1. LOUISIANA MEDICAID PROGRAM DEPARTMENT OF HEALTH AND HOSPITALS Presentation to the Children’s Cabinet Advisory Board By Ben Bearden Director, Medicaid Program January 11, 2005

2. 2 LOUISIANA MEDICAID PROGRAM Enrollees and Payments - SFY 2003/04

3. 3 Medicaid Enrollees SFY 2003/04 EnrolleesPercent All Children (<21)690,09565.3% Adults117,11411.1% Elderly90,8368.6% Disabled158,67215.0% Total*1,056,717 100% Based on MDW as of August 2004

4. 4 Medicaid Payments - SFY 2003/04 $ in MillionsPercent All Children (<21)$959.524.2% Adults$309.47.8% Elderly$838.221.2% Disabled$1,855.846.8% Total*$3,962,9 100% Based on MDW as of August 2004

5. 5 Medicaid Payment per Enrollee SFY 2003/04 All Children (<21)$1,390 Adults$2,642 Elderly$9,227 Disabled$11,696 Total* $ 3,750 Based on MDW as of August 2004

6. 6 LOUISIANA MEDICAID PROGRAM ($ in millions) SFY 2004/05SFY 2005/06 Program Appropriation Requested Budget$5,223.8$5,241.1 Childrens’ Related LaCHIP$125 $136.5 Other Medicaid$1,216.8

7. 7 Services Total Children's Budget Request Case Management Services5,209,933 Certified RN Anesthetists (CRNA's)2,462,359 Durable Medical Equipment15,013,030 EPSDT (Screening and Early Diagnosis)99,978,320 Family Planning4,456,407 Federally Qualified Health Centers4,793,099 Hemodialysis Services12,601,133 Home Health Services11,371,406 Hospice Services7,293,639 Hospital - Inpatient Services270,514,382 Hospital - Outpatient Services67,778,417 ICF-MR - MR/DD Community Homes73,263,250 Laboratory and X-Ray Services25,487,717 Mental Health - Inpatient Services3,874,315 Mental Health Rehabilitation29,501,906 Pharmaceutical Products and Services273,865,064 Physician Services125,322,283 Rural Health Clinics10,103,293 Transportation - Emergency - Ambulance9,637,376 Transportation - Non-Emergency - Ambulance3,771,199 Transportation - Non-Emergency - Non-Ambulance3,310,918 Waiver - Children's (Capped Children MR/DD Waiver)7,122,243 Waiver - MR/DD - Community Services81,300,586 Other Private Providers7,793,404

8. 8 Services Total Children's Budget Request LSU HSC HCSD (including DPU)84,782,320 LSU - EA Conway4,948,265 LSUMC - Shreveport27,295,788 DHH - State MR/DD Services57,364,630 DHH - State Nursing Homes5,788,873 DHH - Office of Public Health7,886,243 DHH - Community Mental Health3,067,490 DHH - Public Psyciatric Free Standing Units634,195 State Education5,485,347 Other Public Providers204,462 TOTAL CHILDREN'S BUDGET1,353,283.294 Childrens’ Budget Continue……

9. 9 New and Expansions requested for Children Targeted Case Management 433,269 Chidrens Choice Waiver 349,323 EPSDT Dental 876,838 Psych. Residential Treatment 9,207,000 Total New/Expansions requested 10,866,430

10. 10 New and Expansions requested for Children Targeted Case Management$433,269 Chidrens Choice Waiver$349,323 EPSDT Dental$876,838 Psych. Residential Treatment$9,207,000 Total New/Expansions requested $10,866,430

11. 11 Children Enrolled in LaCHIP and Louisiana Medicaid 652,759 315,271

12. 12 Monthly Growth in LaCHIP & Medicaid Children (2003 & 2004)

13. 13 Uninsured Children in Louisiana and Other Southern States* l South Carolina 9% l Alabama10% l Arkansas11% l Mississippi12% l Georgia13% l Louisiana14% l Texas22% * Based on 2003 CPS data (most current information available) and taken from Kaiser State Health Facts

14. 14 Counting Louisiana’s Uninsured Children l 2003 LSU Louisiana Household Insurance Survey (LHIS) results-- –60,000 uninsured children > 200% of poverty (some are SCHIP eligible) –77,000 uninsured children < 200 % of poverty (all are SCHIP or Medicaid eligible) l Enrollment has increased by 50,000 children since 2003 survey ended l Follow-up survey beginning February 2005 to measure changes

15. 15 Medicaid/SCHIP Eligibility of Children > 200% FPL l Census Bureau definition of “household” differs from federal Medicaid definition –Medicaid “household” l Child l Child’s legal and/or natural parent(s) living in home l May include minor siblings l Medicaid income deductions result in eligibility for some children < 200% FPL –$90 for each employed person –Child care and child support paid –Educational income –Income of anyone other than legal/natural parent