State Budget Developments: A Legislative Update from Austin Presentation to St. Luke’s Episcopal...
-
Upload
theodore-mathews -
Category
Documents
-
view
214 -
download
0
Transcript of State Budget Developments: A Legislative Update from Austin Presentation to St. Luke’s Episcopal...
State Budget Developments:
A Legislative Update from Austin
Presentation to St. Luke’s Episcopal Health Charities
Eva De Luna Castro, Analyst, [email protected]
Janet Hutchison, Development Specialist, [email protected]
April 22, 2004
900 Lydia Street, Austin, Texas, 78702 (512) 320-0222
2
•First, some CPPP information•Update on Effect of State
HHS Consolidation on State Agencies and on Providers
•Budget Impact by Program at State and Local Level
Presentation OutlinePresentation Outline
3
CPPP ActivitiesCPPP Activities
State Budget
& Taxes
Workforce & Economic
Development
Income/ Support
Health CareChild Well-Being
Hunger & Nutrition
4
Facts & the Future:The William P. Hobby Policy ConferenceDoubletree Hotel – Austin, 6500 N. IH-35
Featuring Addresses By: Former Lt. Governor Bill Hobby, Texas Comptroller Carole Keeton Strayhorn,
State Demographer Dr. Steve Murdock
Mark Your Calendars: May 13-14
Mark Your Calendars: May 13-14
5
January of odd-numbered years:Budget Bill Filed; Comptroller’s
Revenue Estimate
End of Session: Budget Approved, Sent to Comptroller for Certification;
Sent to Governor for Signature
January-March of even-numbered years: Statewide Goals Established; Instructions
for Agency Strategic Plans Issued
September to December: Budget Recommendations Developed;
Legislative Budget Estimates Issued
February to April: House and Senate Budget Hearings, Mark-Up, and Conference Committee
September: New Biennium Begins; Operating Budgets Prepared
Even Years
Two-Year Cycle
Odd Years
April to June: Instructions for Agency Budget
Requests Issued
June to August: Strategic Plans and Budget Requests Due; Budget Hearings Held
Throughout the biennium: quarterly performance reports due
Where We Are in the State Budget Cycle
Where We Are in the State Budget Cycle
6
State Budget, 2004-05 Biennium
State Budget, 2004-05 Biennium
State All-Funds, Two-Year Budget
$7.3 $7.7 $5.2
$23.7$7.0
$7.0$15.4$16.0
$27.3$0.3
$0.3$1.0
$-
$10
$20
$30
$40
Health &Human Svcs
K-12Education
HigherEducation
Business &Econ. Dev.
Public Safety& Crim.Justice
All Other
Billion $
FederalState*
2004-2005 total: $118.2 billion
*"State" is General Revenue, General Revenue-dedicated, and Other Funds.
7
All Funds: $59.3 Billion
All Other: $3.2
Public Safety &
Crim Justice: $4.0 b
Business & Eco Devo: $7.4 b
Higher Ed:
$7.8 b
HHS: $20.2 b
K-12 Schools: $16.7 b
General Revenue: $29.4 Billion
All Other: $1.4 b
Public Safety &
Crim Justice: $3.3 b
Business & Eco Devo: $0.4 b
Higher Ed:
$4.9 b
HHS: $7.5 b
K-12 Schools: $12 b
State Budget, Fiscal 2004
State Budget, Fiscal 2004
8
2004-2005 GR Budget
Percent of All GR
Texas Education Agency $20.7 billion 35%
Health and Human Services Commission
$7.4 billion 13%
Dept. of Criminal Justice $4.6 billion 8%
Teacher Retirement System $3.9 billion 7%
Department of Human Services $3.3 billion 6%
State worker retirement and health insurance
$2.6 billion 4%
Mental Health and Mental Retardation
$2.1 billion 4%
Higher Education Coordinating Board $675 million 1.1%
Family and Protective Services (formerly PRS)
$483 million 0.8%
University of Texas at Austin $483 million 0.8%
Where the GR Is, by Agency
Where the GR Is, by Agency
9
House Bill 1: General Appropriations Act for 2004-05 (charts later in this presentation show budgeted outcomes)
House Bill 2292: Cut $1 billion in General Revenue out of Medicaid, CHIP, and other HHS programs; reorganized HHS agencies
Federal budget decisions: 2005 has not yet been decided by Congress
School Finance Session: Governor’s proposal limits future uses of General Revenue for HHS & other non-K-12 needs; limits ability of local governments to make up for state cuts
Major HHS Agencies and Programs Affected by…Major HHS Agencies and Programs Affected by…
10
February 1, 2004: Department of Family and Protective Services is launched
March 1: Department of Assistive and Rehabilitative Services is launched
September 1: Departments of State Health Services and of Aging and Disability Services will begin operating
Other: Eligibility determination (for cash welfare, Food Stamps, Medicaid) moves to Health and Human Services Commission, along with Nutritional Services and Family Violence programs. HHSC also responsible for centralized administrative services, HHS program policy, and interagency initiatives.
