Agency of Human Services FY 2020 Budget Adjustment Senate - PowerPoint PPT Presentation

A H A H A A H S H S S S F F F Y F Y Y 2 Y 2 2 0 2 0 0 2 0 2 2 0 2 0 0 0 B B B u B u u d u d d g d g g e g e e t e t t t A A A d A d d j d j j u j u u s u s s t s t t m t m m e m e e n e n n t n t t t A A A A H H H H S S S S F F F F Y Y Y Y 2 2 2 2 0 0 0 0 2 2 2 2 0 0 0 0 B B B B u u u u d d d d g g g g e e e e t t t t A A A A d d d d j j j j u u u u s s s s t t t t m m m m e e e e n n n n t t t t Agency of Human Services FY 2020 Budget Adjustment Senate Appropriations Committee January 7, 2020

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS Budget Adjustment Overview • Reflects an increase of $9.5M GF; • Funds 211 contract to allow for 24X7 coverage; • GA Emergency Housing BAA request of $1.9M; • Delivery System Reform Investments (DSRs); • Brattleboro Retreat Rate increase; • Woodside – not part of FY20 BAA. 2

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA Net Neutral & Technical Adjustments • Transfer of funding for VHC Sustainability; • DA/SSA rate increase reconciliation from DMH to DAIL; • DCF – series of DCF net-neutral movements between appropriations; • General Fund Carryforward in AHS GC, DVHA State Only, DAIL CFC, and DAIL for SASH. 3

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA Secretary’s Office – Global Commitment • Update for new adult caseload & utilization change per Medicaid consensus [$4.8M GF]; • Adjust State Health Care Resource Fund and General fund to reflect FY19 carryforward [-$3.3M GF]; • Increase SHCRF for Medicaid Fraud Recoveries [-$906K GF]; • Include FY19 GF carryforward [-$623K GF]; • FY19 GC fund true-up [-$2.0M GF]. 4

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA – DVHA • Updated Medicaid Consensus Forecast from October 2019, will need to be adopted by the E-Board in January [-$5.8M all funds, -$305K GF]; • Delivery System Reform investment with OneCare Vermont: • CY 2019 investments [$1.8M gross, $832K GF]; • CY 2020 investments [$3.9M gross, $1.8M GF]; • Brattleboro Retreat rate increase [$549K all funds, $252K GF]; • FY19 GF Carryforward [-$237K GF]. 5

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA – DMH • Increase for forensic doctors[$55K gross, $25K GF]; • UVVMC Fellowship savings [-$45K gross, -$21K GF]; • Leverage Medicare revenue [-$500K gross, -$231K GF]; • Level 1 Cost Settlement Savings [-164K gross, -$76K GF ]; • Kids Residential Cost & Caseload Increases [$947K gross, $437K GF]; • Brattleboro Retreat rate increases and level 1 cost settlement [$2.2M gross, $1M GF]; • One-time savings from delayed implementation of adult enhanced plans [-$500K gross, -$231K GF]. 6

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA– DCF • Family Services Division: • Transfer two positions from ESD to FSD per Act 72 of 2019 Session; • Caseload & Caseload Related Items: • Sub-adoption caseload decrease [-$518K all funds, -$318K GF]; • Sub-care caseload increase [$4.3M all funds, $2.4M GF]; • Global Commitment Earnings adjustments [-$242K GF]. • Child Development Division: • CIS bundled services for non-Medicaid children – funding shift from GC [$382K GF]. 7

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA– DCF cont. • General Assistance: • Emergency Temporary Housing & Hotel Vouchers [$1.9M GF]; • PNI Caseload [$115K GF]; • Burials Caseload [$216K GF]. 8

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA– DAIL • Carryforward from FY19 – SASH, CFC; • Underutilization [-$638K GF]: • Attendant Services Medicaid Program [-$317K gross]; • Non-HCBS program [-$369K gross]; • AFSCME Collective Bargaining [-$413K gross]; • TBI [-$285K gross]; • Nursing homes – case mix score adjustment [$2.9M gross]. 9

A H A H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t A A H H S S F F Y Y 2 2 0 0 2 2 0 0 B B u u d d g g e e t t A A d d j j u u s s t t m m e e n n t t AHS FY20 BAA– DOC • HCV treatments [$880K GF]; • MAT costs [$430K GF]; • Inmate Health Services contract [$309K GF]; • OOS Caseload – currently at an average of 51 beds over base appropriation [$1.3M GF]. 10