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Health and Hospitals

The Governor's Executive Budget for FY03 reduced the Department of Health and Hospitals' budget by $514.6 million and 763 positions.

In response, the Legislature increased the department's proposed funding level by approximately $280 million and restored 739 positions during the appropriation process to the $5.1 billion recommended in the FY03 Governor's Executive Budget.

The total operating budget for the Department of Health and Hospitals is $5.4 billion FY03. The Department has 12,763 authorized positions for FY03.

Louisiana's Medicaid Program

The total funding for medical services for Medicaid clientele and the uninsured will increase by roughly $130 million from FY02 to FY03. The total Medicaid budget for FY03 is $4.4 billion, including $864.9 million State General Fund.

• $70 million for private and public providers of medical services to both Medicaid clientele and the uninsured.
   
• $25 million for the various existing Home and Community-Based Waiver Programs - MR/DD, Children's Choice, Adult Day Health Care, and Elderly and Disabled Adult - and the development of a new adult waiver program.
  
• $16 million for the continuation of the Behavioral Management Program for autistic individuals.
   
• $16 million for the expansion of the CommunityCARE program, Primary Care Case Management for Medicaid enrollees, including reimbursement rate increases for primary care services provided by physicians.
  
• $4 million for an increase in the cost of Medicare premiums for the state Medicare Buy-Ins program enrolling Medicaid/Medicare dual eligibles in the Medicare program for primary health insurance.
   
• Built into the FY03 Medicaid budget is the expansion of Medicaid eligibility to pregnant women with a family income at or below 200% of the federal poverty limit beginning in January 2003. It is estimated that 2,611 additional pregnant women will now be eligible for Medicaid in FY03.
   
• This investment in prenatal health care ties in directly with LaCHIP, Louisiana's Medicaid eligibility expansion program for children under age 19 living at or below 200% of the federal poverty limit, to ensure continuous access to health care services from conception to age 19 for Louisiana's poorest children. Since 1999, the LaCHIP program has assisted in reducing the number of uninsured children in Louisiana by 207,535. LaCHIP is fully funded in FY03 as well.
   
• Finally, the Breast and Cervical Cancer Program implemented in January 2002 will be fully operational in FY03.

Public Health Services

For FY03, the Office of Public Health's budget is $249.1 million and contains 1,991 authorized positions. This is an increase of $5.8 million and 6 positions over FY02.

The Legislature made a series of adjustments to OPH's budget to ensure adequate funding in FY03:

• Restored funding for the full operation of the Hemophilia program ($2.6 million) and Genetics program ($1.8 million).
   
• Added $900,000 and 25 positions for the collection and transportation of water samples from the local water systems to the public health labs.
   
• $300,000 has been added through the Office of Public Health for the LSU Veterinary School for encephalitis testing.
   
• Funding of the parish public health units has also been stabilized with a restoration of $11.1 million and 231 positions in the Personal Health Service program.
   
• In Act 23, the Capital Outlay Appropriation Act, OPH received funding for a new central laboratory. $2.3 million in non-recurring State General Fund and $20.2 million in Priority 5 General Obligation Bonds.

Mental Health Services

For FY03, the total budget for mental health services is $245.9 million and includes 3,560 authorized positions. This is an increase of $18.6 million and 33 positions over FY02.

In FY03, the Office of Mental Health (OMH) will begin to restructure its provision of services to children and adolescents placing the greatest emphasis on community-based care. As such, there are sizable increases in community mental health services for children and adolescents in FY03 - $4.1 million for crisis intervention services, $2.2 million for newer medications, and $1.6 million for assertive community treatment teams.

In return, $3.1 million has been cut at Southeast Louisiana State Hospital in Mental Health Area A to eliminate 16 adolescent inpatient beds and 10 child inpatient beds and $1.4 million has been cut at Central Louisiana State Hospital in Mental Health Area C to eliminate 16 adolescent inpatient beds and 6 child inpatient beds.

