visits 50 4.7%

Top 5 Facilities Utilized

Facility Name City, State % of ER Visits

Howard County General Hospital Columbia, MD 39.7%

St. Agnes Hospital Baltimore, MD 4.4% Carroll Hospital Center Westminster, MD 3.8% Johns Hopkins Hospital Baltimore, MD 2.6%

Greater Baltimore Medical Center Baltimore, MD 2.4%

41.7%

19.7%

38.6%

% of ER Visits

EmployeeSpouseChild

Sample Company

Jan 01, 2015 - Dec 31, 2015

56.9% of ER Visits are for Female Members

Emergency Room Drill Down HOWARD COUNTY PUBLIC SCHOOL SYSTEM

01-01-2015 - 12-31-2015

Key Observations: • 31% of ER visits were classified as non-urgent. • Visits per 1000 is above the benchmark. • 56.9% of ER visits are for females. • Consider communications directly targeting female members.

14

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/er_HCPSS_2015M12.xls






























































Medical Rx Drill Down

Percent of Total Medical Paid: 7.7%

Top 5 Medical Pharmacy Drugs

Medical Rx Utilization Current Aetna BoB Change Prior

Chemotherapy for Cancer Rate/1,000 10.0 5.6 46.4% 6.8

PMPM $4.85 $6.17 0.5% $4.82

Non-Chemotherapy Rate/1,000 318.0 220.8 1.6% 313.1

PMPM $17.38 $11.87 21.8% $14.28

Immunization Rate/1,000 358.2 210.9 -2.3% 366.6

PMPM $2.15 $1.88 6.9% $2.01

Self Injectibles Rate/1,000 2.1 1.1 5.0% 2.0

PMPM $0.42 $0.85 -22.6% $0.55

Medical Rx Site of Service Rate/ 1,000

Change

PMPM

Chemotherapy for Cancer

Office 5.3 21.1% $1.22

Facility 5.5 99.6% $3.63

Non-Chemotherapy Office 277.0 0.2% $11.24

Facility 65.9 9.6% $6.14

Rank Disease Category Unique

Members Claims

Paid Amount

Paid/Claim Percent of Total Paid

1 Auto-Immune 26 161 $813,353 $5,052 53.8%

2 Onc-Chemotherapy 34 151 $401,828 $2,661 26.6%

3 Colony Stimulant 6 35 $62,981 $1,799 4.2%

4 Immunoglobulin 23 42 $58,941 $1,403 3.9%

5 Neurological Neuromuscular 12 23 $39,669 $1,725 2.6%

Top 5 Medical Disease Categories

Rank Family Name

Disease Category

Unique Members Claims

Paid Amount

Paid Per Claim

Percent of Total Paid

1 Remicade Auto-Immune 23 145 $725,860 $5,006 48.0%

2 Avastin Onc-Chemotherapy 9 34 $118,524 $3,486 7.8%

3 Herceptin Onc-Chemotherapy 3 29 $81,407 $2,807 5.4%

4 Simponi Auto-Immune 2 11 $77,578 $7,053 5.1%

5 Xgeva/Prolia Med Onc-Chemotherapy 13 34 $43,405 $1,277 2.9%

Medical Pharmacy Drill Down HOWARD COUNTY PUBLIC SCHOOL SYSTEM

01-01-2015 - 12-31-2015

15

















//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/RxMed_HCPSS_2015M12.xls
















































































Oncology Drill Down

Prior Current

% Members with Cancer

3.3% 3.6%

% Paid for Members with Cancer

13.2% 12.3%

Members with Cancer All Costs

Current Change

Members 361 15.3%

Medical Paid $4,872,734 -4.8%

Pharmacy Paid $1,167,310 52.0%

Total Paid $6,040,044 2.7%

Members with Cancer Cancer Costs

Current Change

Members 361 15.3%

Medical Paid $2,401,485 -1.0%

Pharmacy Paid $221,986 75.0%

Total Paid $2,623,471 2.8%

Top 10 Cancer Sites Avg Age

Members All Medical Costs Paid

Paid per Member

Cancer Only Medical Paid

Cancer Paid/

Member

Members with

Neutropenic Fever

Other Cancer 54 40 $1,302,507 $32,563 $773,171 $19,329

Breast Cancer 58 81 $1,049,261 $12,954 $614,188 $7,583

Skin Cancer 59 115 $684,208 $5,950 $125,824 $1,094

Lung Cancer 60 10 $574,089 $57,409 $402,560 $40,256

Leukemia 55 9 $423,812 $47,090 $161,378 $17,931 1

Colorectal Cancer 56 14 $386,420 $27,601 $259,437 $18,531

Malignant Melanoma 58 45 $364,279 $8,095 $147,981 $3,288

Endometrial Cancer 58 8 $347,338 $43,417 $248,108 $31,013

Oral Cancer 56 5 $346,984 $69,397 $258,154 $51,631

Hodgkin's Disease/Lymphoma 54 15 $330,665 $22,044 $202,783 $13,519

$18,799

$16,731

Prior

Current

Members with Cancer Paid per Member – All Costs


01-01-2015 - 12-31-2015

External RX data used to identify cancer is dependent on timing, quality and completeness of file feeds from vendor to Aetna’s eDW

16

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/cancer_HCPSS_2015M12.xls


















































































Utilization Inpatient

In Network

Out of Network

% In Network

Prior % In Network

# of Admissions 52 0 100.0% 97.5%

Total Days 169 0 100.0% 99.1%

Utilization Ambulatory

In Network

Out of Network

% In Network

Prior % In Network

Facility Visits 534 79 87.1% 84.6%

ER Visits 205 0 100.0% 99.5%

Office Visits 7,045 455 93.9% 94.7%

Surgeries 1,354 51 96.4% 98.8%

Top Actionable Sites of Service

Paid Amount per Member Utilization per 1,000 Unit Cost

Prior Current % Change $ Change % of Total

(current) Prior Current % Change Prior Current % Change

Inpatient Care

Facility Acute $98 $107 8.6% $8 12.5% 13 17 31.0% $7,804 $6,468 -17.1%

Ambulatory Care

Facility (w/o ER) $217 $194 -10.5% -$23 22.8% 63 66 5.9% $3,453 $2,919 -15.4%

Emergency Room $16 $15 -8.6% -$1 1.8% 25 22 -11.3% $653 $673 3.0%

Physical Therapy $165 $170 2.6% $4 19.9% 2,295 2,332 1.6% $72 $73 0.9%

Chiropractic Manipulation

$18 $19 2.7% $1 2.2% 699 677 -3.0% $26 $28 6.0%

Radiology $57 $61 7.8% $4 7.2% 452 482 6.6% $126 $127 1.2%

Total Medical $825 $853 3.4% $28 100.0%

Employee Spouse Child

Claimants 1,767 850 808

Prevalence 46.3% 42.4% 23.9%

Total Medical Paid $4.3M $2.1M $1.4M

Average Paid per Claimant

$2,436 $2,468 $1,793

Sample Company

Jan 01, 2015 - Dec 31, 2015

All other Conditions, $27,906,767

,78%

Musculoskeletal,

$7,851,102. ,22%

Musculoskeletal as 22% of Total Medical Costs

16%

16%

84%

84%

0% 20% 40% 60% 80% 100%

Prior

Current

Paid PM by Place of Service

Ambulatory Paid Inpatient Paid

Musculoskeletal Drill Down Key Statistics HOWARD COUNTY PUBLIC

SCHOOL SYSTEM

01-01-2015 - 12-31-2015 Key financial and utilization on orthopedic conditions can often be impacted by quality providers, network use and lifestyle modification.

