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Program 030

DSHS - Mental Health

Recommendation Summary

Dollars in Thousands

																								FY 97 FTEs											General Fund-State					Other Funds			Total Funds
1995-97 Expenditure Authority																						2,694.6												448,668					423,020			871,688
Supplemental Changes
ACES Cost Recovery																																		6					6			12
Federal Funds for PHP Payments																																							41,720			41,720
Community Inpatient Savings																																		(9,300)					(9,600)			(18,900)
Medicare Cross-over Payments																																		2,474					2,526			5,000
Maintain Hospital Certification																						5.7												163					157			320
Hospital Settlements																																		4,443					(4,443)
Special Commitment Center																						13.5												862								862
Subtotal - Supplemental Changes																						19.2												(1,352)					30,366			29,014
Total Proposed Budget																						2,713.8												447,316					453,386			900,702
Difference																						19.2												(1,352)					30,366			29,014
Percent Change from Current Biennium																						.7%												(.3)%					7.2%			3.3%

Supplemental Changes

ACES Cost Recovery
This item funds additional Automated Client Eligibility System (ACES) costs associated with system operation and additional contractor and state staff required to reduce problem and change request response times. The original projections in the Advanced Planning Document (APD) did not adequately maintain ACES during the conversion period. (General Fund-State, General Fund-Federal)
Federal Funds for PHP Payments
As the Mental Health Division transitioned community outpatient services into Prepaid Health Plans, more expenditures became eligible for federal match. Under fee-for-service, only specific categories of services were matched, whereas under managed care the entire monthly premium for each Medicaid eligible is matched. This step corrects federal appropriation authority to reflect this higher federal participation. (General Fund-Federal)
Community Inpatient Savings
This step reflects lower projected expenditures for community inpatient mental health services based on adjusted Medicaid Management Information System payment information. (General Fund-State, General Fund-Federal)
Medicare Cross-over Payments
Until January 1996, persons eligible for both Medicaid and Medicare were paid at 20 percent of the Medicare allowable amount, up to the Medicaid allowable amount. In 1996 a federal court determined that the department was out of compliance with federal law in its methodology for calculating crossover payments, and ruled that payments should be made at 50 percent of the Medicare amount, regardless of Medicaid limits. These payments will be made by the state directly to service providers. (General Fund-State, General Fund-Federal)
Maintain Hospital Certification
This step funds additional staff at Eastern State Hospital and the Child Study and Treatment Center (CSTC) in order to maintain federal certification and hospital accreditation. An additional 2.6 FTE staff are provided to Eastern State to correct deficiencies in recreation and occupational therapy services. An additional 3.1 FTE staff at CSTC are for a psychologist, plus clerical staff to ensure that direct care staff have necessary clerical support, and are not performing those functions at the expense of their direct care duties. (General Fund-State, General Fund-Federal, General Fund-Local)
Hospital Settlements
This step makes two adjustments. First, it corrects an assumption that a one-time settlement of $4.4 million in the 1993-95 Biennium would occur again in 1995-97. This level of federal funding cannot be earned and state funding is required to offset the federal shortfall. The second adjustment corrects for a decrease in Medicare collections at the state hospitals. Medicare payments are appropriated as local funds. (General Fund-State, General Fund-Local)
Special Commitment Center
Funding is provided for larger-than-projected population at the Special Commitment Center in Monroe. Current funding is for 36 residents, with a projected total of 50 by the end of the biennium. This step also funds one conditional release (or Less Restrictive Alternative) community placement beginning January 1997.