Department of Health

The enacted budget (May 16, 2002) makes the following changes to the Executive Budget:

·        Increases State Operations funding by $57,000, reflecting an increase in nonpersonal services in the Special Revenue/Other Occupational Health Clinics Account in the Center for Environmental Health Program.

·        Provides a $4 million Aid to Localities appropriation in the Office of Continuing Care for an adult care facility quality incentive payment program.

·        There were no additional funds in the Health Care Standards and Surveillance program to restore the 11 nursing home surveillance positions eliminated in the proposed budget.

The 30-day amendments to the Executive Budget recommend (analysis as of February 25, 2002):

·        An increase in the Center for Community Health Program of $500,000 in the Special Revenue-Federal  Health and Human Services Fund-265, to reflect a Federal appropriation for rape prevention.

·        An increase in the Institutional Management Program of $4.5 million in a maintenance undistributed appropriation for Helen Hayes Hospital to allow the institution to spend projected excess 2001-02 revenues in 2002-03.

·        Elimination of a $1.8 million Special Revenue-Other offset appropriation in the separate Maintenance Undistributed section of the budget which  has been eliminated because a proposed increase in Triplicate Prescription Forms fees has been withdrawn.  The appropriation for the Triplicate Prescription Forms program in the Health Care Standards program is unchanged.

·        An increase of $1.5 million in the Office of Medicaid Management Program for the Special Revenue Funds-Other appropriation for the HCRA Transfer Fund Medical Assistance Account to support additional Family Health Plus facilitated enrollment contract costs.

The Executive Budget recommends (analysis as of January 24, 2002):

·        A net decrease of 148 FTEs, 50 of which will occur in SFY 2002-03.  The SFY 2002-03 reduction reflects a decrease of 174 FTEs offset by an increase of 124 FTEs.  Net changes by program include: Administration and Executive Direction program (-14); AIDS Institute (-24); Child Health Insurance Program (-1);  Community Health Program (-2); Office of Continuing Care (-7); Environmental Health Program (-17); Health Care Financing Program (-2); Health Care Standards and Surveillance Program (-11); Institutional Management Program (+36); Laboratories and Research Program (+16) ; Managed Care (-7); Medicaid Audit and Fraud Prevention (-9); and  Office of Medicaid Management (-8).

·        Shifting several positions from general fund support to special revenue-other funds including:  28 FTEs in the EPIC program, funding for which was moved off-budget by the Health Care Reform Act (HCRA) passed on 1/15/02; 9 FTEs in the Health Care Financing program; and 32 FTEs in the Health Care Standards and Surveillance program.

·        Language in both the Deficiency Budget and the Executive Budget which would allow transfer of  the State Operations appropriation for Medicaid  ($3.6 billion in SFY 2002-03) to other agencies or other appropriations within DOH.  This is very broad transfer authority, and does not specifically restrict such transfers to State Operations.  PEF suspects this language may be related to the recent passage of Health Care Reform Act (HCRA) legislation.

·        An agency-wide decrease of $7.9 million (-3.9%) in General Fund appropriations.

·        An increase of $5 million (81%) in nonpersonal services in the Administration program, which is for the contractual services.  The budget does not specify the purpose of this increase.

·        A $3 million maintenance undistributed appropriation in the Administration program for a time and activity system.

·        Significant changes (+/-$1 million or more) in the following Special Revenue-Federal appropriations:  

-         Administration program:  (-$3.4 million) Federal  Food and Nutritional Services Account .

-         Center for Community Health program:  (+$1.6 million) Child & Adult Care Food Account; (+$4 million) Federal Food and Nutritional Services Account; (+$1.9 million) Health and Human Services Fund 269; (-$6.3 million) Health and Human Services Fund 265; (-$2.5 million) Individuals with Disabilities Part C Account.

-         Child Health Insurance:  (-$1.9 million) Children’s Health Insurance Account.

-         Office of Medicaid Management: (+$492.5 million) Health and Human Services Fund.

-         Medicaid Audit and Fraud Prevention:  (+$1.6 million) Health and Human Services Fund.

·        Significant changes (+/-$2 million or more) in the following Special Revenue-Other appropriations:

-         AIDS Institute:  elimination of $2.1 million in Special Revenue-Other funding for the Maternal and Child HIV Services Account.

-         Environmental Health:  (+$1.7 million Drinking Water Program Management and Administration.

-         EPIC:  $15.4 million transferred from General Funds.

-         Health Care Standards and Surveillance:  (+$3.3 million) Certificate of Need Account; (+$1 million Emergency Medical Services Account.

-         Institutional Management:  (+$2.2 million) Helen Hayes Hospital; (+$1million) Oxford Veterans Home; (+$3.9 million Lower Hudson Veterans Home).

-         Maintenance Undistributed:  (+$4million) Hospital and Nursing Home Management Account; (+$4.5 million) Quality of Care Account; (+$1.8 million) Third-Party Health Insurance Recoveries Account.

·        A reduction of $3 million in maintenance undistributed funding for hospital and nursing home inspection and auditing in the Health Care Standards and Surveillance program.  This reflects the 11 position reductions mentioned above. The Assembly has stated their intention to restore these 11 nursing home surveillance positions.

·        An increase of $6.6 million in nonpersonal services in the Medicaid Management Information Services Account, which is for the contractual services.  The budget does not specify the purpose of this increase.

·        A transfer of $68.5 million in Public Health programs to HCRA funding.  PEF is unable to identify these programs from the budget documents.

·        The Executive Budget indicates that Roswell Park Cancer Institute will receive $90 million.  The HCRA bill memo indicates that Roswell Park will receive $150 million over three years.  The bill itself identifies an increase of $68 million over two years ($45 million in 2002 and $23 million in 2003).  It is possible that the additional funds would come out of the Governor’s off-budget discretionary fund.