Key Statistics

Per Member Costs Prior Current % Change

Allowed Amount $878 $923 5.2%

Paid Amount $825 $853 3.4%

Inpatient Paid $133 $136 2.8%

Ambulatory Paid $692 $716 3.5%

HCC > $75K % of Total Musculoskeletal

3.4% 5.6% 2.1

Avg. Paid per HCC $81,643 $109,444 34.1%

17

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/musc_HCPSS_2015M12.xls























































Musculoskeletal Drill Down Clinical

Paid by Diagnostic Group for HCC % of Total

Fractures $169.7K 38.8%

Rheumatoid Arthritis $98.7K 22.5%

Back Pain/Degenerative Dx $86.3K 19.7%

Osteoarthritis $83.1K 19.0%

Members with Musculoskeletal and Other Comorbid Conditions

Depression 12.4%

Migraines and Other Headaches 8.3%

Obesity 3.4%

Conditions

High Cost Claimants > $75,000

Top 5 Diagnostic Groups by Medical Paid

Claimants Medical Paid Paid per Claimant

Prior Current Change Prior Current Change Prior Current Change

1 Mechanical Joint Disorders

1080 1214 12.4% $1.0M $1.1M 10.5% $963 $947 -1.7%

2

Back Pain/Degenerative Dx

770 839 9.0% $974K $979K 0.6% $1,265 $1,167 -7.7%

3 Osteoarthritis 321 359 11.8% $734K $854K 16.2% $2,288 $2,378 3.9% 4 Fractures 271 277 2.2% $505K $774K 53.3% $1,862 $2,793 50.0% 5 Sprains/Strains 670 718 7.2% $578K $580K 0.3% $863 $808 -6.4%

Co-Morbidities

Orthopedic Institutes of Quality

IOQ Cases

IOQ Cost/Case

Non-IOQ Cases

Non-IOQ Cost/Case

Spine 4 $37,832 20 $30,818

Total Joint Replacement 4 $21,926 18 $32,021


01-01-2015 - 12-31-2015

18















































Benchmarks

Total Medical Paid PMPM Prior Current Aetna BoB Industry

With High Cost Claimants $329 $324 $234 $304

Without High Cost Claimants $259 $264 $161 $215

Cost Category Prior Current Aetna BoB

Inpatient Facility $74 $63 $67 Ambulatory Facility $52 $51 $29 Emergency Room $12 $13 $16 PCP $16 $16 N/A Radiology $20 $21 $17 Laboratory $19 $20 $11 Home Care $5 $6 $7 Medical Pharmacy $22 $25 $21 Outpatient Mental Health $9 $9 $3

Financial and Utilization

Utilization Prior Current Aetna BoB

Admits/1000 58 56 41

Average Length of Stay 4.8 4.9 4.8

30 Day Readmission rate 4.3% 4.6% N/A

ER visits/1000 182.0 181.3 179.5 Specialist visits/1000 2524.9 2596.6 1365.1 PCP visits/1000 2123.2 2110.2 1385.0 Lab Services/1000 8226.0 8242.8 5695.3 Radiology Services/1000 2183.9 2188.8 N/A MRI/1000 116.9 136.1 76.9 CT Scans/1000 153.0 121.5 104.8 Radiation Oncology/1000 49.3 51.9 38.7


01-01-2015 - 12-31-2015

19























Benchmarks

Predictive Modeling & Risk Prior Current Aetna BoB

PULSE 8 8.1 7.6

Member Illness Burden 1.40 1.40 1.21

Inpatient Severity Index 1.3 1.2 1.8

Key Chronic Conditions Prior Current Aetna BoB

Hypertension 12.2% 14.2% 8.1%

Hyperlipidemia 13.4% 15.5% 7.4%

Gastritis 7.5% 8.5% 4.0%

Diabetes 3.3% 4.0% 2.9%

Depression 7.3% 9.2% 3.1%

Low Back Pain 7.9% 9.4% 3.2%

Preventive Services Prior % of Eligibles

Current % of Eligibles Aetna BoB

Breast Cancer Screening (HEDIS) 76.8% 75.9% >62%

Cervical Cancer Screening (HEDIS) 74.6% 73.2% >71%

Colon Cancer Screening (HEDIS) 48.4% 52.4% >38%

Childhood Immunizations 70.1% 77.4% 53.0%

Childhood Preventative Visits under age 2

74.1% 77.9% 58.6%

Childhood Preventative Visits age 2-19

66.6% 66.2% 20.7%

Adult Preventative Visits 24.7% 27.1% 8.1%

Population Health


01-01-2015 - 12-31-2015

20

//midp-sfs-010/csltvanlytcimpctrpts/CAIR_Reports/HOWARD COUNTY PUBLIC SCHOOL SYSTEM/20160322_CAIR_19943/pg_HCPSS_all_2015M12.xls















Benchmarks

High Cost Claimants

Key Statistics Prior Current

Aetna BoB

HCC per 1,000 Members 5.2 5.2 4.3

% of Total Paid 21.2% 18.5% 28.7%

Avg Paid per HCC $160,581 $137,485 $261,777

HCC Demographics

Average Age 44.4 45.4 51.3

Female 44.4% 50.0% 54.2%

Relationship

Subscriber 35.6% 47.9% 60.1%

Spouse/Domestic Partner 33.3% 27.1% 26.6%

Children 31.1% 25.0% 13.2%

Member Tenure Prior Current

Aetna BoB

Enrolled < 12 months 6.7% 8.3% 26.9%


01-01-2015 - 12-31-2015

21










Benchmarks

Behavioral Health

Key Statistics Prior Current Aetna BoB

BH Paid Amount Per Employee $529 $440 N/A

BH Paid Amount Per Member $221 $182 $63

Paid Per Member for Mental Health $144 $134 $45

Paid Per Member for Substance Abuse $77 $49 $18

Claimants per 1,000 0.7 0.3 0.1

Total BH Inpatient Prior Current Aetna

BoB

Paid per Member $66 $38 $23

Avg paid/admission $13,501 $8,400 $8,157

BH Admissions/1,000 4.9 4.6 2.8

Days of Care/1,000 54 32 23

Avg Length of Stay 11.0 7.0 8.2

% Admissions Out of Network 14.3% 2.4% 16.0%

Total BH Outpatient Paid PMPM $156 $144 $40

Paid per Claimant $1,255 $1,188 $906

Visits/1,000 1,304 1,288 382


01-01-2015 - 12-31-2015

*Behavioral Health BOB metrics are based on a 12 month incurred time period with a two month lag.

22















Benchmarks

Emergency Room Drill Down

Overview of Cost Prior Current Aetna BoB

Avg Allowed per Visit $1,180 $1,241 $1,851

Avg Paid per Visit $1,129 $1,190 $1,461


Paid Per Member Per Year $206 $216 $255

Key Utilization Metrics Prior Current Aetna BoB

ER Visits /1,000 182.0 181.3 179.5

Avg Visits per Utilizing Member 1.5 1.6 1.5

PCP to ER Visit Ratio 11.6 11.6 8.6

Alternative Care Settings Retail Clinics

Prior Current Aetna BoB

Visits/1,000 121.8 104.5 28.3

Avg Allowed per Visit $57 $65 $63

Avg Paid per Visit $44 $52 $40


Urgent Clinics

Prior Current Aetna BoB

Visits/1,000 314.0 336.1 115.8

Avg Allowed per Visit $119 $122 $150

Avg Paid per Visit $98 $100 $97



01-01-2015 - 12-31-2015

23

















Benchmarks

Medical RX Drill Down

Medical Rx Utilization Rate/1,000 Prior Current Aetna BoB

Chemotherapy for cancer Rate/1,000 6.8 10.0 5.6

PMPM $4.82 $4.85 $6.17

Non-Chemotherapy Rate/1,000 313.1 318.0 220.8

PMPM $14.28 $17.38 $11.87

Immunization Rate/1,000 366.6 358.2 210.9

PMPM $2.01 $2.15 $1.88

Self Injectibles Rate/1,000 2.0 2.1 1.1

PMPM $0.55 $0.42 $0.85


01-01-2015 - 12-31-2015

24









CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. which are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®′ Registered trademark of CareFirst of Maryland, Inc.

