1 Department of Human Services Budget Request FY2011 Agency Budget Briefing March 10, 2010 Pat Quinn, Governor Michelle R. B. Saddler, Secretary

2 DHS Agency Budget for FY2011 General Revenue Fund – Dollars in billions FY08 Actual Expenditures = $4.086B FY09 Actual Expenditures = $4.144B with BRF $4.240B FY10 Estimated Spending = $4.012B FY11 Appropriation Request = $3.887B

3 DHS FY2011 Budget Request Highlights The FY11 proposed budget represents a $125.0M GRF decrease from FY10 Agency estimated expenditures and $150.0M below FY10 appropriations. Some of the increased funding items are highlighted next. The Home Services Program budget proposal includes $49.5M to support program liability growth and annualization. In addition, $36.3M is included for an investment in the wages paid to providers enabling individuals with disabilities to remain in their homes.

4 DHS FY2011 Budget Request Highlights Continued The introduced budget also supports the move of another 125 individuals currently residing in SODCs to the community in FY11. Funding for additional 93 DCFS transitions into the Division of Developmental Disabilities programs. The Income Assistance lines are increased by $20.2M to support estimated program liability.

5 DHS FY2011 Budget Request Highlights Continued The Child Care proposed budget includes funding to support increase in rates and health insurance.

6 DHS FY2011 Alcoholism and Substance Abuse Budget Request Highlights DASA will complete full implementation of performance based contracting with DARTS calendar year 2009 data as the baseline. In addition, DASA will operationalize a web portal that will allow providers access to their own data and provide data reports. The report function will allow providers to sort in several ways to measure their progress against the benchmarks they have established. DASA will work with the Illinois National Guard and Veterans to improve coordination of care and access to services for guardsmen and veterans returning from duty.

7 DHS FY2011 Alcoholism and Substance Abuse Budget Request Highlights Continued DASA will also implement additional utilization management and quality review measures to assure the most efficient and clinically effective use of scarce resources. The FY11 proposed budget reflects an overall 8% reduction for DASAs non-Medicaid GRF appropriations. Impacts Addiction treatment, welfare reform, and special populations line item appropriations.

8 Alcoholism and Substance Abuse General Revenue Fund – Dollars in millions FY08 Actual Expenditures = $164.5M FY09 Actual Expenditures = $109.5M with BRF $164.6M FY10 Estimated Spending = $147.1M FY11 Appropriation Request = $140.3M

9 DHS FY2011 Community Health and Prevention Budget Request Highlights The FY11 budget proposal reflects line consolidations for Community Youth Services. The Community Services, Delinquency Prevention and Juvenile Justice Reform lines have been combined with the Comprehensive Community Based Youth Services appropriation line. Combining the appropriation lines will facilitate the Departments ability to use these limited resources in a more coordinated manner. The Community Health and Prevention introduced funding includes a 10% reduction for the majority of GRF grant lines.

10 Community Health and Prevention General Revenue Fund – Dollars in millions FY08 Actual Expenditures = $241.8M FY09 Actual Expenditures = $248.0M with BRF $249.7 FY10 Estimated Spending = $226.5M FY11 Appropriation Request = $206.7M

11 DHS FY2011 Human Capital Development Budget Request Highlights The Division of Human Capital Development proposed budget includes funding in the income assistance lines to maintain caseloads. HCD anticipates serving the following customers under the income assistance programs in FY11 319,214 AABD customers annually 32,000 TANF customers monthly 105,857 Transitional Assistance customers annually 10,502 State Family and Child Assistance customers annually 7,212 Refugee customers annually

12 DHS FY2011 Human Capital Development Budget Request Highlights Continued The FY11 budget proposal reflects HCD operations at a maintenance level. The FY11 introduced budget includes funding to support rate increases for home and center child care providers and proposes to serve 160,700 children in FY11. In addition, the child care program plans to implement child care background checks, reduce child care quality spending, and cap spending to non-TANF employment and training clients.

13 DHS FY2011 Human Capital Development Budget Request Highlights Continued The FY11 child care appropriation also plans to defer $55M (one-month) of FY11 liability in FY12. The introduced budget also reflects additional new Supplemental Nutrition Assistance Program (SNAP) administrative funding in the amount of $17.0M, made available under the federal Department of Defense bill. These dollars are available through September 30, 2010 with the potential for reallocation of unexpended dollars through September 30, 2011.

