Joint Committee Meeting

04/22/23 Joint Committee Meeting 1

Joint Committee Meeting

March 23, 2011


State Budget ConceptsFY 12-13

• In Summary:– Budget addresses $8B deficit without raising

taxes– Of 59 state agencies, 44 saw decreases, 7 were

flat funded and 8 saw increases, and one new agency was created (Office of Health Transformation)


State Budget Concepts Cont.

– Budget Elevates MCD match responsibility to the state.

• Boards will continue admin function in FY 12

• In FY 13 full integration of MCD into ODJFS.

• MCD match in FY 12 will come from the Boards’ state allocation.

• MCD match in FY 13 will come from the state line item 525.


State Budget Concepts Cont.

• Traditional line items have been re-aligned,created and in some areas eliminated (i.e. 408)

• State funding for Non-MCD, at the state level remains small

• The departments have not touched local levy funds, however significant reductions to tangible personal property tax replacement fund (TPP) will impact levies


Evaluation

• Board Association lobbied for a three step platform

1. Elevate MCD and fund through line item 525

2. Fully fund state line items (505,408, and 401)

3. Hold levy funds harmless


How did we fare?

• MCD will be elevated beginning FY 12 and match will come from line item 525 in FY 13

• The departments show a net gain in GRF but:

• Line items have been altered

• Allocation methodologies appear to shift from per capita to utilization


How did we fare? Cont.

• Reduction in TPP/Commercial Activity Tax negatively impact levies – Both departments now acknowledge

implications


Language and Policy

• Budget Language not yet published, but expected in 2 weeks.


What do we know: Mental Health

• Emphasis- direct service to individuals with Severely Mental Ill

• Continued Department operation of Six Psychiatric Hospitals

• Continue Medication subsidy at a lower allocation due to generics

• GRF non-MCD subsidy for local priorities


Major Reforms• MCD responsibility is shifted to state level

(funding and management)• FY 12 MCD cost containment strategies

based on data• MCD benefit package in FY 13

– Service utilization will be limited– Payment modifications beginning July 1, 2011

(Scope, Cost and Duration)


Major Reforms Cont.

– Children entitled to all medically necessary services per MCD - Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

– Treatment services outcome measures– Physical/Behavioral Health integration– Care Coordination by Office of Health

Transformation September 2012


Major Reforms Cont.

• Core Focus Populations: MCD/Medicare dual enrollees and individuals with Severely Persistent Mentally Ill (SPMI) (MCD redesign FY 13)

• Hospital, MCD and Non-MCD new line items

• Block grant reformed to emphasized direct services.


Major Reforms Cont.

• Funding Proposal FY 12/13– Line item eliminated and created –KG– Departments will allocate sufficient dollars to

meet Boards MCD obligation (MACSIS utilization trend) plus 8% growth

– MCD Allocation will include cost containment rules and focus on high priority areas


Major Reforms Cont.

• Boards to process MCD as in the past for FY 12 but Department will impose a reconciliation policy

• Boards will be held harmless for MCD match i.e., levy, non-MCD funds and block grant

• ODJFS to pay providers MCD in FY 13


Major Reforms Cont.

• Hospital line item 412 (NEW)– Civil & forensic– The Boards allocation of funds from 412 are to

purchase hospital beds or alternate services– Department may opt for a pay as you go

method on 412 funds or quarterly allocation with reconciliation

– Department will push for regional planning of bed days


Major Reforms Cont.

• Community Service 505– Focus on Non-MCD services– Allocation designed to bring each Board as

close to FY 11 Non-MCD GRF – Priority setting for these funds up to Board


Major Reforms Cont.

• Departments will encourage these services:– Emergency service and crisis intervention – Housing– Children's Services– Consumer returning to Community from

Hospital


What do we know- ODADAS

• MCD elevation - same related issues as ODMH e.g., Cost Controls and Utilization Management

• Revised Non-MCD allocation procedures for FY 13

• Emphasis on the department and RSC State Wide Project.

