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2011-2013 Biennial Budget

2011-2013 Biennial Budget. Regional Stakeholder/Partner Meetings July 2011. Economic Situation. Slow economic recovery Disappointing revenue forecasts Increasing caseloads Concerns for our clients, and your own families’ financial futures

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2011-2013 Biennial Budget

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  1. 2011-2013 Biennial Budget Regional Stakeholder/Partner Meetings July 2011 Washington State Department of Social & Health Services

  2. Economic Situation • Slow economic recovery • Disappointing revenue forecasts • Increasing caseloads • Concerns for our clients, and your own families’ financial futures • Reduce spending while providing core services to Washington’s most vulnerable residents • Continue sharing your ideas not only on how to reduce costs, but on how we can do business more efficiently and effectively continue to explore options for more partnering, shared responsibilities and streamlining business practices • Reset of government in response to the Great Recession • Position the Department and the state of Washington for a strong recovery Washington State Department of Social & Health Services

  3. Department Framework Does the activity need to be paid for with state general funds? Should users pay a portion of the costs? Find and maximize efficiencies and savings within contracts and operations. Controlling the long-term growth of the Department’s general fund budget. Taking actions to improve performance and control expenditures. Strengthen and expand existing home and community based service delivery systems. Provide integrated case management services to high need/high cost individuals served by the Department. Managing and measuring for results. Preserving services for the most vulnerable. Washington State Department of Social & Health Services

  4. 2011-13 Biennial Budget Highlights • Policy level reductions total $621 million GF-State for the 2011-13 Biennium. • FTE appropriation is reduced by 651.9 for the 2011-13 Biennium. Washington State Department of Social & Health Services

  5. Key Additions • Community investments in Developmental Disabilities - $10 million GF-State • Expanded participation in evidence-based programs by the Juvenile Rehabilitation Administration - $1 million GF-State • Additional resources are provided for fraud investigations through the Performance Audits of Government Account-State - $900,000 • Vulnerable Adults/Adult Family Home Quality Assurance - $1.5 million total funds Washington State Department of Social & Health Services

  6. Department of Social andHealth Services 2011-13 Biennial Budget Details by Program Includes: 2ESHB 1087 Excludes: Medicaid Purchasing Administration

  7. Agency Wide Reduction2011-13 Biennial Budget • Medical Purchasing Administration : ($4,395)m GF-State, ($5,977)m Other Funds, (803.6) FTEs The Medical Purchasing Administration and all responsibilities related to the administration of the Medicaid program are transferred to and become part of the Health Care Authority (HCA). Several responsibilities that had been shared between programs/divisions of DSHS will continue to be shared between the Health Care Authority and DSHS. These programs including Long Term Care, Developmental Disabilities, Alcohol and Substance Abuse, and Mental Health will remain with DSHS. • 3% State Employees Pay Cut: ($41.0) m GF-State, ($15.4)m Other Funding is reduced for employee salaries by 3 percent, excluding employees earning less than $2,500 per month. Washington State Department of Social & Health Services

  8. Agency Wide Reduction2011-13 Biennial Budget • Suspend Plan 1 Uniform Cost of Living Adjustment (COLA): ($23.3)m GF-State, ($8.6)m Other Future automatic benefit increases in the Public Employees' Retirement System Plan 1 are stopped. The basic minimum benefit amount is not affected, and the alternative minimum benefit is raised to $1,500 per month. • Management Efficiency and Administrative Reductions: ($18.3)m GF-State, ($4.1)m Other Funding to the Agency is reduced to reflect management and administrative reforms. This represents a 7-10 percent reduction for programs over the biennia. • Workers Comp Changes: $7.1m GF-State, $3.1m Other Medical Aid and Industrial Insurance rates increased. Funding for these increased workers compensation costs was provided. Washington State Department of Social & Health Services