14 DHS FY2011 Human Capital Development Budget Request Highlights Continued Unless extended, ARRA funding for some programs will reach their end early in FY11. Some outcomes seen so far: Supplemental Nutrition Assistance Program (SNAP) -SNAP (Food Stamps) Benefits -Through , $326,594,365 has been issued in additional SNAP benefits to 755,937 households - SNAP Administration - $11.9M -70 caseworkers brought on to do SNAP casework -Covered increased EBT (Electronic Benefits Transfer) costs for LINK benefits distribution -Provided outreach and interpretation to 1,865 customers -These funds expire

15 DHS FY2011 Human Capital Development Budget Request Highlights Continued Emergency Food Assistance - $11.5M –As of , $4,199,814 worth of ARRA food commodities has been distributed statewide. This translates to more than 3.3 million pounds of food. High-protein items, such as whole chickens, deli-style turkey, fresh eggs, cheese and peanut butter in addition to canned fruit items have been distributed to our eight Illinois Food banks who, in turn, distribute to a network of over 750 food pantries, soup kitchens and homeless shelters Child Care - $74.0M –Parent co-payments were reduced by 15% –Job Search was extended to 90 days –An Infant Toddler Specialist Program is being implemented. –These funds must be liquidated by September 30, 2011.

16 Human Capital Development General Revenue Fund – Dollars in billions FY08 Actual Expenditures = $1.057B FY09 Actual Expenditures = $1.093B with BRF $1.095B FY10 Estimated Spending = $1.054B FY11 Appropriation Request = $1.015B

17 DHS FY2011 Developmental Disabilities Budget Request Highlights Continued Rate reductions of 2.5% for all community based programs will be implemented in FY11. In addition, non-Medicaid grant program funding will be eliminated. The community funding for DD services will see an extension of the long-term care payment cycle and the implementation of a 1 ½ month payment cycle for other community residential and day services. The proposed budget supports the transition of an additional 125 individuals out of state-operated developmental centers to community-based settings.

18 DHS FY2011 Developmental Disabilities Budget Request Highlights In addition, $5.9M is included to fund the annualization of the FY10 SODC transitions to the community. DCFS transitions to DD community services are annualized and funding to support 93 additional transitions are reflected in the Governors introduced budget. The FY11 budget proposal restores $15.6M of GRF costs shifted in FY10 to one-time funding sources..

19 Developmental Disabilities General Revenue Fund – Dollars in billions FY08 Actual Expenditures = $1.336B FY09 Actual Expenditures = $1.356B with BRF $1.385B FY10 Estimated Spending = $1.319B FY11 Appropriation Request = $1.224B

20 DHS FY2011 Mental Health Budget Request Highlights The FY11 proposed budget includes a $4.3M increase to support the Money Follows the Person federal grant program. Also, the FY11 introduced budget includes $1.2M for the cost of the population expansion at TDF. Reduction to Community Services of $90.7M (32.5% reduction to GRF Community Grants and an estimated impact of 40% - 42% reduction to Community Contracts) DMH will receive over $24.0M in Federal monies over the next six years to support such initiatives as Veterans Reintegration, and multiple Child & Adolescent serving programs that greatly enhance the care in Illinois for these important populations.

21 DHS FY2011 Mental Health Budget Request Highlights Continued DMH received additional revenues due to the Economic Stimulus Package and the increase in FMAP at $6.7 million in FY09. The Division has received $14.2 million to date and projects total revenues of $20.5 million for FY10.

22 Mental Health General Revenue Fund – Dollars in millions FY08 Actual Expenditures = $618.1M FY09 Actual Expenditures = $610.1M with BRF $614.8M FY10 Estimated Spending = $532.3M FY11 Appropriation Request = $480.7M

23 DHS FY2011 Rehabilitation Services Budget Request Highlights The FY11 proposed budget includes a $69.3M net increase for the Home Services Program. An estimated $36.3M is to support the personal attendant and homemaker wage and health insurance increases. In addition, $49.5M is needed to fund program annualizations and new growth in FY11. The Home Services Program will be implementing services parameters in the five instrumental activities of daily living to standardize the number of hours available for housekeeping, laundry, meal preparation, money management and activities outside the home. In addition, the asset limit test for eligibility for new clients will be reduced from $17.5K to $2.0K (current Medicaid level). Estimated savings of $19.5M from these changes. As a result of the Fletcher arbitration decision, $3M is included to convert contractual staff to state employees.

24 Rehabilitation Services General Revenue Fund – Dollars in millions FY08 Actual Expenditures = $490.4M FY09 Actual Expenditures = $551.8M FY10 Estimated Spending = $581.5M FY11 Appropriation Request = $655.8M

Client & Job Impact Related to FY11 Reductions DivisionClients ImpactedEstimated Job Impact Community Health & Prevention42, Child Care – Background Checks7,900 children Child Care – Cap services to Non-TANF5,900 children Mental Health - Residential4,000 adults in housing Mental Health – Community based services70,000 persons (including 4,200 children)3,850 Developmental Disabilities funding Reductions Grant elimination Rate cuts/payment cycle 3,000 persons, up to 30,000 unduplicated persons annually 700 related to non- Medicaid grant reduction Home Services Program19,000 customers could have reductions in services received Fewer than 1,000 FTEs, up to 19,000 PAs could lose hours Addiction Treatment2, Total178,5006,220 25

26 DHS FY2011 The DHS Budget Briefing Book will not be available in printed form, but the material can be reviewed or downloaded from the DHS Website at May we entertain questions about the Appropriation Request?