Plan Review Meeting January 6, 2016

Carolyn Drumgoole Account Manager, SalesMary Penczek Director, State & Municipalities, SalesJennifer Kuhl, RN, CCM Director, Client Advisory ServicesKrista Bateman Client Advisor, Client Advisory Services


http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi1qsCC6ZPKAhUKJh4KHTZ1DrQQjRwIBw&url=http://www.virtualschoolalliance.org/howard-county-public-school-system-digital-education-program/&psig=AFQjCNFT2AKBzIy0ik2BJQllXbvg6nu03g&ust=1452122773503868

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi1qsCC6ZPKAhUKJh4KHTZ1DrQQjRwIBw&url=http://www.virtualschoolalliance.org/howard-county-public-school-system-digital-education-program/&psig=AFQjCNFT2AKBzIy0ik2BJQllXbvg6nu03g&ust=1452122773503868

PROPRIETARY AND CONFIDENTIAL

2


Agenda

• Introductions

• CareFirst Care Model

Patient-Centered Medical Home (PCMH)

Total Cost and Care Improvement (TCCI)

• HCPSS Clinical Risk Profile

• SearchLight Reporting

• Recommendations/Next Steps

12.6MCigna

18.2MAetna 36.5M

United Healthcare

99.7M


3


Transformation of CareFirst - Population Health Manager

5 years ago CareFirst took significant steps to become a population health manager by:

• Creating a continuum of wellness and care coordination services which assigns the right intervention, at the right time, in the most cost effective setting

• Establishing a value-based program which positions the Primary Care Provider at the center of the members’ care

• Developing a portfolio of value-based plan designs with an integrated healthy incentive program to promote PCP engagement, eliminate barriers to care & facilitate healthy lifestyles


4


Population Health Manager – Engaged & Empowered Providers

Empower Primary Care Providers to lead patient care and be accountable for the

patient’s entire health care spend

Primary Care Provider, 5.7%

Specialists, 22.7%

Inpatient,19.7%

Outpatient, 19.5%

Pharmacy, 28.8%

Other, 3.6%

Presenter

Presentation Notes

When a doctor advises a patient to quit smoking, for example, the chance of that person doing so increases by 30 percent. Shared decision making is a key part of the patient-centered medical home (PCMH), which has been embraced by more and more physician practices and healthcare organizations in recent years. In the PCMH, every patient has a personal physician who takes responsibility for their care and coordinates referrals across care settings. In addition, the patient is considered part of the care team, and the patient and his or her family can participate in quality improvement at the practice level. CALL OUT RX!!!!!


5


Engage Identify Improve

Creating A Continuum of Care

Presenter

Presentation Notes

Success is achieved by uniquely combining three things: 1) Engage; 2) Identify and 3) Improve Elaborate on the bands and then the hand off to appropriate resource (15 programs) We’ve innovated population health by bringing back in all the parts that are historically separate (Wellness, DM, Pharmacy and Behavioral Health) Call-out: pyramid


6


• Hospital Transition of Care Program (HTC)• Complex Case Management Program (CCM)• Chronic Care Coordination Program (CCC)• Behavioral Health and Substance Abuse Program (SBH)

• Home-Based Service Program (HBS)• Enhanced Monitoring Program (EMP)• Community-Based Programs (CBP)• Telemedicine Services (TMS)

• Comprehensive Medication Review Program (CMR)• Pharmacy Coordination Program (RxP)

• Exclusive Specialty Networks Available• Formulary Options Available

• Preauthorization of High Cost, High Impact Services (PRE)• Expert Consult Program (ECP)• Centers of Distinction Program (CDP)• Urgent Care and Convenience Access (UCA)

Wellness & Disease Management

Care Coordination

Additional Provider Support

Enhanced Pharmacy Management

Self-Management Promotion

• Health Promotion, Wellness and Disease Management Services (WDM)• Well Being 5 Assessment • Biometrics• Lifestyle and DM Coaching

Total Care and Cost Improvement Programs (TCCI)


7


Member Health Record – Empowering Providers with Actionable Data

Provider Information

LCC/Case Manager and Care Plan Information

Top 3 Health Conditions

Vendor Integration

Illness Burden Score

Health Scores

Including the Drug Volatility

Score


8


Accidents, cancer, heart attacks, trauma, high-risk pregnancies, hospice, as well as those with chronic disease

Including heart disease, diabetes, obesity and asthma--conditions which largely arise due to lifestyle choices.

Those at risk for chronic diseases and other medical conditions

Generally healthy, needing medicine or doctor’s visits occasionally

0-0.24

0.25-0.99

1.00-1.99

2.00-4.99

0.00 - 0.24

5.00+27.4%

22%

2.7%

7.5%

12.8%

32.4%

44.6%

22.6%

21%

7.1%

Percentage of Costs

Percentage of MembersAvg. Illness Burden Score is 0.89

Identifying The Problem: Illness Burden Triangle

Presenter

Presentation Notes

NOTE: Methodology is on an incurred basis, where all other information in the report is on a paid basis.


9


HCPS Demographics


10


HCPSS Paid Claims - Plan vs. Member


11


HCPSS Paid Claims – Type of Service


12


HCPSS High Cost Claimants


13


HCPSS High Cost Claimants by Dominant Episode


14


HCPSS High Cost Claimants – TCCI Engagement


15


HCPSS Members by Illness Band


16


HCPSS Demographics


17


HCPSS Demographics


18


HCPSS ER Utilization


19


HCPSS Urgent Care Use


20


HCPSS Admission Costs


21


Recommendations

• Increase engagement and identify those members in the healthy or stable band– Wellness/Disease Management– Drug Information

• Increase PCP attribution/PCMH providers• Decrease Emergency Room usage for those in the “stable” category• Consider incentive-based plan design, such as Blue Rewards• Consider a review of the CareFirst/CVS Pharmacy Program• Consider a review of the CareFirst Wellness Program• Discuss TCCI communication campaign for members

2 © 2016 Express Scripts Holding Company. All Rights Reserved.

Today’s Discussion

• Review the mail order plan and days supply. This is over 1M dollar savings

• Look at Medical Chanel Management for Specialty drugs

Your Recent Successes Your 2016 Oppor tunit ies

• Implementation of Rational Med

• 23.5% increase in Advanced Utilization Management savings.


Plan Cost Distribution

* Non Specialty excludes Compounds. ** Specialty excludes Hepatitis C.

Compound

PMPM Trend

-4.3%

PMPM Trend excluding

Hepatitis C and Compounds

was 16.0%

versus overall

PMPM trend of 16.6%

$0

$1

$2

$3

$4

$5

$6

$7

$8

$9

$10

Q1'14 Q2'14 Q3'14 Q4'14 Q1'15 Q2'15 Q3'15 Q4'15M

illio

ns

Non Specialty* Compounds Specialty** Hep C

77.0% 76.0%

2.1% 1.5%

19.2% 20.6%

1.7% 1.8%

% o

f Pla

n C

ost


Plan Cost Distribution

* Non Specialty excludes Compounds. ** Specialty excludes Hepatitis C.

