As was noted above, Monday’s Senate Finance hearing was also on Article II, Department of Assistive and Rehabilitative Services (DARS) and the Department of State Health Services (DSHS).
DARS
In regards to the LBB DARS presentation, IDEA funding was highlighted, among others. Maintenance of Effort (MOE) Requirement for IDEA, Part C Federal Funds: State funding for FY2012 is below the MOE requirement for the Federal Special Education Grant for Infants and Toddlers, known as Individuals with Disabilities Education Act (IDEA) Part C Funds, by $1.6 million. Not meeting the MOE requirement can result in a potential loss of the entire grant of $39.7 million per fiscal year. The state must maintain, at a minimum, non-federal expenditures equal to those of the prior fiscal year. States can apply for a waiver from the Secretary of Education.
The bill assumes no loss of Federal Funds because the state should qualify for the waiver by significantly reducing the number of children served.
The bill also includes reduced funding to a few other DARS programs. In most cases, program GR was scaled back to the fiscal year 2008 funding level. The agency’s baseline request for the program was also taken into consideration. These GR-R reductions include:
- $2,975,513 in the Blind Children’s program and a corresponding decrease in FTEs of 20.1 each fiscal year, as compared to the FY11 level – reduction is expected to occur through attrition.
- $3,300,000 in the Autism program – current plan is that everyone in program would still receive service, something similar to attrition is expected in this program for reductions as well.
- $1,500,000 in the Independent Living Centers program – the cuts could be across the board or specific centers, it has not been determined yet; and
- $501,020 in the Business Enterprises of Texas program.
LBB DARS complete presentation can be found at: http://www.lbb.state.tx.us/Senate_Finance/SFC_Summary_Recs/DARS.pdf
DSHS
In regards to the LBB DSHS presentation a variety of approaches were used in the bill based on what best fit each situation. Wherever possible, the agency’s ten percent reduction submission was used. At times, a lesser or greater percentage reduction was applied to account for factors specific to a situation. Reductions were also made to several items not included in the agency’s ten percent submission. These reductions include: 1) reducing certain programs back to 2008-09 levels (chronic disease, family planning, and regulatory programs); 2) backing out one-time funds (Montgomery County Psychiatric Hospital and G.O. bonds for completed construction projects); and 3) pausing certain programs (WIC Farmer’s Market, tobacco prevention, and Federally Qualified Health Care (FQHC) Infrastructure Grant programs).
The bill includes:
- $59.1 million reduction in General Revenue Funds to Community Mental Health strategies including:
- $32.3 million reduction to Mental Health Services – Adults;
- $7.4 million reduction to Mental Health Services – Children;
- $8.8 million reduction to Community Mental Health Crisis Services; and
- $10.6 million reduction to NorthSTAR Behavioral Health Waiver program.
These reductions have been made proportional to the All Funds amount in each strategy. The bill also includes modification of Rider 13, Limitation: Transfer Authority to provide DSHS with more flexibility to move funding between Community Mental Health strategies.
Increase in Maintenance of Effort (MOE) for Mental Health Block Grant and Loss of Federal Funding: DSHS reclassified $165.0 million in biennial General Revenue Funds appropriated for community mental health crisis services in the 2010-11 biennium as part of the Maintenance of Effort (MOE) for the Community Mental Health Block Grant. The MOE requirement for this grant is to maintain spending at an average amount of state expenditures for the previous two fiscal years. Because of DSHS’ reclassification and federal reporting actions, the recommended $59.1 million reduction to community mental health services will cause us to fall below this higher MOE target in both fiscal year 2012 and 2013. This could jeopardize the entire Community Mental Health Block Grant, a biennial loss of $63.7 million in Federal Funds. The bill assumes the loss of the federal grant in both fiscal years 2012 and 2013.
Federal law, however, does provide for the possibility of a one-time waiver from the MOE requirement. Also federal policy allows for “special” purpose funding to be excluded from the MOE calculations, which means that it is possible to request that the federal government exclude $165.0 million for community mental health crisis services from the fiscal year 2010 and 2011 calculations. DSHS is currently looking into both of these options.
