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Department of Health and Senior Services NSC Budget Forum Presentation
 

Department of Health and Senior Services NSC Budget Forum Presentation

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Margaret Donnelly, Director, Missouri Department of Health and Senior Services presented at the NSC 2012 Missouri Budget Forum

Margaret Donnelly, Director, Missouri Department of Health and Senior Services presented at the NSC 2012 Missouri Budget Forum

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  • Missouri Department of Health and Senior ServicesFiscal Year 2013 Budget Presentation Department of Health and Senior Services Margaret T. Donnelly, Director
  • Principal units comprising DHSSDirector’s OfficeCenter for Health EquityDivision of AdministrationDivision of Community and Public HealthDivision of Senior and Disability ServicesDivision of Regulation and Licensure
  • Division of Community and Public HealthHere is a look at just some of the bureaus and programs the Division of Community and Public Health oversees and administers:Genetics and Healthy ChildhoodNewborn Screening- Conducted 90,374 newborn screenings in 2011Immunization Assessment and Assurance Immunizations Registry (ShowMeVax)Special Health Care NeedsAdult Head InjuryCancer and Chronic Disease Control Organ Donor ProgramShow Me Healthy WomenHealth PromotionComprehensive Tobacco Control ProgramInjury & Violence Prevention/ Safe Kids CoalitionCommunity Food and Nutrition AssistanceSummer Food Service Program - 77,898 children fed in the summer of 2011.Supplemental Nutrition for Women, Infants and Children (WIC) - Served an average of 143,718WIC clients each monthBureau of Environmental EpidemiologyHealthy Indoor Environments – 343 lead inspections and 1942 radon tests administeredBureau of Environmental Health ServicesFood Safety – 437 food recalls issued in 2011Communicable Disease Control and PreventionVeterinary Public HealthBureau of HIV, STD and HepatitisOffice of EpidemiologyCancer RegistryVital RecordsBirth and Death Certificates - 51,213 birth certificates and 16,967 death certificates issued in 2011Marriage and Marriage Dissolution Records
  • Division of Regulation and LicensureThe Section for Child Care Regulation licenses and inspects 4,147 child care facilities with a total capacity for 152,776 children.The Section for Long Term Care licenses and inspects 1,141 Long Term Care Facilities, including:499 Skilled Nursing Facilities (SNFs)31 Intermediate Care Facilities (ICFs)420 Residential Care Facilities (RCFs)191 Assisted Living Facilities (ALFs)The Section for Health Standards and Licensure Bureau of Hospital Standards licenses and inspects 65 hospitals. 
  • Division of Senior and Disability ServicesIn FY 2011, 60,423 Missourians received Home and Community Based Services (HCBS) through the Division of Senior and Disability Services.In FY 2011, DSDS took 26,114 hotline call reports of abuse, neglect, or exploitationThe department is currently using a combination of existing staff and new, temporary hires to provide necessary services (prescreening, level of care assessments, reassessments, authorizations, reauthorizations, care planning, and care plan changes) for individuals eligible for Home and Community Based Services (HCBS).  The Governor’s Fiscal Year 2013 recommended budget includes funding for 90 staff to provide prescreening, level of care assessments, authorizations and care planning.