• Top Priority is the Opiate Addicted


What do we know-ODADAS Cont.

• Other Priorities: Young Adults with dual diagnosis

• Severally Mentally Ill

• Offender re-entering communities

• Vets

• Driver Intervention Program Offenders MUST pay ½ of cost


Fund Account Name FY 2011 FY 2012 FY 2013

General Revenue 38401 Treatment Services 26,784,703 32,784,703 4,620,974

General Revenue 38404 Prevention Services 868,659 868,659 868,659

3J80 38610 Medicaid 77,000,000 69,200,000 0

4750 38621 Statewide Treatment & Prevention 14,475,888 9,971,300 8,123,774

5JWO 38615 Board Match Reimbursement 1,500,000 3,000,000 3,000,000

3G40 38614 Substance Abuse Block Grant Treatment 45,887,134 49,182,530 49,182,530

3G40 38614 Substance Abuse Block Grant Prevention 17,442,755 16,472,912 16,472,912

Totals 183,959,139 181,480,104 82,268,849

increase(decrease)% -1% -55%increase(decrease) -2,479,035 -99,211,255

Note: Medicaid is moved to the state in Fy 2013

ODADAS Funding


Fund Account Name FY 2011 FY 2012 FY 2013

General Revenue 334408 Comm.& Hosp.Mental Health Services 377,332,336 0 0

General Revenue 334412 Hospital Services 202,018,888 192,051,209

General Revenue 335404 Behavioral Health Services Children 7,460,800 0 0

General Revenue 335501 Mental Health Medicaid Match 186,400,000 0

General Revenue 335505 Local Mental Health Sys of Care 20,644,308 38,913,776 48,037,955

Totals 405,437,444 427,332,664 240,089,164

increase(decrease)% 5% -44%increase(decrease) 21,895,220 -187,243,500

Note: Medicaid is moved to the state in Fy 2013

ODMH Funding

22

FY 12 Funding proposal ODMH:FY 12 Bed Day Purchase FY 12 Medicaid Match FY 12 505 FY 12 Block Grant FY 12 Total

$171,802 $1,229,376 $777,492 $134,461 $2,141,329

Note; less than Note; mcd match includes utilization increasesexpected

FY 11 FY 11FY 11 Funding One Time Special

Excluded FundingExcluded

One time $336,001 0

408 $2,017,249 2017249 2017249Block Grt $134,461 134461 134461

408/505 one time $72,661 0408/505 supplemental $22,120 0

Forensic State $4,518 4518 4518Forensic Federal $2,675 2675 2675

404 funds $51,973 51973 51973

Early Child $4,000 4000Early Child $40,575 40575

$2,686,233 $2,255,451 $2,210,876FY 12 %variance -20% -5% -3%

FY 12 variance -$544,904 -$114,122 -$69,547

These funds require clarification from ODMH:Note: Early child funds we funded under a special line item not shown here.

FY 12 Bed Day funds based on FY 11 utilization


Tangible Personal Property Tax ReplacementWhile more language and details will need to follow, the initial news is not good. Boards and other local governments have been held harmless from the loss of tangible personal property taxes as a result of tax reform. Two state revenue distribution funds (see details below) and a transfer of GRF have been used to hold local governments harmless. The Administration proposes to redirect CAT revenues and kilowatt hour tax to the GRF, thus reducing funds to reimburse local governments.The Local Government TPP Replacement Fund (Fund 7081) has traditionally received funds from Commercial Activity Tax to help replace revenue to local governments.SFY '11 SFY '12 SFY '13$414,000,000 $291,000,000 $181,000,000

-30% -38%


Fund 7054 is used to reimburse local governments for property tax revenue lost due to reductions in 2001 in assessment rates on tangible property owned by electric and natural gas utilities.SFY '11 SFY '12 SFY `13$90,000,000 $16,000,000 $11,000,000

