Author: Will Humble

Each Fall state agencies turn in their official budget requests to the Governor’s Office. In my experience while I served in the executive branch, there are usually conversations between the agency directors and governor’s office staff before the official requests are turned in- and there was usually governor’s office support for the requests 

The AZ state agencies turned in their requests a couple of weeks ago. Below is what they asked for:

Department of Health Services:

• Asks for an increase of $1.4 M (GF) from their Emergency Medical Services Fund for:

• Support Operatins within the Bureau of Emergency Medical Services & Trauma System;

• Enhance funding to the 4 regional Emergency Management Services Councils;

• Sustain contracted transportation services for high-risk expectant mothers and for physicians that provide follow-up services for uninsured newborns in intensive care centers;

• Requests one-time funding of $200,000 from the state general fund (not the Newborn Screening Fund) to address aging equipment and ongoing increase of $56,000 for increased costs of reagents.

• Seeks additional funding for Nursing Care Institution Resident Protection Revolving Fund to allow the agency to relocate residents to other facilities, maintenance of operation of a facility pending corrections of deficiencies or closure and reimbursement of residents for monies lost. The funds would go toward:

• $100,000 to address pressure ulcers in nursing homes and training for nursing home staff;

• $70,000 to provide evacuation tracking and staff tracing system to the 148 skilled nursing facilities in AZ; and

• $25,000 for an annual conference on best practices on infection prevention in a skilled nursing facility.

Department of Economic Security:

• Asks for an increase of $15M from the General Fund and $35M (Title XIX) to fund a DDD HCBS provider rate increase that emphasizes quality of direct care worker and service delivery;

• Asks for $30.5 M (CCDF fund) to increase child care assistance rates to serve low income families in quality settings & continue suspense of the child care waiting list;

• Seeks a $48.9 M (GF) and $116.1 (Title 19) funds to cover growth for 42,800 members of the DD ALTCS program for targeted case management, state-only case management & AzEIP populations this is based on a projected growth of 5% for ALTCS cases, 2% for targeted case management; 5% growth in state-only case management; 3% growth in AzEIP caseload, a 2% growth in ALTCS capitation & a 5% growth in state funded long term care room & board costs; and

• Requests additional expenditure authority in the DD line items to use federal Title XIX funds for the DD populations.

AHCCCS: 

Requests an overall increase of $15.15B (Total Funds) of which $1.9B is state general fund (GF), $324.6 M in other appropriated funds, $1.8B in other non-appropriated funds & $11 in federal funds.

Changes driven by Caseload Growth in the population:

• Increases in the ALTCS-EPD population by 4.8% in FY 2020 & FY 2021 by 3.72%

• Forecasts for the Traditional T-19 growth to be flat;

• Estimates growth in Prop 204 Population to increase by 4.14% in FY 2020 and decline in FY 2021 by 3.40%;

• Changes in the Newly Eligible Adults to grow by 3.84% in FY 2021

• Declines in the CMDP program are slightly for FY 2020 of -0/09% and increase by 0.43% in FY 2021; and

• Adds KidsCare growth in FY 2021 of 14.83%.

• Growth in the baseline Capitation Rate for all programs 3.0% due to a rebasing, changes in utilization, savings from pharmacy, provider increases, adjustments to assure actuarial soundness, and other factors;

• Adjustment in the FMAP (federal match rate) going to 70% and making adjustments for KidsCare & the childless adults FMAP (match);

• Seeks authorization or $10.5 M (Federal Funds) for the Medicaid School-Based Administrative Claiming Guide;

• Reduces the hospital assessment fund to $78.8 M which is being used for the restoration of Prop 204 (childless adults, expansion population) populations in FY 2014;

• Increases $43.1 (Federal Funds) for non-appropriated federal for regular and supplemental Prescription Rebates;

• Continues expansion of the Graduate Medical Education program by moving forward the allocation from the FY 2020 appropriations act; and,

• Seeks $11.9 M (GF) to cover federally mandated IT projects of Asset Verification System, Electronic Visit Verification & Provider Management System.

Department of Child Safety:

• Increases funding for Adoption Services by $16.4 M (GF) due to increases in the caseload by a growth of 7%; reduce the Adoption Incentive funding due to a structural shortfall due to changes in federal computations; and provide incentive pays of a daily rate of $75 for families who adopt a child with a developmental disability or serious mental health issue;

• Retains the current appropriation for CMDP in the AHCCCS budget but allocate 4 Single Line Items to manage expenditures and provide transparency with these SLIs: Health Service Request, Higher Level of Care, Care Management & Quality, & Administration and adds 104 FTE which is a 33 FTE increase over current CMDP allocation;

• Enhances by $5.0 M (GF) to continue and Support the Field Structures within DCS;

• Reauthorizes $5.0 M (Automation Projects Fund) to continue development & implementation of the Guardian (child welfare information system);

• Requests $2.6 M (GF) for Legal Costs associated with defending DCS in the class action child welfare case;

• Makes technical adjustments that provide for Extended Foster Care line item for costs of youth aged 18-21; &, consolidate special line item of Records Retention, Overtime, and General Counsel; and,

• Asks for $5.4 M (Child Care Development Funds) to increase the Child Care Assistance Rates for low income and foster families to assure children are in quality settings and suspends the child care waiting list.