PCPA continues to monitor reports and clarifications regarding the 2006/07 state budget. On July 6 Department of Public Welfare (DPW) Deputy Secretary Joan Erney addressed the Office of Mental Health and Substance Abuse Services (OMHSAS) Advisory Committee meeting with budget highlights which were then shared electronically July 11. Additionally, several items of information have been obtained from the Offices of Mental Retardation (OMR) and Medical Assistance Programs (OMAP), as well as the Department of Health’s (DOH) Bureau of Drug and Alcohol Programs (BDAP). Following are highlights of information collected since July 6. More information, as it is available and can be confirmed, will be shared with members.
General Issues and Next Steps
- PCPA’s efforts to secure a four percent cost-of-living adjustment (COLA), while well-received, did not come to fruition. This position promoted equity with other components of the public health system such as hospitals, nursing homes, and managed care organizations. These other components of the public health system did receive a four percent COLA.
- A two percent COLA was realized by the mental health/mental retardation (MH/MR) sectors of the system while the drug and alcohol (D&A) programs received no COLA. It should be noted that the two percent COLA is 1.6% less than the COLA outlined in the Home Health Market Basket Index (HHMBI), on which the inflationary index for MH/MR legislation is based (House Bill 1813 and Senate Bill 1006).
- While these numbers are extremely disappointing to MH/MR/D&A programs and, most importantly, to the nearly one million Pennsylvanians the programs serve, the battle is not over. Decisions such as the funding levels for MH/MR/D&A in this budget are the best examples of why legislation such as the dedicated alcohol tax for D&A (House Bill 1649 and Senate Bill 727) and inflationary index for MH/MR are necessary.
- The Human Services Development Fund received a $2.5 million increase.
Medical Assistance (MA)
- Funds for HealthChoices Behavioral Health statewide expansion are included.
- A Budget Stabilization Reserve Fund is established with funds available to managed care organizations, outpatient providers, inpatient providers, and long-term care in the event that appropriated funds are insufficient to cover payments due to MA providers. This addresses the administration’s initial plan to delay provider payments.
- Expansion of MA Realignment will occur (no budget detail at this time). The integrated children’s services initiative will include Functional Family Therapy and Multi-Systemic Therapy plus over 50 other programs in line for review and approval.
- Selective contracting initiatives for durable medical equipment and supplies, specialty pharmacy, and radiology will be implemented. Selective contracting for home health care services is on hold.
- Emphasis will be placed on eradication of fraud and abuse and as well as the need for pursuit of third party liability.
- Hospital Supplemental Payments are restored.
Mental Health
- A two percent COLA is included as well as restrictive language limiting use to direct care staff.
- The Community Hospital Integration Project Program (CHIPP) also received a two percent COLA.
- Harrisburg State Hospital Closure Community Initiatives are fully funded.
- Federal funding for the Community Mental Health Services Block Grant and the Social Services Block Grant (SSBG) was decreased. (Funding for SSBG may be restored by the federal government in the federal 2006/07 budget. If it is not, OMHSAS intends to explore options to restore the funds to counties.)
- Co-occurring State Incentive Grant funds decreased as expected.
- Twenty discharges are planned from Wernersville and Danville State Hospitals as part of the state hospital consolidation process.
- The CHIPP will accommodate up to 60 discharges from state hospitals to community settings based upon savings accrued from administrative consolidation.
- Administrative functions are to be regionalized in state hospitals.
- Psychiatric Services in Eastern PA received $3.5 million. This is the contract with Drexel Behavioral Healthcare education.
- No additional limitations were established for behavioral health services, but the existing limits remain in effect (i.e., limit of 540 hours of partial hospitalization services in fee-for-service MA).
Drug and Alcohol
- There is no COLA for D&A programs in DOH or DPW.
- Act 152 funds decreased to $17.485 million to reflect transfer to HealthChoices for expansion.
- BHSI funding remained stable at $43.981 million (D&A’s specific allocation is $24.436 million).
- BHSI/IGT is funded at $12.107 million (plus an additional $3 million of carry-over funding; the allocation process is yet to be determined).
- Co-occurring State Incentive Grant funds decreased as expected.
- While the DOH D&A line item appears to have increased, in reality it has not. Gene Boyle, director of BDAP, confirmed that these funds were restored last year but were not reflected in the budget. Boyle also confirmed that BDAP has suffered a 2% cut in federal funding. This cut is a federal across-the-board cut for homeland security/wartime/Katrina purposes.
- The Pennsylvania Commission on Crime and Delinquency (PCCD) Intermediate Punishment Grants for Drug and Alcohol Treatment was sustained at $15.825 million.
Mental Retardation
- A two percent COLA is included for MR with the restrictive language limiting use to direct care staff.
- OMR proposed initiatives for fiscal year 2006/07; but what the final breakdown will be in the revised budget based on the approved budget remains to be seen.
- This budget proposes serving 806 new individuals (68 Early Periodic Screening, Diagnosis and Treatment; 282 consolidated waiver; 156 person/family waiver; 300 special education graduates).
- $11.29 million was allocated for consolidated waiver compliance (ISO, SIS, AE, provider qualifications, trainings).
Children’s Services
- As reported above, the two percent COLA increase on general budget line items for MH/MR and four percent adjustments on HealthChoices allocations should affect children’s services in those areas.
- The child welfare budget reflects a significant increase of $40M in the allocation for county purchased child welfare and adoption services.
- Autism services were funded with a $3 million line item for the establishment of centers for the diagnosis and treatment of autism spectrum disorder, including provider training programs.
- The governor’s proposal to begin rollout of the Cover All Kids (expansion of health insurance coverage to children) program was agreed to by the legislature. More specifics on the plans for implementation, costs associated with enrollment, and children to be served in this first budget are forthcoming.
- There was an overall six percent increase in the Department of Education budget.
Additional
Information
While a link to the budget bill (House Bill 2499) continues to be available
as part of PCPA's legislative tracking device on the web site, a direct link
appears below:
www.legis.state.pa.us/WU01/LI/BI/ALL/2005/0/HB2499.HTM.
The DOH budget section (Section 215) is covered on pages 84-94 of the bill and includes such information as:
- pg. 92, lines 7-22 (D&A, BDAP appropriation).
The DPW budget section (Section 219) is located on pages 103-125 of House Bill 2499 and includes items such as:
- pg. 109, lines 18-30; cont'd pg. 110, lines 1-22 (community mental health),
- pg. 116, lines 21-30; cont'd pg. 117, lines 1-9 (community mental retardation),
- pg. 117, line 30; cont'd pg. 118, lines 1-4 (children - autism initiative).
Members should contact any PCPA staff member at the association with further questions or concerns.