Hepatitis C

PMPM Trend

75.6%

PMPM Trend excluding

Hepatitis C and Compounds

was 16.0%

versus overall

PMPM trend of 16.6%

$0

$1

$2

$3

$4

$5

$6

$7

$8

$9

$10

Q1'14 Q2'14 Q3'14 Q4'14 Q1'15 Q2'15 Q3'15 Q4'15M

illio

ns

Non Specialty* Compounds Specialty** Hep C

77.0% 76.0%

2.1% 1.5%

19.2% 20.6%

1.7% 1.8%

% o

f Pla

n C

ost


Key Metrics by Quarter

Increase

To

Drive

Down

GFR & Home Delivery

Utilization

To

Drive

Down

Generic Fill Rate % calculated with Unadjusted Rxs

Plan Cost

PMPM $0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

$0

$20

$40

$60

$80

$100

$120

$140

$160

Q1'14 Q2'14 Q3'14 Q4'14 Q1'15 Q2'15 Q3'15 Q4'15

Pla

n C

ost

PM

PM

$

Generic Fill

Rate %

Member Cost

%

Home Delivery

Utilization %

% Specialty

Plan Cost

Plan Cost

PMPM $


Top Line Performance Metrics

• Plan Cost PMPM is $144.38, a 16.6% trend over the previous period

• Generic Fill Rate (GFR) increased 1.3 percentage points to 79.6%

• Specialty Plan Cost PMPM is $32.79, a 22.1% trend over the previous period

Description 1-15 - 12-15 1-14 - 12-14 Change

Avg Subscribers per Month 9,164 8,957 2.3%

Avg Members per Month 20,556 19,969 2.9%

Number of Unique Patients 17,070 16,592 2.9%

Pct Members Utilizing Benefit 83.0% 83.1% 0.0

Total Plan Cost $35,613,402 $29,663,368 20.1%

Total Days 10,328,883 9,880,456 4.5%

Total Rxs 221,889 208,975 6.2% 1-15 - 12-15 Change 1-15 - 12-15 Change

Average Member Age 38.3 38.2 0.3% 38.1 38.0

Plan Cost PMPM $144.38 $123.79 16.6% $125.53 7.6% $130.19 6.7%

Plan Cost/Day $3.45 $3.00 14.8% $3.43 6.9% $3.72 7.2%

Plan Cost per Rx $160.50 $141.95 13.1% $133.72 6.4% $153.95 9.5%

Nbr Rxs PMPM 0.90 0.87 3.1% 0.94 1.2% 0.85 -2.6%

Generic Fill Rate 79.6% 78.4% 1.3 80.3% 2.3 78.9% 2.5

Home Delivery Utilization 23.1% 25.2% -2.1 41.2% -0.7 53.1% 4.2

Member Cost % 6.3% 7.1% -0.8 9.2% -0.5 8.8% -0.5

Specialty Percent of Plan Cost 22.7% 21.7% 1.0 27.8% 2.9 27.9% 1.2

Specialty Plan Cost PMPM $32.79 $26.85 22.1% $34.91 20.2% $36.33 11.5%

Formulary Compliance Rate 96.0% 95.9% 0.0 95.4% 0.5 95.1% 0.0


Midmarket Employer -

EducationUnion - Schools


Key Statistics: Specialty Detailed

• Plan Cost PMPM trend on specialty drugs is 22.1%, compared to a 15.1%

Plan Cost PMPM trend on non-specialty drugs

• There are 372 unique specialty patients, an increase of 37 specialty

patients over the previous period

Description 1-15 - 12-15 1-14 - 12-14 Change 1-15 - 12-15 1-14 - 12-14 Change

Avg Subscribers per Month 9,164 8,957 2.3% 9,164 8,957 2.3%

Avg Members per Month 20,556 19,969 2.9% 20,556 19,969 2.9%

Number of Unique Patients 17,065 16,587 2.9% 372 335 11.0%

Pct Members Utilizing Benefit 83.0% 83.1% 0.0 1.8% 1.7% 0.1

Total Plan Cost $27,526,103 $23,229,951 18.5% $8,087,300 $6,433,416 25.7%

Percent of Total Plan Cost 77.3% 78.3% -1.0 22.7% 21.7% 1.0

Total Days 10,275,866 9,835,256 4.5% 53,017 45,200 17.3%

Total Rxs 219,949 207,201 6.2% 1,940 1,774 9.4%

Percent of Total Rxs 99.13% 99.15% 0.0 0.87% 0.85% 0.0 1-15 - 12-15 Change

Plan Cost PMPM $111.59 $96.94 15.1% $32.79 $26.85 22.1% $34.91 20.2%

Plan Cost/Day $2.68 $2.36 13.4% $152.54 $142.33 7.2% $166.33 12.6%

Plan Cost per Rx $125.15 $112.11 11.6% $4,168.71 $3,626.50 15.0% $6,480.56 10.4%

Nbr Rxs PMPM 0.89 0.86 3.1% 0.008 0.007 6.2% 0.005 8.9%

Generic Fill Rate 80.2% 78.9% 1.3 13.8% 11.7% 2.1 15.8% -0.5

Member Cost % 7.9% 8.8% -0.9 0.3% 0.4% -0.1 1.4% 0.1


Non-Specialty Specialty

Specialty

Midmarket Employer -

Education


Clinical Savings and Impact

• Howard County Public

Schools saved

$5,638,267 by

helping patients

make clinically

appropriate decisions

via Clinical Programs

• Savings from these

programs decreased

Plan Cost PMPM by

13.7%

Program fees are not included in these savings numbers.

Plan Cost Savings

AUM $2,647,739 $2,143,528 23.5%

CDUR $2,943,180 $2,300,167 28.0%

RationalMED $28,323 $0 3144.8%

Interchange $19,025 $25,729 -26.1%

ProgramCurrent

1-15 - 12-15

Previous

1-14 - 12-14Change

AUM - Advanced Utilization Management

CDUR - Concurrent Drug Utilization Review (health and safety edits)

RDUR - Retrospective Drug Utilization Review

RationalMED - Clinical Outreach Program that includes messaging to physicians, pharmacists,

and members (optional) regarding health and safety issues.

Interchange - Consists of two primary programs the first targets Multi-Source Brand drugs with

DAW 1 or 2 alerting patients or prescribers of a Generic equivalent. The second program

targets non-preferred Single-Source Brand drugs alerting prescribers of a therapeutically

equivalent lower cost Generic alternative or Preferred Brand.

$167.23$144.38

Pre Clinical Programs Post Clinical Programs

Plan Cost PMPM


Trend Components

• Non-specialty Plan Cost PMPM trend is 15.1% while specialty is at 22.1%

• Inflation is the largest cost driver of your non-specialty Plan Cost PMPM

• Drug Mix is the largest cost saver of your non-specialty Plan Cost PMPM

Rebates are estimated based on paid and expected to be paid amounts. Actual rebate payments may differ from estimates.

1.8% 1.7% 14.9%

7.8% 7.2% 12.7%

1.7% 0.2% -2.1%

4.3% 4.9% -3.4%

1.0% 1.1% 0.1%

Previous Net Cost PMPM $107.24

Change in Net Cost PMPM 13.6%

Current Net Cost PMPM $121.86

16.6% 15.1% 22.1%

Current Plan Cost PMPM $144.38 $111.59 $32.79

Utilization

Inflation

Drug Mix

Discount

Cost Share

Change in Plan Cost PMPM

Overall Non- Specialty Specialty

Previous Plan Cost PMPM $123.79 $96.94 $26.85

Date Range 1-15 - 12-15 versus 1-14 - 12-14

Utilization based on change in days PMPM

Inflation based on change in AWP/quantity at a drug level

Drug Mix based on changes in therapy, addition of new therapies

and the blend of brand/genericsand the blend of brand/generics

Discount based on change in aggregate AWP discount

Cost share based on change in aggregate member share


Top Trend Drivers: Increases

• Majority due to increased Inflation/ Mix

By Indication

0

1 INFLAMMATORY CONDITIONS 1 $13.61 $9.77 39.3% $3.84 Inflation/ Mix

2 DIABETES 2 $13.57 $10.26 32.3% $3.32 Inflation/ Mix

3 HEPATITIS C 14 $4.07 $2.32 75.6% $1.75 Utilization

4 ASTHMA 9 $5.09 $4.11 23.8% $0.98 Discount

5 HIGH BLOOD PRESS/HEART DISEASE 6 $5.91 $4.97 19.1% $0.95 Discount

6 SKIN INFECTIONS 24 $1.91 $0.97 96.5% $0.94 Inflation/ Mix

7 MULTIPLE SCLEROSIS 4 $6.92 $6.18 12.0% $0.74 Inflation/ Mix

8 HIGH BLOOD CHOLESTEROL 3 $9.01 $8.29 8.7% $0.72 Inflation/ Mix

9 URINARY DISORDERS 21 $2.41 $1.71 41.0% $0.70 Discount

10 ANTICOAGULANT 20 $2.42 $1.75 37.7% $0.66 Inflation/ Mix

Trend

Driver

Rank

Total Trend %

Indication

Curr Plan

Cost Rank

Curr Plan

Cost PMPM

Prev Plan

Cost PMPM

Plan Cost

PMPM %

Change

Plan Cost

PMPM $

Change

Primary Trend

Driver (+)

