DEPARTMENT OF PUBLIC WELFARE
As part of the enacted budget of Fiscal Year 2011-2012, Act 22 of 2011, the Public Welfare Code Bill, was amended to give unprecedented rule making authority to the Secretary of Public Welfare to redesign public assistance programs. To date, the Secretary has not used this authority to make any significant changes to those programs.
Secretary Alexander has sent a request to the United States Department of Agriculture making them aware that Pennsylvania will re-instate the asset test for the Supplemental Nutrition Assistance Program (SNAP). Currently 35 states have eliminated the asset test for the SNAP program. It is expected that about 0.2% of the 1.8 million Pennsylvanians that utilized this program will lose their benefits, mostly elderly and disabled.
In January 2012, the Governor placed $55 million in budgetary reserve for DPW, reducing the already drastically reduced budget and cutting even more services as a result. It is estimated that approximately 88,000 children have been removed from the Medical Assistance (MA) rolls since August, mostly due to paperwork issues. Since children are entitled to health care in Pennsylvania, these children, who were in a shared state/federal program in MA, will now most likely be covered in CHIP, a state only funded program.
The Commonwealth’s General Fund total expenditures are projected to decrease by $22.5 million or -0.1% and DPW’s General Fund spending will decrease by $29.6 million.
Medical Assistance
During FY 12/13, Medical Assistance will provide health care coverage and long term care services to more than 2.1 million Pennsylvanians, a 9.4% decrease from the current year.
“Big 5” Medical Assistance Appropriations
FY 11/12 FY 12/13 Difference
Outpatient $ 645,095 $ 506,677 ($138,418)
Inpatient $ 325,685 $ 275,208 ($ 50,477)
Capitation $3,330,457 $3,667,626 $337,169
LTC (all) $ 965,614 $ 981,945 $ 16,331
Medicare Part D $ 473,612 $ 521,035 $ 47,423
Total $5,266,851 $5,431,456 $164,605
The current demographics for the Medical Assistance system are as follows:
% of Caseload % of Dollars
Disabled 15% 26%
Elderly 23% 47%
Children & Families 57% 23%
Adults without children 5% 4%
** Although the disabled and elderly are only 38% of the total Medical Assistance population, they account for 73% of the Medical Assistance expenditures.
|
Program Funding Reductions |
Millions |
| Human Services Development Fund Block Grant Proposal | |
| This initiative combines several county administered programs into one grant giving counties more flexibility in that area. |
$168.4 |
| General Assistance Program Reform | |
| Savings generated from revisions to the eligibility criteria for medical assistance benefits through the General Assistance program. Savings are also realized by elimination of cash assistance benefits provided through the GA program. |
$319.2 |
| Revised Provider Reimbursement | |
| Savings generated from a 4% reduction to provider reimbursement rates to hospitals and nursing facilities. |
$58.9 |
| Hospital Application Process | |
| Savings generated from maintaining recipients enrolled through the hospital application process in the fee-for-service program until redetermination |
$10.0 |
| Child Care Reimbursement Reform | |
| Savings generated from a reduction in the number of paid absences and a decrease in the reimbursement rates for unregulated relative and neighbor care. |
$10.0 |
| High-Cost Case Review | |
| Savings generated through intensive review and case management of high-cost consumers enrolled in medical assistance programs that reimburse for services based on utilization and fee schedules. |
$45.0 |
| Audit Enhancements | |
| Savings generated through the implementation of an automated audit system to identify waste, fraud and abuse prior to and after the issuance of provider payments. |
$5.0 |
| Foster Care Enhancements | |
| Savings generated through increased federal funds to support additional youth ages 18-24 in foster care. |
$4.5 |
| MAWD Premium Reform | |
| Increase premiums from 5% up to 7.5% based on CPI for those receiving benefits. The premiums have not been adjusted since 2001. The requirement of paying these premiums will be enforced. |
$10.0 |
| TOTAL |
$631.0 |
Human Services Funding
County Child Welfare Needs Based Budget funding will increase by $48.5 million in FY 12/13. The funding for the Nurse Family Partnership, Domestic Violence, Rape Crisis and Breast Cancer Screening programs will be maintained at the FY 11/12 funding level.
Child Care Services and Child Care Assistance remain level funded with the exception of the savings associated with paid absences and rate changes for the Relative/Neighbor providers.
Human Services Development Fund Block Grant
DPW is proposing to combine several county based service appropriations into one Human Services Development Fund Block Grant. This new block grant will give counties added flexibility in the areas of Mental Health Community Programs, Behavioral Health Services, Intellectual Disabilities – Community Base Program, County Child Welfare Special Grants, Homeless Assistance Program and the Act 152 Drug & Alcohol Program. DPW is projecting this change will result in 20% efficiency savings of $168.4 million.