HHS Reorganization Update
HHS Reorganization Update
11
Governor
Health and Human Services
Commission
Aging and Disability Services
State Health Services
Family and Protective Services
Assistive and Rehabilitative
Services
HHSC Transition Legislative Oversight
Committee
Health & Human Services Council
Office of Inspector General
Post-Consolidation Org. Chart
Post-Consolidation Org. Chart
12
Department of Family and Protective Services: Everything that was overseen by Protective and Regulatory Services (child abuse and neglect investigations, foster care and adoption payments, at-risk prevention and intervention programs, adult protective services, child care licensing and regulation, MHMR investigations)
Department of Assistive and Rehabilitative Services: everything that was at the Rehabilitation Commission, Commission for the Blind, Commission for the Deaf and Hard of Hearing, and Interagency Council on Early Childhood Intervention
Department of State Health Services: programs provided by the Department of Health, the Commission on Alcohol and Drug Abuse, and the Health Care Information Council, and mental health community services and state hospitals run by the Dept. of Mental Health and Mental Retardation (MHMR)
Department of Aging and Disability Services: mental retardation and state schools run by MHMR, community care and nursing home services at the Department of Human Services, and services of the Department of Aging
What’s in the New Agencies?
What’s in the New Agencies?
13
Many contractors and vendors will now only have to deal with HHSC (because of consolidation of leasing/facilities management, legal services, human resources, purchasing, information resources management, financial management, and other admin. functions).
Some providers may have to work with MORE agencies (for example, a provider helping people who have mental retardation AND mental illness now works with MHMR, but in the future may have to deal with DADS and DSHS).
Consolidation of central administrative functions is supposed to result in 716 fewer employees by the end of fiscal 2005, saving the state almost $46 million in General Revenue.
Not a lot of information yet on what will happen to staffing at local offices; outcome depends on decisions about call centers (eligibility determination).
What Does this Mean for Providers?
What Does this Mean for Providers?
14
Texas Acute Care Medicaid Caseloads
-
0.5
1.0
1.5
2.0
2.5
3.0
3.5
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Millio
ns o
f Tex
ans
Actual through 2003; budgeted in H.B. 1 for 2004-05
Feb. 2003 HHSC Projection before Cuts Made in H.B. 1 and H.B. 2292
Medicaid Acute Care after HB 2292 and other State Budget Cuts
Medicaid Acute Care after HB 2292 and other State Budget Cuts
15
Medicaid Caseloads, by Client Category
Medicaid Caseloads, by Client Category
Caseloads for Medicaid Acute Care
-
300
600
900
1,200
1,500
1,800
1998 1999 2000 2001 2002 2003 2004 2005
Children Aged & Disabled
TANF Adults Pregnant Women & Medically Needy
Thousands
16
Long-Term Care ClienteleLong-Term Care Clientele
-
30,000
60,000
90,000
120,000
150,000
180,000
1998 1999 2000 2001 2002 2003 2004 2005
Nursing facilities Hospice Clients
Community-Care Clients
17
Community Care, by ProgramCommunity Care, by Program
-
8,000
16,000
24,000
32,000
1998 1999 2000 2001 2002 2003 2004 2005
Community-Based Alternatives Community Living Assistance and Support
In Home and Family Support STAR+PLUS: Aged and Medicare-Eligible
STAR+PLUS: Disabled and Blind
18
Children's Health Insurance Program (CHIP) Caseloads
-
0.2
0.4
0.6
0.8
2000 2001 2002 2003 2004 2005
Mill
ions
of T
exas
chi
ldre
n
Actual through 2003; budgeted in H.B. 1 for 2004-05
Feb. 2003 HHSC Projection before Cuts Made in H.B. 1 and H.B. 2292
HB 2292 Policy Changes Also Cut CHIP
HB 2292 Policy Changes Also Cut CHIP
19
