Department of Health

     

The budget enacted by the Legislature makes the following changes to the Executive Budget (analysis as of March 30, 2005):

 

·          Reduces General Fund nonpersonal service appropriations by  $4.8 million in the following programs:

·          Administration and Executive Direction, reduced $357,371

·          AIDS Institute, reduced $142,712

·          Center for Environmental Health, reduced $50,899

·          Health Care Finance, reduced $21,311

·          Health Care Standards and Surveillance, reduced $1,198,109

·          Office of Managed Care, reduced $113,807

·          Medicaid Management Information System, reduced $1,945,437

·          Office of Medicaid Management, reduced $105,109

·          Medicaid Audit and Fraud Prevention, reduced $96,884

·          Wadsworth Center for Laboratories and Research, reduced $755,573

·          Reduces the Center for Community Health Program by $570,000 in personal service and $30,000 in nonpersonal service, funding that was added by the Executive in the 30 day amendments and according to DOB was “to accommodate administrative costs for the nutrition program.”

·          Increases the offset within the Maintenance Undistributed appropriations for the Quality of Care Account by $15 million.

 

The 30 day amendments to the Executive Budget recommend the following changes (analysis as of February 14, 2005):

 

·          Creates new appropriation of $600,000 (General Fund) within the Center for Community Health Program: $570,000 in Personal Service and $300,000 in Non Personal Service.  According to DOB, this is “to accommodate administrative costs for the nutrition program.”

·          In the Health Care Standards and Surveillance Program reduces Non Personal Service (General Fund), by $500,000 “to avoid double-counting”, and increases the Special Revenue Other Non Personal Services within the Certificate of Need Account by $600,000 “to be consistent with planned spending.”

·          Reduces the Special Revenue Other appropriation for the Western New York Veterans Home by $50,000 because of a “typographical error.”

·          Increases the Special Revenue Other Non Personal Service in the Wadsworth Center’s Environmental Laboratory Fee Account, from $1,325,000 to $1,568,000 to “accommodate the indirect costs of the Environmental Laboratory Reference and Accreditation Program.”

 

The Executive Budget recommends (revised January 20, 2005):

 

·          An increase of 90 FTEs in SFY 2005-06 from the adjusted 3/31/05 FTE level.  In SFY 2004-05 there was a net increase of 11 FTEs during the fiscal year (4 more FTEs in Health Care Standards and Surveillance, 7 fewer FTEs in the Office of Medicaid Management, and a shift of 13 FTEs in the AIDS Institute from Special Revenue-Other to General Fund support).  Proposed increases in SFY 2005-06 are in the following programs:  60 FTEs in Community Health (Special Revenue-Federal); 15 FTEs in Health Care Standards and Surveillance (Special Revenue-Other); and 15 FTEs in the Office of Medicaid Management.

·          An All Funds appropriation of $4.7 billion, an increase of $77.4 million (1.5%).

·          Federal EPA Grants in the Center for Environmental Health program are reduced by $11.9 million (43.3%).

·          An increase of $34 million in Federal funding, and a net increase of $785,000 in Special Revenue-Other funding for the Elderly Pharmaceutical Insurance Coverage (EPIC) program.

·          An increase of $7.1 million in non-personal services in the Health Care Standards and Surveillance Program which appears to be predominantly a shift of $6.1 million from Maintenance Undistributed funding.  According to the Executive Budget, $6.6 million will be used for contractual services. The use of this funding should be clarified at Labor-Management.

·          A $5.3 million appropriation in the Health Care Standards and Surveillance Program for a new Criminal Background Check Account (Special Revenue-Other and Special Revenue - Federal) for required checks of non-licensed long term care employees including employees of nursing homes, certified home health agencies, long term home health care providers, AIDS home care providers, and licensed home care service agencies.

·          Increased appropriations in the Institutional Management Program include a:

            --$4.9 million or 7.7% increase in the SRO appropriation in the Helen Hayes                                Hospital Account

            --$3.4 million or 17.1% increase in the SRO appropriation in the Veterans Home Account

            --$4.2 million or 23.4% increase in the SRO appropriation in the Oxford Veterans Home            Account

            --$4.07 million or 19.2% increase in the SRO appropriation in the Lower Hudson                                    (Montrose) Veterans Home Account

            --$1.89 million or 20.6% increase in the SRO appropriation in the Western New York                Veterans Home Account

            --The purpose for all these increases should be clarified at Labor-Management.

·          An agency-wide increase of $5.5 million reflecting fixed cost increases and other adjustments as offset by non-personal service efficiencies.  These increases and efficiencies should be identified in Labor-Management.