Beyond this reallocation of resources, the Legislature made a series of adjustments to OMH's budget to ensure adequate funding in FY03:

• $1.2 million was added to increase funding for inpatient acute psychiatric services provided through the facilities of the Louisiana State University Health sciences Center - Health Care Services Division.
   
• $10.1 million and 123 positions has been added to avoid a reduction of 328 civil adult inpatient beds across the state.
   
• $933,328 and 9 positions has been restored to the Mental Health State Office for administrative services.

Services for the Developmentally Disabled

For FY03, the total budget for the Office for Citizens with Developmental Disabilities (OCDD) is $223.2 million and includes 4,557 authorized positions. This is an increase of $18.0 million and a reduction of 10 positions from FY02.

• For FY03, the OCDD will begin to restructure its provision of services placing greater emphasis on community-based care. As such, $4.9 million State General Fund has been added to the OCDD budget to build capacity in the community. This State General Fund increase offsets a reduction of $3.1 million reduction in Interagency Transfers from the Medicaid program for institutional services.
   
• In the facilities, funding has been added to expand community services - $800,000 for specialized medical/behavior resource centers, $248,808 for consumer and family training, and $1.2 million for assertive community treatment teams. At the same time, $4.4 million has been restored for patient care in the facilities.
   
• Also funded in FY03 for the various OCDD agencies is $10.2 million for employee salaries. Included in the additional funding is the annualization of the position reallocations started in FY02, increased funding for group benefits and true funding of the costs of personnel merit increases.

Services for persons with Addictive Disorders

• For FY03, the total budget for the Office for Addictive Disorders (OAD) is $65.8 million and includes 464 authorized positions. This is a reduction of $6.9 million and of 1 position from FY02.
   
• Overall, funding has been stabilized for treatment services for addictive disorders.
   
• The biggest change in OAD's budget is the removal of $8.2 million of State General Fund from the base budget for the expenditures associated with drug courts. These funds will be budgeted directly in the Supreme Court's budget for FY03. OAD is still committed to provide approximately $1.5 million in treatment for the individuals enrolled in the drug court treatment slots.
   
• New in the budget for FY03 is $2.3 million for the Office of Addictive Disorders from the Tobacco Tax Health Care Fund for operating expenses per Act 19 (HB 157) of the 2002 Regular Legislative Session.

Homeland Defense Measures

DHH Office of the Secretary

• DHH has received a federal grant of $1.9 million from the DHHR Health Resources & Services Administration - Bio-terrorism Hospital Preparedness Program for the development of a bio-terrorism medical response plan in FY03.
   
• This project will be cooperative endeavor uniting DHH with the Louisiana Hospital Association and the LSU Health Sciences Center.
   
• The ultimate goal of this program is the development and implementation of a series of comprehensive medical response plans dividing the state on a regional basis to coordinate health care services providers and emergency response agencies to effectively respond to and manage the health consequences of an incident resulting from the use of a biological, chemical, radiological, nuclear, or explosive Weapon of Mass Destruction.

Office of Public Health

• Continued into FY03, the OPH budget contains $3.9 million and 44 positions to detect and/or respond to a bio-terrorism event.
   
• This funding will be used to address biological and/or chemical threats to the citizens of Louisiana by providing training and assessment of the statewide competence of health care staff in this arena, by coordinating emergency response activities in the medical community, and by performing infectious disease surveillance for the early detection of potential bio-terrorist event.
   
• OPH is also in the process of securing a multi-million grant from the federal government to assist in Louisiana's efforts to prepare its health care infrastructure for a mass casualty/destruction incident.

Office of Mental Health

• $300,000 and 4 positions are in OMH's budget for FY03 to train mental health professionals for the psychological fallout that will occur in the event a mass crisis strikes Louisiana. This is an increase of $150,000 over the amount added by BA-7 in FY02.