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Program 080

DSHS - Medical Assistance Payments

Recommendation Summary

Dollars in Thousands

																								FY 97 FTEs											General Fund-State					Other Funds			Total Funds
1995-97 Expenditure Authority																						755.3												1,327,503					2,181,120			3,508,623
Supplemental Changes
ACES Cost Recovery																																		463					428			891
GA-U for New Aliens																																		3					(76)			(73)
DDDS Workload																						13.6																	196			196
SSI Drug Addiction & Alcohol																																		(417)					(1,792)			(2,209)
Forecast Change																																		5,939					(28,154)			(22,215)
Increase Admin FFP-Other Entities																																							24,000			24,000
Medicare Limit for Dual Eligibles																																		3,086					4,509			7,595
Protease Inhibitors																																		2,418					2,788			5,206
Subtotal - Supplemental Changes																						13.6												11,492					1,899			13,391
Total Proposed Budget																						768.9												1,338,995					2,183,019			3,522,014
Difference																						13.6												11,492					1,899			13,391
Percent Change from Current Biennium																						1.8%												.9%					.1%			.4%

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)
GA-U for New Aliens
Under the Federal Personal Responsibility and Work Opportunity Act of 1996, newly arriving aliens (after August 22, 1996) will not be eligible for SSI (Supplemental Security Income). It is estimated that approximately 10 persons per month will no longer be eligible for SSI; 10 percent of these will be children served under the state only under 18 program and the rest will receive GA-U medical assistance. (General Fund-State, General Fund-Federal)
DDDS Workload
The Division of Disability Determination Services (DDS) is responsible for determining medical eligibility for Social Security Disability Insurance and Supplemental Security Income benefits under the Social Security Disability Program. Due to recent federal changes in law, DDS is required to process a significant increase in caseload for Drug Abuse and Alcoholism, Continuing Disability reviews and children's cases. The Social Security Administration funds these costs. (General Fund-Federal)
SSI Drug Addiction & Alcohol
Federal legislation has reduced eligibility for federal disability benefits for those with drug addiction and alcoholism. For Fiscal Year 1997 there will be a net decrease of 134 Medical Assistance eligibles as a result of this federal action. (General Fund-State, General Fund-Federal)
Forecast Change
This step represents other changes in Medical Assistance based on the November 1996 forecast. Changes include increased General Fund-State due to increases in General Assistance and ADATSA caseload, increased per capitas in the Medically Indigent program and increased Medicare premium payments. General Fund-Local has increased because of the ability to earn more funding through the Intergovernmental Transfers program. Other funds (Health Services Account and Federal) are decreased because of underexpenditures in dental services for children, Refugee Assistance and Family Planning. (General Fund-State, General Fund-Federal, General Fund-Local, Health Services Account-State)
Increase Admin FFP-Other Entities
This step represents the additional federal Title XIX dollars being earned by other entities. These entities use their own funds to meet the matching requirements. Most of these earnings are from Seattle/King County Health Department. (General Fund-Federal)
Medicare Limit for Dual Eligibles
In January 1996, a group of providers successfully sued to require the DSHS Medical Assistance Administration to pay the higher Medicare reimbursement for clients who are eligible for both Medicaid and Medicare. This provision was effective immediately and impacted bills that were paid for services which were rendered in the fall of 1995. (General Fund-State, General Fund-Federal)
Protease Inhibitors
A new class of drugs, protease inhibitors, has become available for treatment of HIV clients. The Federal Health Care Financing Administration has directed that Medicaid programs must cover the costs of these drugs. This step shows the additional cost of including protease inhibitors in drug therapy where appropriate. (General Fund-State, General Fund-Federal)