Current Plan Cost PMPM $144.38

Previous Plan Cost PMPM $123.79

% Change Plan Cost PMPM 16.6%

Overall Trend


Top Trend Drivers: Decreases

• Decreases in trend vary by drug class and

may be due to a number of factors,

including new generics, new dispensing

guidelines or changes in benefit design

By Indication

0

1 INFERTILITY 27 $1.66 $2.24 -26.0% -$0.58 Utilization

2 PULMONARY HYPERTENSION 61 $0.20 $0.70 -72.2% -$0.51 Inflation/ Mix

3 BLOOD CELL DEFICIENCY 50 $0.33 $0.67 -50.4% -$0.34 Inflation/ Mix

4 FUNGAL INFECTIONS 70 $0.09 $0.41 -78.0% -$0.32 Inflation/ Mix

5 INFECTIONS 16 $2.81 $2.96 -5.1% -$0.15 Utilization

6 MISC CONDITIONS 18 $2.58 $2.71 -4.8% -$0.13 Utilization

7 SPECIALIZED INFECTIONS 77 $0.02 $0.15 -87.8% -$0.13 Inflation/ Mix

8 CHEMICAL DEPENDENCE 43 $0.53 $0.62 -14.3% -$0.09 Utilization

9 CYSTIC FIBROSIS 54 $0.24 $0.30 -21.3% -$0.06 Utilization

10 HORMONAL SUPPLEMENTATION 26 $1.67 $1.73 -3.5% -$0.06 Utilization

Trend

Driver

Rank

Total Trend %

Indication

Curr Plan

Cost Rank

Curr Plan

Cost PMPM

Prev Plan

Cost PMPM

Plan Cost

PMPM %

Change

Plan Cost

PMPM $

Change

Primary Trend

Driver (-)




Overall Trend


Trend Components: Increases Specialty

• Majority due to increased Utilization

By Indication

0

1 INFLAMMATORY CONDITIONS 1 $10.43 $7.02 48.5% $3.41 Inflation/ Mix

2 HEPATITIS C 4 $4.07 $2.32 75.6% $1.75 Utilization

3 MULTIPLE SCLEROSIS 2 $6.92 $6.18 12.0% $0.74 Inflation/ Mix

4 CANCER 3 $4.96 $4.60 7.9% $0.36 Inflation/ Mix

5 CNS/AUTONOMIC DISORDERS 10 $0.41 $0.14 199.3% $0.27 Utilization

6 ANTICOAGULANT 6 $0.88 $0.66 31.9% $0.21 Utilization

7 Idiopathic Pulmonary Fibrosis 15 $0.20 0.0% $0.20 Newly Utilized

8 OSTEOPOROSIS 8 $0.53 $0.37 43.1% $0.16 Utilization

9 GROWTH DEFICIENCY 11 $0.33 $0.23 45.7% $0.10 Utilization

10 ENDOCRINE DISORDERS 7 $0.73 $0.67 10.3% $0.07 Utilization

Trend

Driver

Rank

Total Trend %

Indication

Curr Plan

Cost Rank

Curr Plan

Cost PMPM

Prev Plan

Cost PMPM

Plan Cost

PMPM %

Change

Plan Cost

PMPM $

Change

Primary Trend

Driver (+)




Overall Specialty Trend


Trend Components: Decreases Specialty

• Decreases in trend vary by specialty drug

class and may be due to a number of

factors, including a change in

demographics, new dispensing guidelines

or changes in benefit design

By Indication

3

1 INFERTILITY 5 $1.53 $2.11 -27.5% -$0.58 Utilization

2 PULMONARY HYPERTENSION 16 $0.20 $0.70 -72.2% -$0.51 Inflation/ Mix

3 BLOOD CELL DEFICIENCY 12 $0.33 $0.67 -50.4% -$0.34 Inflation/ Mix

4 CYSTIC FIBROSIS 13 $0.24 $0.30 -21.3% -$0.06 Utilization

5 ASTHMA 9 $0.42 $0.47 -10.1% -$0.05 Utilization

6 CHEMICAL DEPENDENCE 22 $0.03 $0.03 -26.6% -$0.01 Utilization

7 NEUROMUSCULAR CONDITIONS/COSMETIC 19 $0.05 $0.05 -7.5% $0.00 Inflation/ Mix

Trend

Driver

Rank

Total Trend %

Indication

Curr Plan

Cost Rank

Curr Plan

Cost PMPM

Prev Plan

Cost PMPM

Plan Cost

PMPM %

Change

Plan Cost

PMPM $

Change

Primary Trend

Driver (-)