  • How DHSS Delivers ServicesDHSS directly performs some functions (for example:staffing the elder abuse and neglect hotline; and inspecting hospitals, nursing homes, and child care providers).In order to maximize efficiency and cost-effectiveness, the department works with local partners and through contracts with private sector companies to provide services. Performance is overseen by DHSS.Examples include: DHSS contracts with the 115 Local Public Health Agencies to improve public health;DHSS contracts with the 10 Area Agencies on Aging to improve the lives of seniors;DHSS contracts with institutions of higher education for a variety of purposes; including chronic disease awareness and tobacco cessation programs; as well as the Missouri Cancer Registry and the Behavioral Risk Factor Surveillance System (BRFSS) DHSS works with home and community based service providers throughout the state who assist Missouri seniors and persons with disabilities to remain in their homes.DHSS works with not-for profits organizations and schools to provide a variety of services,including:Contracting with Missouri Kids First to provide technical assistance and training to physicians and medical professional who examine children suspected of suffering from sexual abuse or physical abuse and neglect.Partnering with the Parents as Teachers program to reach children during the critical years of early life. Partnering with schools to conduct free radon testing.Contracting with the AIDS Project of the Ozarks (Springfield) area for HIV investigation, prevention and case management of HIV clientsPartnering with the Missouri Primary Care association for chronic disease management
  • Sources/uses of DHSS funds71.4 percent of all DHSS funding comes from federal funds-Medicaid; Maternal and Child Health; Women, Infants and Children (WIC), etc.Only 26.8 percent of DHSS funding comes from General Revenue.Because the majority of DHSS’ General Revenue funding is used as matching funds, most General Revenue cuts result in the loss of an equal or greater amount of federal funds.Federal funding received by DHSS is designated for specific, programmatic purposes, so General Revenue reductions cannot be covered through use of federal funds.
  • Director's Office/Support ServicesFY2010- $20 million; FY2011-$18 million; FY2012-$16 million; FY2013*-$18 millionDivision of Community and Public HealthFY2010- $290 million; FY2011-$300 million; FY2012-$291 million; FY2013*-$307 millionDivision of Senior and Disability ServicesFY2010- $555 million; FY2011-$577 million; FY2012-$645 million; FY2013*-$676 millionDivision of Regulation and LicensureFY2010- $27 million; FY2011-$26 million; FY2012-$25 million; FY2013*-$25 million*Governor’s Proposed
  • This chart shows that DHSS General Revenue funding for Medicaid Home and Community Based Services (HCBS) has increased by 38 percent since Fiscal Year 2009—while General Revenue funding for the remainder of the department has decreased by 35 percent
  • Fiscal Year 2013 Budget Core ReductionsThe $4.1 million dollar General Revenue core reduction is an 8 percent reduction to DHSS (excluding Medicaid Home and Community-Based Services).Staff and expenses were reduced in each unit of the department, including:$742,317 for 21.71 FTE; and$103,802 (a 5 percent reduction) to selected expense and equipment categories.DHSS programs were also reduced significantly ($3.8 million General Revenue).
  • DHSS Budget Sources: Overall BreakdownGovernor's Recommended FY2013 Budget for DHSS is:$1,026,538,178(One trillion, twenty-six million, five hundred thirty-eight thousand, and one hundred seventy-eight dollars)Sources: $275,383,403 General Revenue$732,526,785 Federal Funding $18,627,990 Other Sources
  • Fiscal Year 2013 DHSS Budget by Division/Program- Governor’s Recommendations

