Appropriation and Revenue Source FED PR FED PR
Centers for the Developmentally Disabled
(medical assistance) $0 $25,000 $0 $90,000
Mental Health Institutes
(county funds, MA and other third-party payers) 0 50,000 0 160,000
MA contracts administration
(federal MA matching funds) 637,200 0 2,533,300 0
Health care information
(assessments to health care providers) 0 17,500 0 52,600
Health facilities plan review
(nursing home and hospital plan review fees) 0 28,800 0 94,300
MA administration
(federal MA matching funds) 25,900 0 90,800 0
MA survey and certification operations
(federal MA matching funds) 28,800 0 94,300 0
DHFS information systems
(PR-S funds transferred from other DHFS programs) 0 184,300 0 620,100
Income augmentation services
(Title IV-E funds) 238,300 0 935,200 0
Total $930,200 $305,600 $3,653,600 $1,017,000
7. DELETE VACANT POSITIONS
Funding Positions
GPR - $273,200 - 1.22
FED - 57,400 - 1.00
PR - 85,000 - 0.58
Total - $415,600 - 2.80
Governor: Reduce funding by $207,800 ($136,600 GPR, $28,700 FED and $42,500 PR) annually and delete 2.80 positions (1.22 GPR positions, 1.00 FED position and 0.58 PR position) beginning in 1999-00. These positions have been vacant for more than 15 months.
8. PARTNERSHIP PROGRAM POSITIONS
Funding Positions
GPR $225,500 2.00
FED 225,500 2.00
PR - $38,500 0.00
Total $412,500 4.00
Governor: Provide $96,500 GPR, $96,500 FED and -$34,300 PR in 1999-00 and $129,000 GPR, $129,000 FED and -$4,200 PR in 2000-01 to support 2.0 GPR two-year project positions and 2.0 FED two-year project positions, beginning in 1999-00, which will no longer be funded from a Robert Wood Johnson grant after September 1, 1999. These project positions, which would terminate on September 1, 2001, would be funded with MA administration funds on a 50% GPR/50% FED basis. The four positions currently administer the partnership program, a managed care program that integrates all acute, primary and long-term care services for persons with significant and chronic illness or disability. These positions would continue to monitor contracts, implement fully capitated MA/Medicare service contracts and collect cost and utilization data. In addition, the bill would transfer support for these positions from the Division of Supportive Living to the DHFS Office of Strategic Finance.
9. FEDERAL REVENUE REESTIMATES
FED $2,799,800
Governor: Provide $962,700 in 1999-00 and $1,837,100 in 2000-01 to reflect reestimates of the amount of federal funding that will be available to support selected federally-funded state operations, aids and local assistance program in the next biennium. This item includes: (a) $138,600 in 1999-00 and $191,200 in 2000-01 for MA administration; (b) -$79,100 in 1999-00 and $768,300 in 2000-01 for federal projects operations; (c) -$124,300 in 1999-00 and -$370,700 in 2000-01 for local assistance programs administered by the Division of Children and Family Services; (d) $105,600 in 1999-00 and $104,700 in 2000-01 for state foster care and adoption assistance operations; (e) $296,700 in 2000-01 for disability determinations operations; (f) $850,900 annually for community mental health block grant assistance to counties; (g) $75,000 in 1999-00 from Title IV-E income augmentation revenues to support a fatherhood initiative administered by DWD; and (h) -$4,000 annually from the social services block grant for the displaced homemakers program.
10. PROGRAM REVENUE REESTIMATES
Funding Positions
PR - $28,076,900 - 0.50
Governor: Reduce funding by $13,091,900 in 1999-00 and $14,985,000 in 2000-01 and delete 0.50 position, beginning in 2000-01, to reflect reestimates of program revenue required to support certain programs administered by DHFS. The following table identifies the components of this item.
1999-00 2000-01
Funding Positions Funding Positions
Radiation Protection $0 0.00 -$16,500 -0.50
Care and Treatment Facilities -- Activity Therapy 55,000 0.00 55,000 0.00
Care and Treatment Facilities -- Gifts and Grants 50,000 0.00 50,000 0.00
Care and Treatment Facilities -- Institutional Services 143,000 0.00 143,000 0.00
Health Facilities Review Fees -63,500 0.00 -63,500 0.00
Nursing Facility Resident Protection 150,000 0.00 150,000 0.00
Severely Emotionally Disturbed Children -5,043,600 0.00 -5,043,600 0.00
SSI Caretaker Supplement -9,235,100 0.00 -10,590,100 0.00
Administration and Support -47,700 0.00 -69,300 0.00
DHFS Information Systems 900,000 0.00 400,000 0.00
Total -$13,091,900 0.00 - $14,985,000 -0.50
Several of the most significant items are described below.
