80 th Session Post-Legislative HHS Forum United Way Tarrant County, Sept. 17, 2007 80 th Session Post-Legislative HHS Forum United Way Tarrant County,

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Presentation transcript:

80 th Session Post-Legislative HHS Forum United Way Tarrant County, Sept. 17, th Session Post-Legislative HHS Forum United Way Tarrant County, Sept. 17, 2007 Implications of Health & Human Services Accomplishments for the State Budget Eva DeLuna Castro, Senior Budget Analyst (512) x 103

Tuesday, Nov. 13, 2007, 7:30 to 9 AM Fort Worth Botanic Gardens

Full Report and Metro Data:

Where the Money Would Go: Texas State Budget, Source: Legislative Budget Board; HB 1, 2 and 15, before Governor’s vetoes. 84% 75%

How Much for Tarrant County? $3.4 billion in 2006; $4 billion per year in ’08-09 Source: Comptroller of Public Accounts, State Expenditures by County 2006.

What a “Current Services” Proposal Would Have Done with $14.3 Billion (public employee pay/ health ins./pension; prisons; all other) (would restore state parks funding; utility discount; more)

What the State Budget Will Do with “New” GR 27% of revenue ($3.9 billion) would not increase state spending Source: Legislative Budget Board; HB 1, 2 and 15, before Governor’s vetoes.

Budget: $5.8 Billion Gap Between Tax Cut Cost & Revenue

The Budget: Medicaid Acute-Care caseloads would increase 2.8% by 2009 (from 2.8 million in 2007 to 2.9 million; more than two-thirds are children). Nursing homes: 1% increase (≈70,600 in ’09) Cost increases not fully covered; may require supplemental funding in 2009, along with caseloads. Health care provider rate restorations and increases authorized, some to comply with Frew ($707 million GR). Nursing home rate increase in Article IX of almost 4% in ’08, 10% in ’09. Total Medicaid funding (long-term care, acute care, prescription drugs, etc.): will increase by 8.7% overall, from $36.6 billion in to $39.8 billion All Funds. General Revenue-related change: from $13.4 billion to $15.8 billion.

Tarrant County Medicaid/CHIP Enrollment (September ) Source: Texas Health and Human Services Commission.

The Budget: CHIP HB 1: Caseloads increase 7.5% by 2009 (from ≈ 309,000 in 2006 to 332,262, not counting perinates). Perinatal CHIP: ≈ 14,000 in April ’07; 65,817 in ’08, 69,316 in ’09. HB 109 restorations: 96,400 children (beyond HB 1 levels) added by Less restrictive asset test & waiting period; some income disregards restored; 12-month eligibility with 6-month income review for those above 185% of poverty Cost increases only funded for fiscal 2008, not Health care provider rate restorations and increases authorized. Total CHIP funding: up 105% overall, from $1.0 billion in to almost $2.1 billion All Funds. General Revenue increase of 90%: from $335 million to $638 million. Half of the GR increase is for the perinatal program.

Tarrant County: CHIP only Enrollment (Sept , and projected) Source: Texas Health and Human Services Commission; LBB/HB 1.

Not included in previous chart: CHIP Perinates Source: Texas Health and Human Services Commission; LBB/HB 1. Tarrant County Jan Feb March April 20071,578 May 20072,310 June 20072,854 July 20073,578 Fiscal 2008 ?6,700 Fiscal 2009 ?7,100

The Budget And Community Care/Other HHS Waiting Lists Program Served in Fiscal 2006 Added by 2009 Increase from 2006 Community-Based Alternatives26,7331,6076% Home & Community-Based Svcs.10,3182,67626 Community Living Assistance2, Deaf-Blind Multiple Disabilities Medically Dependent Children In-Home and Family Support3,9441,37412 Independent Living Services (DARS) 2, Comprehensive Rehab.Svcs. (DARS) Children w/Special Health Care Needs646 Children’s Community MH Services288 DADS Non-Medicaid Community Svcs.2,228

The Budget and Child Protective Services Provides funds needed to keep Child Protective Services reform going (caseloads/pay as of Aug. 2007; 2,523 added staff) and to implement next round of reform to further reduce caseloads and improve services (another 1,092 staff added by 2009) Foster care has a new rate to pay for post-psychiatric hospitalization; also a 4.3% rate increase. Budget assumes a decrease of almost 1,100 children in foster care by 2009 (5% drop from 2007). Almost 3,700 more children will get adoption subsidies by 2009 (17% increase from 2007). Prevention programs: All-Funds increase of almost 12% for the biennium.

The Budget: Other Article II Health Care Programs More than 21,000 community care clients will move to a managed care model (STAR+PLUS) by 2009 Repairs and renovations for State Schools (mental retardation) and State Hospitals (mental health) $88 million in new General Revenue for community mental health crisis services and a public safety triage/detox unit in Bexar County 65% ($8.5 million) increase in funding for tobacco prevention and control programs, including smokeless tobacco use by rural youth $17 million GR for tuberculosis and HIV services/medications Breast and cervical cancer: more sites to provide screenings/ diagnosis; easier access to treatment for low-income women Nurse Family Partnership grants program (SB 156)

Budget: Other HHS Programs HHS eligibility determination/enrollment staff: HB 1 funds 7,202 state workers (6,700 in local offices) at HHSC; more can be requested if needed to deal with changes to outsourcing/privatized call center plan. (In 1996, state had 12,000 local staff; in 2003, 8,000). Cash welfare (Temporary Assistance for Needy Families): 133,330 Texans—the vast majority of them children—are budgeted to receive TANF cash aid in , down from 163,800 in 2006, 137,100 in Monthly grant per client will average just under $66 by 2009, vs. $64.46 in 2007.

Recent Changes, TANF Enrollment in Tarrant County Source: Texas Health and Human Services Commission State Budget for : a 2.7% decrease in TANF caseloads statewide

Recent Changes, Food Stamp Enrollment in Tarrant County Source: Texas Health and Human Services Commission

What Else Would the Budget Do? UTMB Charity/Indigent Health Care: continues at 2007 levels Reduces subsidized child care slots for “working poor” families from 104,439 in 2006 to 96,964 in 2009 (7% cut). But, also designates $18 million in federal funds for rate increases for services to children under 6 years old; $2 million for early childhood projects. Higher Ed scholarships: Texas Grants for 69,320 students in 2009, 14% more than 61,067 served in ’06 Restore System Benefit Fund support for electric utility discount program (summer months only)

Preparing for 2009 Session CHIP Reauthorization by Congress Immigration reform (federal/state) Interim House and Senate committee reports Sunset Commission reviews originally scheduled for 2009 (DADS, DARS, DSHS, DFPS, HHSC and others) were changed to 2011 (HB 3249)

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