-82% -31%


Property Tax Rollback Reimbursement (110901)This line item is used to reimburse local governments other than school districts for losses incurred as a result of the 10% and 2.5% "rollback" reductions in real and manufactured home property taxes and as a result of the "homestead exemption" reductions in taxes.SFY '11 SFY '12 SFY '13$592,463,014 $610,900,000 $616,000,000

+3% +1%


$4,150,000

$3,651,106

$2,539,557

$1,865,829

991,502$829,809

$1,207,739 $1,100,000

$1,297,739 $1,200,000

$2,127,783 $2,047,127

$1,836,013 $1,674,899

$3,466,316

$2,912,969

$1,790,228

$1,147,116

$238,191 $35,330

$348,909 $301,035 $527,755 $437,302

$1,365,151 $1,284,495 $1,073,381 $912,267

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$3,500,000

$4,000,000

$4,500,000

FY 01 FY 02 FY 03 FY 04 Fy 05 Fy 06 Fy 07 Fy 08 Fy 09 Fy 10 Fy 11 Fy 12 Fy 13 Fy 14

Replacement Levy-November 2008 PassedNew Levy Dollars Collected CY 2011

Loss of Levy reimbursement from state "draft"

Year End Fund Balance

Unallocated Board Reserve

FY12 Tasks & Timeframe

Task Categories• FY12 New Services

– Description of need, service, outcomes, costs– E.g., Hospital Liaison, behavioral health/criminal

justice integration• FY12 Outcomes

– Measurements, frequency, and reporting– Contract language/costs

• FY12 Board Budget (admin/special projects)• F12 Service purchasing & System Budget

– Usual and Customary Rates– New/expanded projects

• FY12 Contracts• FY 12-13 Community Plan

April Transition Meetings

• FY 12 Provider Budget Development

• Work with Providers on usual and customary rate reductions

• New or enhanced programming

• Outcomes measurements implementation

• Provider and Board Staff priority list for Board review in May


April - Other• Contracts

– Conversation/advice from Molly Mack• Termination needed? And if so, implications• Outcomes language coming• Length of contract term

• Data Reports– Costs, Utilization, Trends

• Community Plan work• Hospital Utilization Management Bed day

planning

April – Committees

• Program– Program changes for FY12

• New programs, expansions, modifications– Outcomes measurement– State budget updates– Health Officer designation

• Finance– UCC reduction plan/proposals– Outcomes costs– State budget updates

• Executive– FY12 Contract Issues Discussion– FY12 Board Officers

Timeframe: Scheduled Meetings

• June Board Meeting – June 28th

– Exec 6/15 (third Wednesday)– Prog 6/13 (second Tuesday)– Fin 6/8 (second Wednesday)

• May Bd Mtg – May 23– Exec 5/18– Fin 5/11– Prog 5/10

• April Bd Mtg – April 25– Exec 4/20– Fin 4/13– Prog 4/12

NOTE: Joint Meetings may be required

May Transition Meetings

• Unfinished business from April

• Community Plan

• Budget development/service purchasing


May - Other

• Finish Outcomes language with Outcomes workgroup

• Finish Contract with Molly Mack

May - Committees• Program

– Final report on agency proposals– Data reports– Community Plan– Health Officers

• Finance– FY12 Board Budget– Utilization Reports– Agency’s proposed FY12 Budgets– Community Plan

• Executive– Contract Work (term, outcomes, other)– Board Budget – Community Plan– Executive Director Contract

• Nominating– Board Appointments

June - Decisions

• Program– Recommendations to Board on Programming– Discussion/recommendations on Contracting language

• Finance– Recommendations on

• Board Budget– Including rental agreement

• System Budget– Executive

• Contract Recommendations• Delegation of Authority recommendations

Joint Committee Meeting

Documents

Transcript of Joint Committee Meeting