Overall Specialty Trend


Trend Components: Inflation

• Drug inflation accounted for an

increase of $9.71 in Plan Cost

PMPM

• Reduce this impact by moving

members away from highly inflated

brands to generic therapeutic

alternatives

*Compounds are excluded from the Top 10 Impacted Drugs

0

HUMIRA PEN 40MG/0.8ML Yes 2016 $1,442,123 748 $1,927.97 $943,382 594 $1,588.19 21.4% $254,161

CLOBETASOL PROPIONATE 0.0005 No N/A $215,636 31,824 $6.78 $124,431 30,492 $4.08 66.0% $85,769

ENBREL 50 MG/ML Yes N/A $521,562 541 $964.14 $473,139 584 $810.06 19.0% $83,353

GLUMETZA 500 MG No 2016 $93,076 2,220 $41.93 $2,076 330 $6.29 566.4% $79,109

HUMALOG 100/ML No N/A $437,112 16,844 $25.95 $314,261 14,529 $21.63 20.0% $72,777

CRESTOR 10 MG No 2016 $566,569 67,231 $8.43 $492,571 66,873 $7.37 14.4% $71,361

GLUMETZA 1000 MG No 2016 $80,158 1,080 $74.22 $22,998 1,620 $14.20 422.8% $64,826

WELLBUTRIN XL 300 MG No N/A $119,773 2,400 $49.91 $66,542 2,880 $23.10 116.0% $64,321

HUMALOG KWIKPEN U-100 100/ML No N/A $374,435 11,239 $33.32 $332,870 12,048 $27.63 20.6% $63,916

HYDROXYCHLOROQUINE SULFATE 200 MG No N/A $107,677 27,025 $3.98 $55,444 32,564 $1.70 134.0% $61,664

AWP QTYAWP/

QTY

AWP/

QTY

Inflation

Impact on

AWP

Drug Inflation - Top Impacted Drugs*

1-15 - 12-15 1-14 - 12-14 % Change

Drug Name/ StrengthSpecialty

Flag

Scheduled

ReleaseAWP QTY

AWP/

QTY

12.7%

24.3%

2.4%

7.8%

0%

5%

10%

15%

20%

25%

30%

Single

Source

Multi-

source

Generic Total

Drug Inflation


Trend Components: Specialty Inflation

• Drug inflation accounted for an

increase of $3.41 in Specialty Plan

Cost PMPM

• Reduce this impact by moving

members away from highly inflated

brands to generic therapeutic

alternatives

0

HUMIRA PEN 40MG/0.8ML Yes 2016 $1,442,123 748 $1,927.97 $943,382 594 $1,588.19 21.4% $254,161

ENBREL 50 MG/ML Yes N/A $521,562 541 $964.14 $473,139 584 $810.06 19.0% $83,353

TECFIDERA 240 MG Yes N/A $518,128 4,680 $110.71 $341,521 3,420 $99.86 10.9% $50,783

COPAXONE 40 MG/ML Yes 2017 $637,018 1,272 $500.80 $232,062 500 $464.12 7.9% $46,652

FORTEO 20MCG/DOSE Yes 2025 $128,735 134 $957.85 $91,340 122 $746.25 28.4% $28,439

SPRYCEL 100 MG Yes 2024 $246,832 600 $411.39 $190,897 516 $369.96 11.2% $24,859

HUMIRA 40MG/0.8ML Yes 2016 $119,299 62 $1,924.18 $60,693 38 $1,597.19 20.5% $20,273

SIMPONI 50MG/0.5ML Yes 2026 $103,167 13 $7,935.93 $48,804 8 $6,507.23 22.0% $18,573

GONAL-F RFF REDI-JECT 900/1.5 ML Yes N/A $211,212 156 $1,353.92 $217,995 176 $1,242.14 9.0% $17,438

CIMZIA 400MG/2ML Yes 2024 $189,902 52 $3,651.96 $89,720 27 $3,322.98 9.9% $17,107

AWP QTYAWP/

QTY

AWP/

QTY

Inflation

Impact on

AWP

Drug Inflation - Top Impacted Drugs

1-15 - 12-15 1-14 - 12-14 % Change

Drug Name/ StrengthSpecialty

Flag

Scheduled

ReleaseAWP QTY

AWP/

QTY

13.0%

27.9%

3.0%

12.7%

0%

5%

10%

15%

20%

25%

30%

Single

Source

Multi-source Generic Total

Drug Inflation


Trend Components: Member Cost

• Overall Member Cost is 6.3% a 0.8 point decrease over previous

period

Previous Member

Cost %

Current Member

Cost %

Retail Home Delivery Total

7.7%

9.0%

4.0%

12.6%

8.5%

10.8%

4.3%

15.7%

Overall

Non-

Preferred

Brand

Preferred

Brand

Generic

3.5%

5.6%

1.5%

12.4%

4.3%

6.8%

2.1%

14.3%

6.3%

8.1%

2.9%

12.6%

7.1%

9.6%

3.4%

15.4%


Top 10 Indications

• The largest trend is in Inflammatory Conditions at

39.3%

Peer = Express Scripts Peer 'Midmarket Employer - Education' market segment

ST/PA/DQM 1 2 INFLAMMATORY CONDITIONS 1,434 250 $3,356,139 16.3% 19.6% $13.61 2 1,179 236 17.8% $9.77 39.3%

ST/PA/DQM 2 1 DIABETES 8,838 1,151 $3,348,468 44.7% 47.9% $13.57 1 7,875 1,054 46.3% $10.26 32.3%

ST/PA/DQM 3 4 HIGH BLOOD CHOLESTEROL 13,212 3,098 $2,223,647 74.5% 78.6% $9.01 3 12,175 3,025 72.8% $8.29 8.7%

ST/PA/DQM 4 3 MULTIPLE SCLEROSIS 352 32 $1,707,651 1.4% 2.1% $6.92 4 315 29 0.0% $6.18 12.0%

ST/PA 5 12 ATTENTION DISORDERS 6,504 1,004 $1,465,702 75.9% 70.7% $5.94 5 5,953 925 71.8% $5.40 10.0%

ST/DQM 6 8 HIGH BLOOD PRESS/HEART DISEASE 27,454 4,305 $1,458,695 94.2% 93.3% $5.91 7 26,285 4,174 92.3% $4.97 19.1%

ST/PA/DQM 7 5 CANCER 1,236 287 $1,352,736 87.1% 87.5% $5.48 6 1,085 262 82.2% $5.05 8.6%

ST/PA/DQM 8 6 PAIN/INFLAMMATION 18,075 5,270 $1,296,644 92.5% 92.4% $5.26 8 17,734 5,180 90.4% $4.66 12.9%

ST/PA/DQM 9 7 ASTHMA 8,322 2,656 $1,255,990 36.6% 39.6% $5.09 11 7,372 2,486 37.2% $4.11 23.8%

ST/DQM 10 9 HEARTBURN/ULCER DISEASE 7,206 2,047 $1,112,682 88.4% 88.8% $4.51 10 6,607 1,978 78.0% $4.14 8.9%

Total Top 10: 92,633 $18,578,354 77.8% $75.32 86,580 76.3% $62.83 19.9%

Differences Between Periods: 6,053 $3,522,986 1.5% $12.49

Patients

Generic

Fill

Rate

Plan

Cost

PMPM

Plan

Cost

PMPMPlan Cost

Generic

Fill

Rate

Peer

Generic

Fill

Rate

Plan

Cost

PMPM Rank Rxs

AUM

Strategy Rank

Peer

Rank Indication Rxs Patients

Top Indications by Plan Cost

1-15 - 12-15 1-14 - 12-14

%

Change

REPRESENT

52.2% OF YOUR TOTAL

PLAN COST


Top 25 Drugs • Represent 30.0% of your total Plan Cost and comprise 12 indications

• 6 of your top 25 are specialty drugs


0 % Change

1 1 HUMIRA PEN* INFLAMMATORY CONDITIONS 298 44 $1,207,414 $4.89 2 258 33 $3.39 44.3%

2 2 CRESTOR HIGH BLOOD CHOLESTEROL 2,292 606 $1,101,084 $4.46 1 2,137 604 $4.04 10.4%

3 11 VIEKIRA PAK* HEPATITIS C 28 8 $776,466 $3.15

4 4 COPAXONE* MULTIPLE SCLEROSIS 130 13 $667,204 $2.70 5 105 12 $2.38 13.7%

5 5 COMPOUND MISC CONDITIONS 785 311 $636,553 $2.58 3 816 360 $2.70 -4.3%

6 3 ENBREL* INFLAMMATORY CONDITIONS 155 18 $509,926 $2.07 8 156 23 $1.83 13.2%

7 8 TECFIDERA* MULTIPLE SCLEROSIS 79 10 $442,617 $1.79 11 54 9 $1.38 29.9%

8 26 ESOMEPRAZOLE MAGNESIUM HEARTBURN/ULCER DISEASE 715 257 $375,301 $1.52

9 37 DEXTROAMPHETAMINE-AMPHET ER ATTENTION DISORDERS 1,644 317 $371,258 $1.51 10 1,485 288 $1.42 6.3%

10 14 HUMALOG DIABETES 284 79 $346,116 $1.40 17 271 77 $1.06 32.1%

11 22 VIAGRA IMPOTENCE 1,382 364 $334,440 $1.36 13 1,393 343 $1.15 18.2%

12 9 LANTUS SOLOSTAR DIABETES 407 116 $331,472 $1.34 12 413 121 $1.33 0.7%

13 10 JANUVIA DIABETES 458 109 $314,700 $1.28 15 363 98 $1.08 17.9%

14 16 GILENYA* MULTIPLE SCLEROSIS 55 5 $307,603 $1.25 45 26 2 $0.55 127.5%

15 15 ABILIFY MENTAL/NEURO DISORDERS 242 72 $300,096 $1.22 6 456 91 $2.33 -47.8%

16 13 HUMALOG KWIKPEN U-100 DIABETES 345 111 $297,375 $1.21 14 320 115 $1.13 6.3%

17 32 LEVEMIR FLEXTOUCH DIABETES 335 87 $297,266 $1.21 106 70 51 $0.26 366.5%

18 19 ARIPIPRAZOLE MENTAL/NEURO DISORDERS 297 83 $287,516 $1.17

19 17 CIALIS IMPOTENCE 1,067 254 $273,314 $1.11 24 998 234 $0.82 34.6%

20 18 SYMBICORT ASTHMA 714 257 $272,784 $1.11 16 686 286 $1.07 2.9%

21 28 VYVANSE ATTENTION DISORDERS 927 197 $272,376 $1.10 18 862 170 $0.96 15.1%

22 40 METHYLPHENIDATE ER ATTENTION DISORDERS 820 180 $246,223 $1.00 20 900 182 $0.94 6.7%

23 33 XARELTO ANTICOAGULANT 398 120 $244,075 $0.99 33 326 105 $0.67 47.0%

24 24 ZETIA HIGH BLOOD CHOLESTEROL 406 119 $229,329 $0.93 25 391 112 $0.79 17.6%

25 65 ATORVASTATIN CALCIUM HIGH BLOOD CHOLESTEROL 5,368 1,407 $229,127 $0.93 29 4,590 1,312 $0.73 27.0%

Total Top 25: 19,631 $10,671,637 $43.26 17,076 $32.02 35.1%

Differences Between Periods: 2,555 $2,998,706 $11.24

PA

ST

DQM

N/A

DQM

PA/DQM

PA/DQM

ST/PA

PA

PA/DQM

N/A

ST/DQM

ST

DQM

N/A

VARIOUS

ST/PA/DQM

ST

DQM

PA

N/A

Plan Cost

PMPM

Plan Cost

PMPM

ST/PA/DQM

ST/DQM

ST/PA/DQM

ST/PA/DQM

Pts.

Plan

Cost

Plan Cost

PMPM Rank Rxs Pts.