  9. Children’s Administration2011-13 Biennial Budget • Reduce Regional Staffing: ($6.4)m GF-State, ($10.2)m Other The Children's Administration (CA) will reduce 244.0 FTE to achieve savings. This reduction is a continuation from the 2011 Supplemental Budget. • Medicaid Treatment Child Care (MTCC): ($5.0)m GF-State, ($4.3)m Other Through agreement funding for MTCC is transferred from the CA to the Department of Early Learning. MTCC provides intensive child development services to young children. This reduction is a continuation from the 2011 Supplemental Budget. No impact to clients – program transferred to DEL. • Private Agency Fees: ($2.7)m GF-State, ($0.5)m Other The fees paid to private agencies are reduced. The CA contracts with private agencies for services for family foster homes, including case management and intensive case management fees for each child placed in a privately licensed foster home. Each fee includes foster parent recruitment, support, monitoring and certification. Washington State Department of Social & Health Services

  10. Juvenile Rehabilitation Administration2011-13 Biennial Budget • Reduce Parole Services: ($3.7)m GF-State Funding is reduced for parole services by reducing rates paid for diagnostic services and amounts budgeted for client services. This reduction is a continuation from the 2011 Supplemental Budget. Youth will receive services at a reduced level of frequency. • Close Maple Lane School: ($3.3)m GF-State Maple Lane School in Rochester will close at the end of Fiscal Year 2011. These savings occur as a result of the closure. 184 Beds are reduced due to caseload, minimum early release, and transfers to Green Hill School and Echo Glen Children’s Center . • Reduce Juvenile Rehabilitation Administration (JRA) Institution Costs: ($4.6)m GF-State The JRA will make reductions at the state-run institutions. Washington State Department of Social & Health Services

  11. Mental Health2011-13 Biennial Budget • Close Western State Hospital (WSH) Ward: ($6.6)m GF-State The number of patients who can receive treatment at WSH under the state's civil commitment laws was reduced in October 2010, by closing a hospital ward. This reduction is a continuation from the 2011 Supplemental Budget. Bed capacity will be reduced by 30. • Reduce Regional Support Network (RSN): ($8.7)m GF-State Community mental health allocations for persons and services not eligible for federal Medicaid matching funds are reduced by 3.5 percent. RSNs will prioritize between crisis response, involuntary commitment, emergency hospitalization, and residential support services. This reduction is a continuation from the 2011 Supplemental Budget. 26,000 clients could receive fewer non-crisis services. • RSN Medicaid Rates: ($8.7)m GF-State, ($8.7)m Other RSN Medicaid capitation rates are reduced 3 percent, or to the bottom of the federally-allowable rate range, reducing state and federal funds for community mental health services by an average of 2.3 percent. Washington State Department of Social & Health Services

  12. Alcohol & Substance Abuse and Vocational Rehabilitation2011-13 Biennial Budget • Reduce Chemical Dependency Services: ($7.1)m GF-State Outpatient and residential services for low income individuals who do not qualify for other state programs, non-federally matched services for individuals on Medicaid or receiving medical care through the 1115 waiver, and the associated state and county administration is reduced by approximately 11 percent. This reduction is a continuation from the 2011 Supplemental Budget. Approximately 1,443 clients a year needing chemical dependency treatment services may not be served. • Basic Support Grant : ($2.5)m GF-State, ($9.2)m Other Across-the-board reductions are made to the Division of Vocational Rehabilitation (DVR), reducing GF-State expenditures while still meeting the Federal Maintenance of Effort (MOE) requirements. This reduction is a continuation from the 2011 Supplemental Budget. The opportunity to provide employment services to approximately 3,000 individuals with barriers to employment will not be realized. Washington State Department of Social & Health Services

