The deputy secretary for the DHHR presented the agency’s budget, which included plans to eliminate the IDD waiver wait list, the proposed creation of a Families First Reserve Fund, and plans to hire more CPS workers throughout the state.
Jeremiah Samples, deputy secretary for the DHHR, outlined the agency’s budget proposal in Monday morning’s House Finance Committee meeting.
Samples explained the DHHR is heavily federally funded with a federal match rate of about 75%. The total budget is $6.1 billion with $4.1 billion in federal revenue projected for the 2021 fiscal year. Medicaid makes up the bulk of proportional spend for the department, representing about 75%. Following Medicaid, the Bureau for Children and Families represents about half of non-Medicaid spending, he said.
The agency has a $19.7 million improvement request for Medicaid, including for the IDD waiver to add enough slots in the program to eliminate the wait list. Currently, he said, there are 1,100 people – 609 children— on the wait list.
Samples said between 12 and 15 people a month sign up for the program and as soon as people sign up July 1, the start of the new fiscal year, the wait list would start again. However, he told legislators there will be people who transition off the waiver too. Samples said there are usually around 150 people per year who no longer need to be in the program. Increasing the number of slots will help mitigate the further buildup of the wait list, he said.
Improvements for the Bureau for Children and Families total about $60 million including social services, child protective services, and facilities, all of which represent the largest improvements. About $14.9 million would cover things including foster care subsidies and adoption subsidies.
Samples said since 2011, there has been a more than 60% increase of kids in state custody and a 75% increase of babies taken into state custody. He said the rate of children taken into state custody is 16 kids per 1,000, compared to the national rate of six kids per 1,000.
For CPS, the department has a $4.4 million improvement request to add 87 staff across the state in child welfare, including CPS seniors, coordinators, social service coordinators, and adoption workers.
Samples also discussed the Medicaid surplus, which is projected to be $309 million at the end of the 2020 fiscal year. Reasons for the surplus included changes in the match rate, a 9% decrease in enrollment, mitigation of pharmacy costs, and maturation of managed care.
About $150 million of that surplus is proposed to be set aside into a Family First Reserve Fund, which would cover improvements in child welfare, facilities, and CHIP.
“Absent a reserve fund, we could find ourselves in a difficult situation where as soon as next year, in fiscal year 2022, we could have shortfalls in Medicaid,” he told the committee.