Top Drugs by Plan Cost

1-15 - 12-15 1-14 - 12-14

AUM

Strategy Rank

Peer

Rank Brand Name Indication Rxs


Top Specialty Indications

• The largest trend is in Cns/Autonomic Disorders at 199.3%


ST/PA/DQM 1 2 INFLAMMATORY CONDITIONS 634 83 $2,572,370 $10.43 2 514 70 $1,682,777 $7.02 48.5%

ST/PA/DQM 4 3 MULTIPLE SCLEROSIS 352 32 $1,707,651 $6.92 4 315 29 $1,481,053 $6.18 12.0%

ST/PA/DQM 7 5 CANCER 159 32 $1,223,623 $4.96 6 167 37 $1,102,161 $4.60 7.9%

ST/PA/DQM 14 10 HEPATITIS C 56 11 $1,004,002 $4.07 18 26 7 $555,498 $2.32 75.6%

ST/DQM 27 37 INFERTILITY 200 34 $376,824 $1.53 19 308 43 $505,028 $2.11 -27.5%

PA 20 23 ANTICOAGULANT 184 90 $215,989 $0.88 22 131 83 $159,021 $0.66 31.9%

ST/PA/DQM 31 36 ENDOCRINE DISORDERS 56 11 $181,222 $0.73 29 31 9 $159,547 $0.67 10.3%

ST/PA/DQM 37 39 OSTEOPOROSIS 74 21 $130,088 $0.53 41 58 11 $88,319 $0.37 43.1%

ST/PA/DQM 9 7 ASTHMA 38 6 $103,763 $0.42 11 54 7 $112,093 $0.47 -10.1%

PA 48 57 CNS/AUTONOMIC DISORDERS 3 1 $101,101 $0.41 61 1 1 $32,818 $0.14 199.3%

Total Top 10: 1,756 $7,616,633 $30.88 1,605 $5,878,314 $24.53 25.9%

Differences Between Periods: 151 $1,738,319 $6.35

Plan Cost

PMPM

Plan Cost

PMPMPlan Cost

Plan Cost

PMPM

Overall

Rank Rxs Patients Plan Cost

AUM

Strategy

Overall

Rank

Overall

Peer

Rank Indication Rxs Patients

Top Specialty Indications by Plan Cost

2 1-15 - 12-15 1-14 - 12-14

%

Change


Top 25 Specialty Drugs

• Represent 18.4% of your total Plan Cost and comprise 9 indications


0 % Change

1 1 HUMIRA PEN INFLAMMATORY CONDITIONS 298 44 $1,207,414 $4,052 $4.89 2 258 33 $3,150 $3.39 44.3%

3 11 VIEKIRA PAK HEPATITIS C 28 8 $776,466 $27,731 $3.15

4 4 COPAXONE MULTIPLE SCLEROSIS 130 13 $667,204 $5,132 $2.70 5 105 12 $5,431 $2.38 13.7%

6 3 ENBREL INFLAMMATORY CONDITIONS 155 18 $509,926 $3,290 $2.07 8 156 23 $2,805 $1.83 13.2%

7 8 TECFIDERA MULTIPLE SCLEROSIS 79 10 $442,617 $5,603 $1.79 11 54 9 $6,128 $1.38 29.9%

14 16 GILENYA MULTIPLE SCLEROSIS 55 5 $307,603 $5,593 $1.25 45 26 2 $5,053 $0.55 127.5%

27 7 HARVONI HEPATITIS C 7 3 $220,105 $31,444 $0.89 104 2 2 $32,672 $0.27 227.2%

32 82 SPRYCEL CANCER 20 3 $207,019 $10,351 $0.84 32 24 2 $6,896 $0.69 21.5%

36 106 GONAL-F RFF REDI-JECT INFERTILITY 44 20 $196,489 $4,466 $0.80 19 60 27 $3,738 $0.94 -14.9%

37 41 STELARA INFLAMMATORY CONDITIONS 14 4 $195,090 $13,935 $0.79 51 8 2 $15,154 $0.51 56.3%

38 56 ENOXAPARIN SODIUM ANTICOAGULANT 163 87 $178,630 $1,096 $0.72 42 108 69 $1,228 $0.55 30.8%

41 79 CIMZIA INFLAMMATORY CONDITIONS 42 5 $166,843 $3,972 $0.68 96 16 4 $4,930 $0.33 105.5%

43 12 REVLIMID CANCER 16 3 $163,917 $10,245 $0.66 37 15 4 $9,522 $0.60 11.5%

44 20 GLEEVEC CANCER 18 2 $163,711 $9,095 $0.66 22 25 2 $8,332 $0.87 -23.6%

50 165 XTANDI CANCER 17 2 $148,468 $8,733 $0.60 73 11 3 $8,443 $0.39 55.3%

61 197 MENOPUR INFERTILITY 39 18 $122,886 $3,151 $0.50 26 74 28 $2,502 $0.77 -35.5%

65 288 TARCEVA CANCER 19 3 $118,013 $6,211 $0.48 376 2 1 $6,589 $0.05 769.9%

72 25 HUMIRA INFLAMMATORY CONDITIONS 29 7 $113,832 $3,925 $0.46 124 19 4 $2,753 $0.22 111.4%

74 95 FORTEO OSTEOPOROSIS 56 9 $113,010 $2,018 $0.46 93 51 5 $1,608 $0.34 33.8%

83 43 XOLAIR ASTHMA 38 6 $103,763 $2,731 $0.42 59 54 7 $2,076 $0.47 -10.1%

86 105 H.P. ACTHAR CNS/AUTONOMIC DISORDERS 3 1 $101,101 $33,700 $0.41 197 1 1 $32,818 $0.14 199.3%

94 143 AMPYRA MULTIPLE SCLEROSIS 52 6 $92,555 $1,780 $0.38 65 64 6 $1,650 $0.44 -14.9%

100 86 SIMPONI INFLAMMATORY CONDITIONS 26 2 $86,782 $3,338 $0.35 161 15 2 $2,779 $0.17 102.2%

106 177 ORENCIA INFLAMMATORY CONDITIONS 26 3 $82,130 $3,159 $0.33 150 16 2 $2,743 $0.18 81.8%

114 67 REBIF MULTIPLE SCLEROSIS 14 1 $77,072 $5,505 $0.31 57 22 3 $5,153 $0.47 -34.0%

Total Top 25: 1,388 $6,562,645 $4,728 $26.60 1,186 $3,623 $17.93 48.4%

Differences Between Periods: 202 $2,265,862 $1,105 $8.67

PA

PA

ST/PA

ST/PA

ST/PA/DQM

ST/PA/DQM

N/A

PA/DQM

ST/PA/DQM

PA/DQM

PA/DQM

N/A

ST/PA

N/A

ST/PA

PA

PA/DQM

ST/PA/DQM

ST/PA/DQM

ST

ST

ST/PA/DQM

PA/DQM

Pts.

Plan Cost

/ Rx

Plan Cost

PMPM

Plan Cost

PMPM

ST/PA/DQM

ST/PA/DQM

Pts.

Plan

Cost

Plan Cost

/ Rx

Plan Cost

PMPM

Overall

Rank Rxs

Top Specialty Drugs by Plan Cost

1-15 - 12-15 1-14 - 12-14

AUM

Strategy

Overall

Rank

Overall

Peer

Rank Brand Name Indication Rxs


Upcoming Patent Expirations

• Implement programs now

to realize savings on

brand drugs losing patent

protection

• Based on your current

utilization, $7,790,346 in

brand drugs are losing

patent protection by

2020

GFR Savings calculation excludes Specialty drugs

HUMIRA PEN INFLAMMATORY CONDITIONS 2016 1 $4.89 $4,051.72

CRESTOR HIGH BLOOD CHOLESTEROL 2016 2 $4.46 $480.40

COPAXONE MULTIPLE SCLEROSIS 2017 4 $2.06 $4,878.37

VIAGRA IMPOTENCE 2017 11 $1.36 $242.00

GILENYA MULTIPLE SCLEROSIS 2019 14 $1.25 $5,592.79

CIALIS IMPOTENCE 2018 19 $1.11 $256.15

ZETIA HIGH BLOOD CHOLESTEROL 2016 24 $0.93 $564.85

LYRICA PAIN/INFLAMMATION 2019 29 $0.87 $536.58

LIALDA INFLAMMATORY CONDITIONS 2020 30 $0.86 $1,163.40

EPIPEN 2-PAK ANAPHYLAXIS 2016 35 $0.81 $510.11

0

Top Drugs Scheduled to Lose Patent Protection through 2020

Drug Name Indication

Scheduled

Release

Year

Plan Cost

Rank

Plan Cost

PMPMPlan Cost / Rx

1%

plan cost

For every

increase in GFR

the plan could

save approximately

2.3% of total

$4,179,582

$1,168,579

$757,066$911,062

$774,058

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$3,500,000

$4,000,000

$4,500,000

Spend on Brand Drugs Losing Patent Protection

2016 2018 202020192017

Expiration dates based on current status and may change due to litigation, patent challenges, etc.