  13. Developmental Disabilities2011-13 Biennial Budget • Provide Community Placements: $5.6m GF-State, $5.4m Other • Funding is provided for out-of-home community residential placements for 58 individuals with developmental disabilities. These clients have been identified as aging out of foster care, ready for discharge from juvenile rehabilitation and mental health institutions, or ready for release from the Department of Corrections. • Individuals will receive services in a community setting. • Reduce Personal Care Hours: ($14.4)m GF-State, ($14.4)m Other • Personal care provides assistance with activities of daily living to individuals who meet functional and financial eligibility. Clients personal care services hours will be reduced 6 to 18 percent depending on acuity. This reduction is a continuation of the 2011 Supplemental Budget. • 43,000 persons with disabilities or long term care needs will receive a reduced level of personal care hours each month. • Delay Mandatory Training: ($13.2)m GF-State, ($10.7)m Other • Mandatory increases and enhancements to training, new certification requirements, and federal fingerprint background checks for long term care workers are delayed until the 2013-15 Biennium. This reduction is a continuation from the 2011 Supplemental Budget. • Providers will not receive additional fund to provide expanded in-home training. Washington State Department of Social & Health Services

  14. Developmental Disabilities2011-13 Biennial Budget Continued… • Modifications to Employment and Day Services : ($2.9)m GF-State Several changes are made to employment and day services for clients with developmental disabilities and the adult working policy will be reformed. Clients currently receiving adult day health services may continue to do so by moving to a long term care waiver program or may choose to receive employment or community access services through a developmental disability waiver program. Washington State Department of Social & Health Services

  15. Long Term Care2011-13 Biennial Budget • Nursing Home (NH) Quality Incentive Payments: ($3.2)m GF-State, $172.8m Other NHs will be required to pay a Skilled Nursing Facility Safety Net Assessment. These funds will be used to leverage federal Medicaid matching funds that will be used to increase rates to most providers. 166 NHs will be assessed a per bed fee. • Reduce Personal Care Hours: ($73.9)m GF-State, ($73.9)m Other Personal care provides assistance with activities of daily living to individuals who meet functional and financial eligibility. Clients personal care services hours will be reduced an average of 10 percent. Clients with lower need levels will have a larger proportional reduction than those with higher needs. 43,000 persons with disabilities or long term care needs will receive a reduced level of personal care hours each month. • Delay Mandatory Training: ($14.1)m GF-State, ($11.0)m Other Mandatory increases and enhancements to training, new certification requirements, and federal fingerprint background checks for long term care workers are delayed until the 2013-15 Biennium. This reduction is a continuation from the 2011 Supplemental Budget. Providers will not receive additional funds to provide expanded in-home training. Washington State Department of Social & Health Services

  16. Long Term Care2011-13 Biennial Budget Continued… • Modifications to Employment and Day Services : ($8.6)m GF-State Several changes are made to employment and day services for clients with developmental disabilities and the adult working policy will be reformed. Clients currently receiving adult day health services may continue to do so by moving to a long term care waiver program or may choose to receive employment or community access services through a developmental disability waiver program. Washington State Department of Social & Health Services

  17. Economic Services Administration2011-13 Biennial Budget • Eliminate Child Support Pass Through: ($18.8)m GF-State, ($18.8)m Other Funding is reduced to reflect the suspension of the child support pass through which was authorized under the federal Deficit Reduction Act of 2005. This reduction is a continuation from the 2011 Supplemental Budget. Approximately 14,000 TANF families will not receive an average of $114 in child support pass-through payments each month. • Reduce Disability Lifeline (DL) Grant: ($100.3)m GF-State The budget continues the reductions made in Fiscal Year 2011 to DL cash grants. In Fiscal Year 11, the monthly cash grant for all DL recipients was reduced by 42 percent. About 36,000 persons receive a DL cash grant each month. • Disability Lifeline (DL): ($79.5)m GF-State Engrossed Substitute House Bill 2082 ends the DL program effective October 31, 2011, and creates three new programs effective November 1, 2011: (1) Aged, Blind or Disabled Assistance, (2) Pregnant Women Assistance, and (3) Essential Needs and Housing Support. About 19,000 persons will lose their DL-U cash grant but will continue to receive medical assistance. Washington State Department of Social & Health Services

