PCPA continues to monitor clarifications and questions regarding the 2005/06 state budget. On July 7 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. Additionally, several items of information have been attained from the Office of Mental Retardation (OMR) and the Department of Health’s (DOH) Bureau of Drug and Alcohol Programs (BDAP). Following are highlights of information collected in the last 24 hours. More information, as it is available and can be confirmed, will be shared with members.
Medical Assistance - Physical Health
- The limit on inpatient admissions was removed for all except General Assistance (GA) categories of eligibility. A one inpatient admission limit for physical health remains for GA.
- Outpatient visits are limited to 18 per year.
- Pharmacy limits were removed.
- Co-payments remain for physical health, although not as originally proposed. No final decision was made on changes, but they should either remain at current levels or have a slight increase.
- The preferred drug list is moving forward.
Mental Health
- All limits for Fee-For-Service behavioral health remained in the budget: 30 day inpatient limit per fiscal year, 5 hours of outpatient services (excluding medication checks and psychiatric evaluations) per thirty consecutive day period, and 540 hours of partial hospitalization services per fiscal year. OMHSAS expects that implementation of the Fee-For-Service behavioral health limits will begin during the second week of August.
- The OMHSAS allocation was increased by $500,000 of which $100,000 is for a study of the Allegheny County Mental Health Court. OMHSAS was not certain at this early date what the remaining $400,000 was to be used for.
- $17 million remained in the budget for Harrisburg State Hospital closure.
- A 2 percent cost-of-living adjustment (COLA) is included for direct care staff.
- A HealthChoices expansion for four counties in the northeast is to be implemented by March 2006. The involved counties are Lackawanna, Luzerne, Susquehanna, and Wyoming.
- Psychiatric
Services in Eastern Pennsylvania (referred to by some as EPPI) received
$3.5 million. - Behavioral Health Services Initiative (BHSI) funding remained stable, although the portion of funding for BHSI and Community Hospital Integration Plan Program (CHIPPS) through Intergovernmental Transfer ($21 million) may not be available in the coming fiscal year.
Drug and Alcohol
- Funding in DPW remained flat.
- While the 2 pecent COLA for drug and alcohol (D&A) programs is not readily seen in the budget by PCPA, administration officials believe it IS in the budget; a transfer of funds would need to be made from DPW to DOH to fund the BDAP line item with a 2 percent COLA. PCPA will continue to monitor this developing situation.
- Throughout budget discussions DOH/BDAP have continued to assure PCPA and the provider community that the proposed $3 million reduction in its D&A line item would be "absorbed administratively" and not impact D&A services.
- The Pennsylvania Commission on Crime and Delinquency Intermediate Punishment Grants for Drug and Alcohol Treatment received $15.825 million.
Mental Retardation
- Intermediate Care Facilities for the Mentally Retarded (ICF/MR) state appropriations are $123.058 million with a federal match at $167.078 million.
- Community
Mental Retardation Services, which include a Waiting List initiative and
a
2 percent COLA for direct care staff, has a state appropriation of $729.623 million with federal Medical Assistance of $701.193 million and Social Services Block Grant (SSBG) federal funds of $13.984 million. - Early Intervention services have a state appropriation of $89.535 million and federal dollars including SSBG of $2.195 million, Medical Assistance at $18.838 million, and Education for Children with Disabilities at $12.988 million.
Children’s Services
- "Loophole" savings assumptions were lowered allowing for change in the amounts of premiums that will be required for those with family incomes over 200% of poverty level. No proposal for a premium scale has been drafted to accommodate the revised savings assumptions.
- The Office of Children Youth and Families (OCYF) will draft a formula to support counties for matching $45 million for juvenile detention centers.
- $3 million was appropriated for the establishment of centers for diagnosis and treatment of autism spectrum disorders and for provider training.
Miscellaneous Information
- OMHSAS, OCYF, and OMR will reach agreement on the definition of direct care staff.
- OMHSAS has had significant staff reductions.
- Changes to the Public Welfare Code (House Bill 1168) passed before the budget was passed.
- Departments have been instructed to begin work on the 2006/07 budget.
- Medical Assistance Transportation will require a co-payment.
- DPW has been given authority to set co-payments.
Members should contact any PCPA staff member at the association with further questions or concerns.