CHIP Enrollment Down 25% Statewide
CHIP Enrollment Down 25% Statewide
20
Public Health Programs at TDHPublic Health Programs at TDH
TX Dept. of Health Immunization Programs
-
2.0
4.0
6.0
8.0
1998 1999 2000 2001 2002 2003 2004 2005
In M
illio
ns o
f Dos
es
Doses Administered To Children To Adults
21
More TDH Programs (moving to HHSC)
More TDH Programs (moving to HHSC)
TDH Medicaid Program Clientele
-
200
400
600
800
1,000
1,200
1,400
1998 1999 2000 2001 2002 2003 2004 2005
In T
hous
ands
Family Planning HealthSteps Medical HealthSteps Dental
22
More Public Health Program CutsMore Public Health Program Cuts
TDH Women & Children's Health Services Clientele
-
20,000
40,000
60,000
80,000
100,000
1998 1999 2000 2001 2002 2003 2004 2005
Women Children
23
More Responsibilities for Locals, Less $$
More Responsibilities for Locals, Less $$
State Matching Funds for County Indigent Health Care Programs
$-
$2.0
$4.0
$6.0
$8.0
$10.0
$12.0
1991 1993 1995 1997 1999 2001 2003 2005
In million $
24
Community MH Services for Adults, Children
Community MH Services for Adults, Children
MHMR: Community Mental Health Services
-
5,000
10,000
15,000
20,000
25,000
1998 1999 2000 2001 2002 2003 2004 2005
Adults receiving Assertive Community Treatment
Consumers Receiving Supported Housing Services
Children Receiving Services in the Community
25
Services for Texans with Mental Retardation
Services for Texans with Mental Retardation
MHMR: Community & Campus-Based Mental Retardation Services
-
3,000
6,000
9,000
1998 1999 2000 2001 2002 2003 2004 2005
Consumers Receiving In Home and Family SupportServed in Home & Community-Based Services Waiver ProgramICF/MR Medicaid BedsMR Campus Residents
26
Services for Neglected/Abused Children
Services for Neglected/Abused Children
Child Protective Services Programs
-
40,000
80,000
120,000
160,000
1998 1999 2000 2001 2002 2003 2004 2005-
1,000
2,000
3,000
Completed Investigations of Child Abuse/Neglect (left axis)
Families Receiving Intensified Preservation/Reunification Services(right axis)
27
Services for Neglected/Abused Elderly
Services for Neglected/Abused Elderly
Adult Protective Services
-
16,000
32,000
48,000
64,000
1998 1999 2000 2001 2002 2003 2004 2005
-
200
400
600
800
1,000
Completed APS Investigations (left axis)
Completed MHMR Investigations (left axis)
APS Clients Receiving Guardianship Services (right axis)
28
TWC Child Care Subsidy Programs
-
20,000
40,000
60,000
80,000
100,000
2000 2001 2002 2003 2004 2005
"Working Poor" child care Child care for welfare recipients
Child Care: Less Help for Working Poor
Child Care: Less Help for Working Poor
29
Cash Assistance Will be Even Scarcer
Cash Assistance Will be Even Scarcer
Texans Receiving TANF Cash Assistance
-
1.0
2.0
3.0
4.0
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Mill
ions
of T
exan
s Below Federal Poverty Line (in 2003, $15,260/yr for a family of three)
Receiving Cash Assistance (in 2003, $2,136/yr for a family of three)
30
Nutrition Programs Will Grow, But There’s Still a Large Unmet
Need
Nutrition Programs Will Grow, But There’s Still a Large Unmet
NeedNutrition Program Caseloads
1.4 1.41.6
1.82.1 2.2
0.8590.8380.8170.7990.7610.744
4.8
4.4 4.1
5.2 5.3 5.4
-
1.0
2.0
3.0
4.0
5.0
6.0
2000 2001 2002 2003 2004 2005
Mill
ions
of T
exan
s
Food Stamp Caseloads WIC Caseloads
Estimated Need for Food Stamps
31
50-State Ranking
11th
47th
31st
34th
13th
15th
35th
41st
21st
36th
41st
38th
Texas Per Capita State/Local Spending, Fiscal 2000
$550
$470
$345
$313
$180
$154
$111
$87
$65
$58
$50
$1,362
$- $300 $600 $900 $1,200 $1,500
K-12 Education
Medicaid and Welfare
Higher Education
Highways & Streets
Hospitals
Prisons
Police/State Troopers
Public Health
Housing/Comm Dev
Judicial/Legal
Parks/Recreation
Natural Resources
Even Before Cuts, Texas was Low-Spending
Even Before Cuts, Texas was Low-Spending
32
Budget Impact Stories Needed!