The bill also includes a new rider, Rider 65, Limitation: Reclassification of General Revenue Associated with Maintenance of Effort, requiring the agency seek approval for future reclassifications of General Revenue associated with MOE requirements. The rider also directs the agency to provide annual federal reports associated with MOEs to the LBB and Governor.
Other key highlights:
- $49.5 million reduction in General Revenue and General Revenue-Dedicated Funds to preparedness and prevention programs and client services. Major items included in this reduction are: 1) $14.3 million reduction to chronic disease programs including diabetes services, obesity prevention, and cardiovascular council projects (including 5.5 FTEs); $12.1 million reduction in funding for client services for the Children with Special Health Care Needs program; 3) $7.3 million reduction in public health and preparedness funding (including 15.8 FTEs); and 4) $5.3 million reduction in funding for lab services.
- $42.0 million reduction in General Revenue Funds to Hospital Facilities and Services strategies including: 1) $28.0 million reduction in funding to state mental health hospitals (including 113.0 FTEs); 2) $9.0 million reduction in funding to mental health community hospitals; and 3) $5.0 million reduction to funding for the South Texas Health Care System (including 11.0 FTEs).
- $43.9 million reduction in General Revenue and General Revenue-Dedicated funding for trauma care and other indigent care programs including: 1) $25.0 million reduction in uncompensated trauma care reimbursements; 2) $7.0 million reduction in funding for indigent health care reimbursements to UTMB; 3) $5.0 million reduction in funding for reimbursements to counties for indigent health care expenditures in excess of the 8% general revenue tax levy; and 4) $6.9 million reduction to Federally Qualified Health Care (FQHC) Infrastructure Grant program due to decision to zero fund the program. The decision to zero fund this program is based on the fact that there does not appear to be any statutory mandate for DSHS to administer this program; additionally, DSHS recommended cutting this program by 70 percent in their initial 5% reductions.
- $24.8 million reduction in General Revenue and General Revenue-Dedicated Funds to substance abuse and tobacco prevention programs including $20.9 million reduction due to reduction of all GR and GR-D funds in the Reduce Use of Tobacco Products strategy (including 25.7 FTEs). The bill “pauses” the grant program in this strategy for the biennium and lets the corpus of the Permanent Tobacco Fund grow; this grant program primarily provides funds to just seven Texas communities. Approximately $5.0 million in Federal Funds and $0.8 million in Other Funds are retained in the strategy to provide for some tobacco prevention activities. This item also includes a $3.8 million reduction to the Outreach, Screening, Assessment and Referral Services (OSARS) program.
- $19.2 million reduction in General Revenue Funds to primary care and nutrition services including: 1) $7.5 million reduction in funding for family planning services; 2) $7.0 million reduction in funding for community primary care services (including 3.0 FTEs); 3) $3.0 million reduction due to zero-funding the Farmer’s Market Program; and 4) $1.6 million reduction to children’s dental service program (including 9.0 FTEs).
- $14.1 million reduction in regulatory programs including: 1) $5.6 million reduction to food and drug safety programs; 2) $2.0 million reduction to environmental health programs; 3) $2.4 million reduction to radiation control programs; 4) $1.7 million reduction to health care professionals programs; and 5) $2.3 million reduction to health care facilities programs. The bill also includes a new rider which directs DSHS to evaluate which programs can be self-funded, which fees can be increased, and where the number of inspections, investigations can be reduced having the least negative impact on public and consumer safety. The rider provides more flexibility for DSHS to move funding between the Regulatory strategies.
- $8.3 million reduction in General Revenue for one-time items including a $7.5 million reduction in targeted one-time funds to provide contracted mental health services at the Montgomery County Psychiatric Hospital.
LBB complete DSHS presentation can be found at: http://www.lbb.state.tx.us/Senate_Finance/SFC_Summary_Recs/DSHS.pdf
Dr. David Lakey, Commissioner of the Department of Health and Human Services, followed the LBB’s presentation with the agency presentation. He requested as the first item for agency request, to restore critical base bill reductions which would total $169 million.
For a complete copy of agency requests and presentation: Presentation to the Senate Finance Committee