*Includes all drugs with patent expirations through 2016

Source: U.S. Drug spend estimates are based on IMS Health data for 2014. The patent expiration dates of the biologic products is current as of March 2014.

Patent expiration does not necessarily imply biosimilar availability. The availability of biosimilars is highly variable due to litigation, patent challenges, FDA’s

establishment of 351(k) pathway, or other factors.

$22

$0.34

$6.2 $7.1

$4

Bil

lio

ns

54 Biotech Products With Patent Expirations Through 2020

2016 2017 2018 2019 2020

Humira®

Neulasta®

Rituxan®

Epogen® / Procrit®

Synagis®

Pulmozyme®

Lemtrada®

Amevive®

Remicade®

Xolair®

Erbitux®

Avastin®

Herceptin®

Orencia®

Actemra®

Lucentis®

Tysabri

Vectibix®

Intron A®

Simulect®

Overall U.S. Market Opportunity

(in $ Billions) $39.7B BIOSIMILAR OPPORTUNITY


Generic Fill Rate Opportunity

Savings calculations exclude Specialty drugs

GFR and Maximum Potential GFR calculated with Unadjusted Rxs

Every 1% increase in GFR leads

to Plan Cost savings of

2.3%

Increased GFR this period saved

you

$1,001,467

Improve your GFR to maximum

potential of

88.7%

78.4%79.6%

88.7%

Previous GFR Current GFR Maximum Potential GFR

Generic Fill Rate Potential


A TRC-Stratified Look at Your Member Population

Clinical specialization in a specific condition helps to

better identify issues and improve health outcomes.

Specialist pharmacists learn extensive communication skills

to enhance the patient experience and improve adherence.

98%*

F O R S P E C I A L I S T

P H A R M A C I S T S

M E M B E R

S AT I S FA C T I O N AT

Reporting period: January 01, 2015 thru December 31, 2015. Spend based on Plan Cost.

* Member Satisfaction rates are not client specific.

PLAN COST % SPEND

19.3% 6.0% 5.2% 17.7% 21.5% 12.0% 13.1% 2.8%

1,244

PLAN COST SPEND

$6.9M $2.1M $1.9M $6.3M $7.7M $4.3M $4.7M $1.0M

Neuro-

science

Women’s

Health

PATIENTS

244 340 236 1,076 3,477 3,371 3,934

Rare and

SpecialtyOncology

HIV/

ImmunologyDiabetes

Cardio-

vascularPulmonary


Plan Demographics

• The average member age is 38.3

years old, an increase of 0.1 years

over the previous time period

• The 65+ age group has the highest

Plan Cost per member at

$3,721.79

• ACA’s Dependent Care Coverage to

Age 26 requirement has impacted

the age group 20-29

Generic Fill Rate calculated with Unadjusted Rxs

Age % % % Plan Cost/ % Patient/ Days/ %

Group Members Change Days Change Plan Cost Change Member Change Member Change Member Change

0-9 2,310 4.2% 171,369 7.3% $629,988 21.8% $272.73 16.9% 75.6% -1.0 74.19 3.0%

10-19 2,814 2.7% 476,723 4.0% $2,239,359 18.9% $795.67 15.7% 75.3% -1.3 169.39 1.3%

20-29 2,873 1.1% 716,176 3.3% $2,761,449 18.2% $961.09 17.0% 84.1% 1.8 249.26 2.2%

30-39 2,641 5.4% 808,918 8.8% $3,550,921 21.1% $1,344.79 14.9% 85.9% -1.4 306.35 3.3%

40-49 2,798 0.8% 1,227,244 0.2% $4,577,715 10.2% $1,636.16 9.2% 90.1% -1.8 438.64 -0.6%

50-59 3,216 1.2% 2,233,959 1.5% $7,737,042 23.7% $2,405.48 22.3% 95.0% -0.5 694.55 0.4%

60-64 1,501 0.6% 1,484,311 -0.3% $5,173,164 10.2% $3,446.86 9.6% 106.5% 0.1 988.99 -0.8%

65+ 2,403 8.4% 3,210,183 10.2% $8,943,764 29.8% $3,721.79 19.7% 97.6% 0.9 1,335.86 1.7%

Total 20,556 2.9% 10,328,883 4.5% $35,613,402 20.1% $1,732.51 16.6% 83.0% 0.0 502.48 1.6%

81.6%77.4%

81.1% 81.0% 80.5% 79.1% 77.8% 79.9%

0%

20%

40%

60%

80%

100%

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

0-9 10-19 20-29 30-39 40-49 50-59 60-64 65+

Ge

ne

ric F

ill Ra

te

Pla

n C

ost/

Me

mb

er

Plan Cost/Member GFR

Patient Age

Generic Fill Rate by Age Group


Channel Management: Specialty

• Less than 1% of your claims account

for 22.7% of your Plan Cost

158

232

Specialty Patients -

Retail vs. Home Delivery

Retail Home Delivery22.7%

0.9%

Plan Cost Rxs

Specialty

525

1,415

Specialty Rxs -


Retail Home Delivery


Channel Management: Home Delivery

• 76.4% of your Plan Cost for

maintenance drugs is filled at retail

Slide excludes Specialty drugs

Lower cost and improve

adherence by moving

12.8Kof your retail patients

to Home Delivery

352

983

2,538

1,827

2,752

4,360

>10 DRUGS

7-10 DRUG

4-6 DRUG

3 DRUG

2 DRUG

1 DRUG

Number of Patients by Number of

Retail Maintenance Drugs*

$16,907,671

76%

$5,230,809

24%

Plan Cost by Delivery Channel

(Maintenance Drugs)



Channel Management: Maintenance Medications

• 76.4% of your Plan Cost for

maintenance drugs is filled at retail

Slide excludes Specialty drugs

12,812

2,816

Maintenance Patients -



$16,907,671

76%

$5,230,809

24%

Plan Cost by Delivery Channel

(Maintenance Drugs)

Retail Home Delivery125,412

26,106

Maintenance Rxs -




Addressing the Headwinds

Almost 50% of Americans have at least one

chronic condition

Chronic Condi t ions Ris ing

31% in 2015 Inflammatory conditions, multiple

sclerosis, cancer and hepatitis C

are driving a specialty cost boom

Cl imbing Specia l ty Trends

86% of Americans are online.

Technology is changing how

consumers access care, manage

benefits and monitor their health.

Evolv ing Pat ient Engagement

Option 1- Patient engagement

Howard County Public School SystemFY 2017 Operating Budget

Five-Year Turnover Analysis

Fund Program Program Name FY17 BOE RequestedBudgeted Turnover

FY16Budgeted Turnover






10 1301 Early Childhood Programs - 350,000 450,000 450,000 10 3010 Elementary School Instruction 3,200,000 3,900,000 4,250,000 4,468,000 2,100,000 4,000,000 1,226,190 10 3020 Middle School Instruction 800,000 800,000 655,000 652,000 10 3030 High School Instruction 1,800,000 990,350 400,000 1,000,000 10 3201 Program Support for Schools 800,000 1,000,000 1,105,000 1,102,000 10 3320 Countywide Services 330,000 10 5601 School Counseling 300,000 100,000 80,000 78,000 10 5701 Psychological Services - 150,000 175,000 172,000

6,900,000 7,290,350 6,715,000 7,252,000 2,500,000 4,000,000 2,226,190 Total

howard county public school system fy 2017 operating

Documents