·          Article VII Medicaid Reform legislation includes provisions which may affect State operated nursing homes in the long term.  This includes:  removing inflationary cost increases from nursing home rates; increasing the reimbursable assessment on nursing home receipts from 5% to 6%; establishing a regional pricing system for nursing homes; removing the cost of Medicare and all other non-Medicaid patients from the Medicaid nursing home rates; and reducing the supplemental payments to nursing homes related to quality of care. FTE levels are not affected by these proposals in the current year, but they should be evaluated for their long term impact.

·          A bi-partisan Commission on Health Care Facilities in the 21st Century is proposed to address the support of hospitals and nursing homes that are underutilized and no longer necessary.  The impact of this proposal on DOH operated nursing homes and hospitals needs to be addressed at Labor-Management.

·          Health Care Reform Act funding is on budget for the first time.  A significant portion of it appears in the DOH budget as an Aid to Localities appropriation.  This includes $78 million for Roswell Park Cancer Institute.

·          Article VII legislation identifies these “non-essential” programs that would be repealed:  Endoscopy Study; Reflex Sympathetic Dystrophy Syndrome Prevention and Education Program; license and regulation of Tattooing and Body Piercing establishments; and regulation and inspection fees for the Durable Home Medical Equipment.  The budget attributes savings from the elimination of these programs as $700,000.  It should be determined at Labor-Management if PEF members are associated with any of these programs, and if so, how they will be affected.

 

 

Department of Health

Program Details-State Operations

 

 Enacted

 Proposed

 Enacted

Change in

Percent

Program

 2004-05 Budget

 2005-06 Budget

 2005-06 Budget

Appropriation

Change

All Funds

$4,646,467,000

$4,718,796,000

$4,713,408,788

$66,941,788

1.4%

General Fund

$167,319,000

$185,165,000

$164,777,788

($2,541,212)

-1.5%

Special Revenue - Federal

$4,049,572,000

$4,054,898,000

$4,054,898,000

$5,326,000

0.1%

Special Revenue - Other

$429,566,000

$478,723,000

$493,723,000

$64,157,000

14.9%

Enterprise Fund

$10,000

$10,000

$10,000

$0

0.0%

 

 

 

 

 

 

Admin & Exec Direction Pgm

$61,251,000

$63,788,000

$63,430,629

$2,179,629

3.6%

Personal Service

$7,408,000

$7,463,000

$7,463,000

$55,000

0.7%

Nonpersonal Service

$11,500,000

$13,600,000

$13,242,629

$1,742,629

15.2%

Special Rev - Fed (SRF)

$10,370,000

$9,824,000

$9,824,000

($546,000)

-5.3%

Special Rev - Other (SRO)

$31,973,000

$32,901,000

$32,901,000

$928,000

2.9%

 

 

 

 

 

 

Child & Adult Care Food Acct - (SRF)

$716,000

$818,000

$818,000

$102,000

14.2%

Fed Food & Nutrition Services acct - (SRF)

$2,892,000

$3,004,000

$3,004,000

$112,000

3.9%

Fed Health &Human Services Fund - (SRF)

$1,845,000

$1,085,000

$1,085,000

($760,000)

-41.2%

Fed Block Grant Fund - (SRF)

$4,917,000

$4,917,000

$4,917,000

$0

0.0%

 

 

 

 

 

 

Technology Transfer Acct - (SRO)

$500,000

$500,000

$500,000

$0

0.0%

 

 

 

 

 

 

Health Occupation Dev & Workplace Demo  - (SRO)

$2,158,000

$2,344,000

$2,344,000

$186,000

8.6%

Personal Service

$553,000

$589,000

$589,000

$36,000

6.5%

Nonpersonal Service

$1,373,000

$1,507,000

$1,507,000

$134,000

9.8%

Fringe benefits

$232,000

$248,000

$248,000

$16,000

6.9%

 

 

 

 

 

 

Pilot Health Insurance Acct - (SRO)

$2,011,000

$2,355,000

$2,355,000

$344,000

17.1%

Personal Services

$1,080,000

$1,162,000

$1,162,000

$82,000

7.6%

Nonpersonal Services

$478,000

$704,000

$704,000

$226,000

47.3%

Fringe Benefits

$453,000

$489,000

$489,000

$36,000

7.9%

 

 

 

 

 

 

Primary Care Initiatives Acct - (SRO)

$856,000

$920,000

$920,000

$64,000

7.5%

Personal Services

$427,000

$445,000

$445,000

$18,000

4.2%

Nonpersonal Services

$250,000

$288,000

$288,000

$38,000

15.2%

Fringe benefits

$179,000

$187,000

$187,000

$8,000

4.5%

 

 

 

 

 

 

Health Care Delivery Administration Acct - (SRO)

$821,000

$894,000

$894,000

$73,000

8.9%

Personal Service

$305,000

$323,000

$323,000

$18,000

5.9%