April 3, 2013- Backgrounders and Health and Human Services

 Backgrounder Materials

 Below you will find links to budget backgrounders on a number of issues.

Health and Human Services Budget Background

Impact of Tax Relief Programs in the Governor’s Biennial Budget

Revenue Sharing and the Governor’s 2014-2015 Budget

Education funding in the Governor’s Budget

 Public Hearing

The Appropriations Committee, in conjunction with the Health and Human Services Committee, held a public hearing, today in regard to

Substance Abuse program

  • Adult Mental Health programs
  • Medical Payments to Providers [Medicaid]
  • Administrative programs and entities within DHHS

 Major Issues

 Federal Medical Assistance Match Rate.   The Federal Medical Assistance Match Rate drops from 62.57% to 61.55% on October 1, 2013.   For every 1% drop in the federal match rate, the state loses $12 million over a 12 month period.  The total loss of federal funds in the 2014-2015 Biennium is $40 million.

Office of Substance Abuse.    The Administration has adopted a policy that bases reimbursement for services based on performance-based contracting and measures of successful outcomes.  With respect to crisis services that attempt to divert substance abuse clients from hospital emergency rooms and from jail, the Administration proposed dramatic cuts in these services in the FY 2013 Supplemental Budget.   These cuts would have resulted in more substance abusers using the emergency rooms and ending up in jail.   Crisis services, as the name of the program implies, deals with clients with the most difficult problems, and outcomes cannot always avoid emergency rooms and jails.

Penalty Payments to Federal Government.   The Governor’s budget provides within the Medical Care Payments to Providers account, penalty payments amounting to $12,730,519 to the federal government.   These payments are the result of federal government single-audit findings and penalties incurred as a result of negative balance funds existing prior to FY 2012.

Increased MaineCare cycle payments.   The governor’s budget provides an additional $103.5 million in FY 2014 and $130.6 million in FY 2015 for increased Medicaid cycle payments.   The Budget  cites increased program growth and utilization as the reasons for increasing funding over the Biennium.

Fund for A Healthy Maine.    Prior to this budget, there was no official Fund for a Healthy Maine [FHM].   Funding for programs unofficially part of the FHM were actually “Other Special Revenues” in which unofficial FHM programs were comingled.   The Office of Fiscal and Program Review established a distinct and special account number to the several Other Special Revenue Accounts that composed the unofficial FHM, in order to track the funding and expenditures related to the FHM.

This budget Funds the new, distinct, and official Fund for A Healthy Maine at $18,175,419 in each year of the 2014-2015 Biennium.   This budget also provides $5.4 million of additional funding for the Fund for a Healthy Maine Medical Care Services account.   The funding requirements in the related General Fund account are reduced.

Portland Dental Clinic.    The Governor’s budget eliminates funding for the Portland Dental Clinic which is operated by Riverview Psychiatric Center that provides dental services to nearly all patients statewide with serious mental illness and behavioral issues.    In many cases, the patients require sedation and cannot be approached to begin treatment until sedated.    The elimination of funding for the dental clinic will essentially eliminate all dental treatment for this population.

Traumatic Brain Injury Seed money.   The Governor’s bill provides $121,280 each year of the biennium to be matched with federal fund to support a six (6) bed PNMI in Northern Maine for persons with brain injuries resulting in significant impairments.   The intent is to allow brain-injured persons currently in out-of-state programs to return to Maine.   The seed money is roughly $5,000 more each year than appropriated each year in FY 2011 and FY 2012.

Infant Mental health Program.   The Infant Mental Health Program is eliminated by the budget effective July 1, 2013, and the funding is transferred from Community Medicaid Mental Health Services to provide family support services involved with the child welfare system.

Health and Human Services

Budget documents for the HHS committee may be here.

Commissioner Mayhew joined both the HHS and AFA committees to present testimony on more than 30 programs and items.

The Commissioner noted that a change package will be brought forward to revise certain initiatives.  Among those revisions will be a different approach to the planned elimination of the Portland dental clinic that provides dental services under IV sedation to individuals with developmental difficulties.

The Governor’s budget requests $2.0M to address needs identified under the AMHI Consent Decree (You can find a discussion of the AMHI Consent Decree here.)  The Department is bound by the Consent Decree to request the full $11.0M it determines is necessary to finally meet the terms of the agreement as informed by the judgment of the Court Master, former Chief Justice Daniel Wathen.

 

Members of the public presented testimony in opposition to the Governor’s proposed cuts.

 

Public Testimony- April 3, 2013

Schedule

On Thursday, April 4, 2013 1:00 PM the Appropriations committee will again be joined by the HHS committee.  This time testimony will center on the portions of the Governor’s budget related to services for elderly and dually eligible individuals.

The full schedule may be found here.

Audio and more

Please feel free to join the committee as they do their work. You may also listen online using the following link: http://www.maine.gov/legis/ofpr/appropriations_committee/audio/index.htm

You also may watch broadcasts of these and other committee hearings on the Maine Capitol Connection pilot channel through Maine Public Broadcasting.  You may watch over the air or through your cable provider as well as online here: http://www.mpbn.net/News/MaineCapitolConnection.aspx

Thank you and please let me know if you have questions.

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