  18. Economic Services Administration2011-13 Biennial Budget Continued… • State Food Assistance: ($30.3)m GF-State Funding is reduced to reflect a reduction in benefit amounts for clients eligible for the State Food Assistance Program. The current implementation timeline is not yet determined due to a preliminary injunction in federal court. About 14,000 people in 10,000 households may receive less food assistance if the injunction is lifted. • WorkFirst Changes ESSB 5921 addresses reforms and changes to Washington’s Temporary Assistance for Needy Families program. These changes and further development of WorkFirst Redesign recommendations will be realized within the framework of the program’s core assumptions, in balance with current and future fiscal realities and constraints. Eligible families and children will receive benefits and services enabling them to be on a pathway out of poverty. • Naturalization and Refugee and Immigrant Services: ($7.3)m GF-State Funding is reduced for the Naturalization Program and for Refugee Employment Services. In State Fiscal year 2010, about 345 people each month received Naturalization Services. About 3,000 low-income refugees and immigrants received Refugee Employment Services each month. Washington State Department of Social & Health Services

  19. Special Commitment Center2011-13 Biennial Budget • Reduce Administrative Staff: ($3.3)m GF-State Funding is reduced for administrative staffing positions at the Special Commitment Center. (SCC). • Fund McNeil Island Operations: $6.1m GF-State McNeil Island Corrections Center closed April 1, 2011. The funding necessary for marine and island operations is transferred from the Department of Corrections to the Department of Social and Health Services. This is a continuation from the 2011 Supplemental Budget. • Reduce Secure Community Transitional Facilities (SCTF) Staffing Ratios: ($3.8)m GF-State Legislation reduced staffing levels for the SCTF in Pierce and King Counties. This reduction is a continuation from the 2011 Supplemental Budget. Washington State Department of Social & Health Services

  20. Administration and Supporting Services &Payments to Other Agencies 2011-13 Biennial Budget • Eliminate Family Policy Council: ($2.8)m GF-State • Eliminate Council for Children and Families: ($2.1)m GF-State, ($0.4)m Other Second Substitute House Bill 1965 (adverse experiences/children) eliminates the Family Policy Council and the Council for Children and Families effective July 1, 2012, and creates a new public-private partnership aimed at reducing adverse childhood experiences. • Interagency Charges - AG: $2.9m GF-State, $1.2m Other Funding levels reflect anticipated changes in billings for services provided by the Office of the Attorney General. Washington State Department of Social & Health Services

  21. Questions, Comments and Suggestions • Questions on Budget • Implementation Issues or Suggestions • Ideas for the Agency’s 2012 Supplemental Budget Request • Other questions, comments or suggestions Washington State Department of Social & Health Services

  22. Shared Leadership & Responsibility • Continue helping people transform their lives, decreasing poverty, increasing health status and educational and employment success . • State government shares responsibility for the work of social services with communities and with partners like you. • We must work together to leverage resources and opportunities • Not just reducing; but resetting for the future Washington State Department of Social & Health Services

  23. Shared Leadership & Responsibility • Emerging from difficult economic times better positioned to succeed. • We will work with you to help free up resources. • History will judge our leadership, creativity and ability to envision a different future. • Thank for all you do each day to serve and represent our citizens who depend on us. Washington State Department of Social & Health Services

  24. Further Information This presentation is available on our website: http://www.dshs.wa.gov/ppt/ea/BiennialBudget.pptx Other legislation information can be found at: DSHS.wa.gov Click on: “DSHS legislative highlights” And on the Legislative Evaluation & Accountability Program Committee’s website: http://leap.leg.wa.gov/leap/Budget/Detail/2011/SOAgencyDetail0524.pdf Washington State Department of Social & Health Services

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