Caretaker Supplement. Reduce funding by $9,235,100 in 1999-00 and $10,590,100 in 2000-01 to reflect reestimates of the amount of TANF funding transferred from DWD that will be required to support SSI caretaker supplement payments in the 1999-01 biennium, based on the current $100 per child per month benefit level. DHFS provides SSI recipients with dependent children a caretaker supplement payment to support the costs of care for these children. DHFS base funding for these payments ($13,472,400) was provided in 1998-99 under the assumption that the supplement would be supported entirely with TANF funds. However, the federal Social Security Administration has permitted the state to partially support SSI caretaker supplement payments with GPR funds budgeted for the state SSI supplement and count these GPR funds in meeting the state's maintenance-of-effort requirement. Consequently, base TANF funding can be deleted to reflect the availability of these GPR funds.
Services for Emotionally Disturbed Children. Reduce funding by $5,043,600 annually to reflect a reestimate of the amount of funding that would be transferred from the MA benefits appropriation to the Division of Supportive Living (DSL) to fund community-based mental health services for children with severe emotional disturbances. This item reflects that service providers in Milwaukee County now receive capitated payments directly from the MA benefits appropriation, rather than MA funds transferred to DSL. Under the bill, $1,242,300 would be budgeted annually to fund services for children in other counties that wish to participate in the program.
DHFS Information Systems. Increase funding by $900,000 in 1999-00 and $900,000 in 2000-01 to reflect: (a) an increase in the amount of funding transferred to the Division of Management and Technology (DMT) from other divisions to support information technology services purchased by DMT ($2,500,000 annually); and (b) a decrease in funding to support services for DMT (-$1,600,000 in 1999-00 and -$2,100,000 in 2000-01).
Nursing Home Quality Improvement. Provide $150,000 annually for the Bureau of Quality Assurance to fund grants of up to $1,500 each for projects that proactively protect the health or property of nursing home residents and for DHFS to monitor or operate facilities in the event of a closure or termination. Funding would be provided from revenue DHFS receives from civil monetary penalties against federally certified nursing homes for violations of federal quality standards.
11. EXTEND AND CONVERT PROJECT POSITIONS
Funding Positions
GPR $120,700 1.29
FED 42,900 0.50
PR 20,600 0.21
Total $184,200 2.00
Governor: Provide $86,000 ($57,300 GPR, $18,400 FED and $10,300 PR) in 1999-00 and $98,200 ($63,400 GPR, $24,500 FED and $10,300 PR) in 2000-01 to extend 1.0 project position and convert 1.0 project position to permanent status. First, extend the termination date for 1.0 project accountant position from June 30, 1999 to June 30, 2001. This position, which is supported on a 79% GPR/21% PR basis, would continue to work on financial matters relating to administering the child welfare system in Milwaukee County. Second, convert 1.0 program and planning analyst position which is scheduled to terminate on October 1, 1999, to a permanent position. This position, which is supported on a 50% GPR/50% FED basis, would continue to assist school districts in claiming MA funds.
12. POSITION CONVERSION AND BILLING AND COLLECTIONS TRAINING
Funding Positions
GPR - $43,000 - 1.00
PR 104,000 1.00
Total $61,000 0.00
Governor: Delete $21,500 GPR and provide $52,000 PR annually and convert 1.0 GPR position to 1.0 PR position, beginning in 1999-00 to: (a) reflect the availability of federal MA matching funds to support a position that is currently supported entirely with GPR; and (b) support training for third-party collection activities.
Position Conversion. Delete $31,900 GPR and provide $52,000 PR annually to convert 1.0 financial specialist position from GPR to PR, beginning in 1999-00. This item reflects that $20,100 GPR would be retained in the DHFS budget as the state match for federal MA funds to support the position.
Billing and Collections Training. Provide $10,400 GPR annually to fund training for staff in the billing and collections unit. These staff collect and report third-party liability information from a variety of sources (MA, Medicare, counties and private insurance) for DCTF facilities.
13. APPROPRIATION AND POSITION RESTRUCTURING
Funding Positions
GPR $0 3.15
FED 4,400 5.25
PR - 2,192,600 - 7.28
Total - $2,188,200 1.12
Governor: Modify funding by -$1,094,100 ($2,200 FED and -$1,096,300 PR) annually and provide 1.12 positions (3.15 GPR positions, 5.25 FED positions and -7.28 PR positions) beginning in 1999-00, to reflect: (a) the recent creation of the Division of Health Care Financing from the former Division of Health, which has been renamed the Division of Public Health; (b) appropriation consolidation; and (c) corrections to transfers of positions and funding in 1997 Wisconsin Act 27. The fiscal effect of these changes by DHFS program is identified in the following table.
1999-00
GPR FED PR SEG
Program Funding Positions Funding Positions Funding Positions Funding Positions
Public Health - state operations -$22,826,400 -118.17 -$48,058,200 -366.75 -$6,152,700 -66.14 -$102,700 -1.50
Public Health - aids and local assistance -950,150,700 0.00 -1,686,254,300 0.00 -14,502,700 0.00 0 0.00
Care and Treatment Facilities -21,600 -0.30 0 0.00 0 -0.70 0 0.00
Children and Family Services 755,300 -2.00 -82,200 -0.72 -14,800 0.22 0 0.00