Budget Impact Stories Needed!
•CPPP’s web site (at http://www.cppp.org/stories.html) is collecting information about the impact of state budget cuts and policy changes made during the 78th Legislature.
• We are interested in hearing about the impact of budget decisions at all levels, from individuals to businesses/organizations to units of government. Social service agencies; advocacy organizations; schools and teachers; hospitals and clinics; agency caseworkers; Medicaid, CHIP, TANF, or Food Stamps recipients; city or county government officials; non-profit leaders; and anyone else who was affected are all encouraged to participate.
• If you have a personal story or a report to share about how 2004-05 state budget decisions have changed your life, your work, your organization, or your community, please use the online form.
33
• Early April 2004: HHSC reports higher-than-budgeted costs in Medicaid and CHIP (vendor drugs); shortfall of $582 million?
• Comptroller urging restorations to CHIP. Unused funds: $583 million (April 13th estimate)
• Leadership so far has been reluctant to undo HHS and other budget cuts, arguing that unspent funds may be needed for Medicaid or other shortfalls that develop before January 2005
HHS Budget UpdatesHHS Budget Updates
34
• Eliminate “Robin Hood” system that redistributes local property tax revenue and benefits 88% of Texas school children
• Lower school property taxes and limit the ability of other local governments (counties, cities, hospitals, special districts) to raise property taxes in the future
• Make some small changes to state/local funding for K-12 (cigarette tax increase, new tax on adult entertainment, revenue from video slot machines, business school property taxes considered state rather than local revenue, etc.), but nothing that will significantly increase what Texas spends on K-12 or any other public service
Governor’s Goals for Special Session on K-12
Finance
Governor’s Goals for Special Session on K-12
Finance
35
Governor Rick Perry (www.governor.state.tx.us) Citizen's Opinion Hotline: (800) 252-9600; Fax: (512) 463-1849; Office of the Governor, P.O. Box 12428, Austin, Texas 78711-2428
Lieutenant Governor David Dewhurst (P.O. Box 12068, Austin, TX 78711)
Speaker of the House Tom Craddick (P. O. Box 2910, Austin, TX 78768)Your Own Legislators: Representative (P. O. Box 2910, Austin, TX 78768) and
Senator (P.O. Box 12068, Austin, TX 78711)Other Members of the LBB:
Senator Steve Ogden Representative Talmadge HeflinSenator Robert Duncan Representative Brian McCallSenator John Whitmire Representative Fred Hill
Senator Judith Zaffirini Representative Vilma LunaHealth and Human Service Chairs of Budget Committees:
Senator Jane Nelson, HHS Workgroup Chair, Senate Finance CommitteeRepresentative John Davis, HHS Subcommittee Chair, House Appropriations
Committee
(see www.capitol.state.tx.us for more contact info and “Who Represents Me?” search engine)
Contacting State OfficialsContacting State Officials
36
• www.hhsc.state.tx.us/Consolidation/Consl_home.html (Health and Human Services Commission webpage on HHS Transformation)
• www.lbb.state.tx.us (Fiscal Size Up 2004-05; Texas Budget Source; Federal Funds Watch; appropriations act)
• www.cppp.org (William P. Hobby Conference, May 13-14; Policy Page subscriptions, policy briefs, presentations, and other reports)
More Reorganization and State Budget-Related
Information
More Reorganization and State Budget-Related
Information