Department of Health and Senior Services NSC Budget Forum Presentation Department of Health and Senior Services NSC Budget Forum Presentation Presentation Transcript

  • FISCAL YEAR 2013 BUDGET PRESENTATIONDEPARTMENT OF HEALTH AND SENIOR SERVICES MARGARET T. DONNELLY, DIRECTOR
  • Principal Units Comprising DHSS Director’s Office Division of Administration Division of Community and Public Health Division of Senior and Disability Services Division of Regulation and Licensure
  • What DHSS Does: Division of Community and Public Health (DCPH) Genetics and Healthy Childhood  Supplemental Nutrition for Women,  Newborn Screening Infants and Children (WIC) Immunization Assessment and  Bureau of Environmental Epidemiology Assurance  Healthy Indoor Environments  Immunizations Registry (ShowMeVax)  Bureau of Environmental Health Special Health Care Needs Services Adult Head Injury  Food Safety Cancer and Chronic Disease Control  Communicable Disease Control and  Organ Donor Program Prevention  Show Me Healthy Women  Veterinary Public Health Health Promotion  Bureau of HIV, STD and Hepatitis  Comprehensive Tobacco Control Program  Office of Epidemiology  Injury & Violence Prevention/ Safe Kids  Cancer Registry Coalition  Vital Records Community Food and Nutrition  Birth and Death Certificates Assistance  Marriage and Marriage Dissolution Records  Summer Food Service Program
  • What DHSS Does: Division of Regulation and Licensure The Section for Child Care Regulation licenses, regulates and inspects 4,147 child care facilities. The Section for Long Term Care licenses and inspects 1,141 Long Term Care Facilities, including  499 Skilled Nursing Facilities (SNFs)  31 Intermediate Care Facilities (ICFs)  420 Residential Care Facilities (RCFs)  191 Assisted Living Facilities (ALFs) The Section for Health Standards and Licensure Bureau of Hospital Standards licenses and inspects 165 hospitals.
  • What DHSS Does: Division of Senior and Disability Services In FY 2011, 60,423 Missourians received Home and Community Based Services (HCBS). In FY 2011, DSDS took 26,114 hotline call reports of abuse, neglect or exploitation. The department is currently using a combination of existing staff and new, temporary hires to provide necessary services for individuals eligible for HCBS. The Governor’s FY 2013 recommended budget includes funding for 90 staff to provide prescreening, level of care assessments, authorizations and care planning.
  • How DHSS Delivers Services DHSS directly performs some functions The department works with local partners and through contracts with private sector companies to provide services. Examples include: DHSS contracts with the 115 Local Public Health Agencies. DHSS contracts with the 10 Area Agencies on Aging. DHSS contracts with institutions of higher education. DHSS works with home and community based service providers. DHSS works with not-for-profits and schools to provide a variety of services.
  • Sources/Uses of DHSS Funds Federal Funds 71.4% General Other Revenue Funds 26.8% 1.8%•71.4 percent of all DHSS funding comes from federal funds.•26.8 percent of DHSS funding comes from General Revenue.
  • Funding by Division, FY 2010-2013 700 600 500 Millions of Dollars 400 300 200 100 0 2010 2011 2012 2013* Fiscal Years Directors Office/Support Services Division of Community and Public Health Division of Senior and Disability Services Division of Regulation and Licensure*Governors recommendations
  • DHSS General Revenue Funding History 38% Increase 220,918,787230,000,000 204,090,950210,000,000 186,238,071 172,438,881190,000,000 159,590,239170,000,000150,000,000 35% Decrease130,000,000110,000,000 84,017,755 74,808,136 90,000,000 61,167,649 56,540,886 54,464,616 70,000,000 50,000,000 FY-09 FY-10 FY-11 FY-12 FY-13 Gov. Rec. GR Medicaid In-Home Services Budget GR Budget excluding Medicaid In-Home Services
  • Fiscal Year 2013 Budget Core Reductions The $4.1 million dollar General Revenue core reduction is an 8 percent reduction to DHSS (excluding Medicaid Home and Community-Based Services). Staff and expenses were reduced in each unit of the department, including:  $742,317 for 21.71 FTE; and  $103,802 (a 5 percent reduction) to selected expense and equipment categories. DHSS programs were also reduced significantly ($3.8 million General Revenue).
  • DHSS Budget Sources: Overall BreakdownGovernors Recommended FY2013 Budget for DHSS is: $1,026,538,178 Sources: $275,383,403 General Revenue $732,526,785 Federal Funding $18,627,990 Other Sources
  • FY 2013 DHSS Budget by Division/Program Governor’s Recommendations Percent of Division/Program Amount Total FTEDirectors Office $2,611,753 0.3% 44.29Center for Health Equity $6,160,260 0.6% 25.98Division of Administration $6,238,575 0.6% 70.73 Federal Grants and Donated Funds $3,449,989 0.3% Disaster Fund $1 0.0%Division of Community and Public Health Program Operations $27,464,250 2.7% 548.63 Aid to Local Public Health Agencies $5,665,842 0.6% Division of Community and Public Health Programs and Contracts $62,806,481 6.1% Nutrition Services $178,761,640 17.4% Center for Emergency Response and Terrorism $23,345,020 2.3% 61.51 State Public Health Laboratory $9,064,818 0.9% 93.52Division of Senior and Disability Services Program Operations $20,226,377 2.0% 485.59 Naturalization Assistance $200,000 0.0% Adult Protective Services and NME Programs $2,309,546 0.2% Medicaid Home and Community Based Services $610,820,562 59.5% Alzheimer Grants $517,000 0.1% Senior Programs - Area Agencies on Aging Contracts and Grants $42,084,040 4.1% Naturally Occurring Retirement Communities $127,500 0.0% Missouri Quality Home Care Council $150,000 0.0%Division of Regulation and Licensure Program Operations $23,937,484 2.3% 460.96 Childcare Improvement Program $461,675 0.0% Missouri Health Facilities Review Committee $135,365 0.0% 2.00Total $1,026,538,178 100.0% 1,793.21