| 2002 Yellow Book |
| Backward Forward Cover Overview Table of Contents |
| DEPARTMENT OF HEALTH |
Adjusted Executive
Appropriation Request Percent
2001-02 2002-03 Change Change
AGENCY SUMMARY
General Fund 7,177,038,600 6,961,009,000 (216,029,600) -3.01%
Special Rev.-Fed. 21,523,732,00022,968,192,0001,444,460,000 6.71%
Special Rev.-Other 2,202,495,900 3,629,898,0001,427,402,100 64.81%
Fiduciary 3,965,000 4,125,000 160,000 4.04%
Enterprise 10,000 10,000 0 0.00%
Capital Projects Fund 11,600,000 11,600,000 0 0.00%
Capital Projects Fund-1996
CWA (Bondable) 50,000,000 70,000,000 20,000,000 40.00%
Federal Capital Projects Fund 53,659,000 75,000,000 21,341,000 39.77%
Total for Agency: 31,022,500,50033,719,834,0002,697,333,500 8.69%
Total Contingency: 850,000,000 963,500,000 113,500,000 13.35%
Total for AGENCY SUMMARY: 31,872,500,50034,683,334,0002,810,833,500 8.82%
STATE OPERATIONS
General Fund 203,858,600 195,954,000 (7,904,600) -3.88%
Special Rev.-Fed. 3,404,828,000 3,901,179,000 496,351,000 14.58%
Special Rev.-Other 347,062,900 389,734,000 42,671,100 12.29%
Fiduciary 3,965,000 4,125,000 160,000 4.04%
Enterprise 10,000 10,000 0 0.00%
Total for STATE OPERATIONS:3,959,724,500 4,491,002,000 531,277,500 13.42%
Administration and Executive Direction
General Fund 14,056,200 22,365,000 8,308,800 59.11%
Special Rev.-Fed. 12,839,000 10,473,000 (2,366,000) -18.43%
Special Rev.-Other 26,209,000 29,389,000 3,180,000 12.13%
Total for Program: 53,104,200 62,227,000 9,122,800 17.18%
AIDS Institute
General Fund 16,851,000 16,818,000 (33,000) -0.20%
Special Rev.-Other 2,136,000 0 (2,136,000)-100.00%
Total for Program: 18,987,000 16,818,000 (2,169,000) -11.42%
Environmental Health
General Fund 10,059,000 9,987,000 (72,000) -0.72%
Special Rev.-Fed. 11,105,000 12,670,000 1,565,000 14.09%
Special Rev.-Other 14,270,000 15,999,000 1,729,000 12.12%
Total for Program: 35,434,000 38,656,000 3,222,000 9.09%
Community Health
General Fund 9,670,000 9,852,000 182,000 1.88%
Special Rev.-Fed. 98,268,000 102,151,000 3,883,000 3.95%
Special Rev.-Other 5,554,000 5,554,000 0 0.00%
Fiduciary 1,000,000 1,200,000 200,000 20.00%
Total for Program: 114,492,000 118,757,000 4,265,000 3.73%
Laboratories and Research
General Fund 35,252,000 36,434,000 1,182,000 3.35%
Special Rev.-Fed. 7,932,000 9,124,000 1,192,000 15.03%
Special Rev.-Other 29,234,900 28,795,000 (439,900) -1.50%
Fiduciary 2,600,000 2,600,000 0 0.00%
Total for Program: 75,018,900 76,953,000 1,934,100 2.58%
Managed Care
General Fund 15,297,000 15,416,000 119,000 0.78%
Total for Program: 15,297,000 15,416,000 119,000 0.78%
Health Care Standards and Surveillance
General Fund 30,319,000 25,620,000 (4,699,000) -15.50%
Special Rev.-Other 42,860,000 48,044,000 5,184,000 12.10%
Total for Program: 73,179,000 73,664,000 485,000 0.66%
Health Care Financing
General Fund 5,575,000 5,116,000 (459,000) -8.23%
Special Rev.-Other 5,945,000 6,915,000 970,000 16.32%
Total for Program: 11,520,000 12,031,000 511,000 4.44%
Institution Management
Special Rev.-Other 104,960,000 112,890,000 7,930,000 7.56%
Fiduciary 325,000 325,000 0 0.00%
Enterprise 10,000 10,000 0 0.00%
Total for Program: 105,295,000 113,225,000 7,930,000 7.53%
Medicaid Management Information System
General Fund 48,676,000 55,275,000 6,599,000 13.56%
Special Rev.-Fed. 67,510,000 67,510,000 0 0.00%
Total for Program: 116,186,000 122,785,000 6,599,000 5.68%
Elderly Pharmaceutical Insurance Coverage
General Fund 11,039,000 0 (11,039,000)-100.00%
Special Rev.-Other 0 15,447,000 15,447,000 --
Total for Program: 11,039,000 15,447,000 4,408,000 39.93%
Office of Medicaid Audit and Fraud Prevention
General Fund 18,665,000 18,591,000 (74,000) -0.40%
Special Rev.-Fed. 36,278,000 37,856,000 1,578,000 4.35%
Special Rev.-Other 14,500,000 14,500,000 0 0.00%
Total for Program: 69,443,000 70,947,000 1,504,000 2.17%
Office of Continuing Care
General Fund 20,654,000 22,095,000 1,441,000 6.98%
Special Rev.-Fed. 13,116,000 13,055,000 (61,000) -0.47%
Special Rev.-Other 3,626,000 3,893,000 267,000 7.36%
Fiduciary 40,000 0 (40,000)-100.00%
Total for Program: 37,436,000 39,043,000 1,607,000 4.29%
Child Health Insurance
Special Rev.-Fed. 30,280,000 28,340,000 (1,940,000) -6.41%
Special Rev.-Other 11,680,000 11,920,000 240,000 2.05%
Total for Program: 41,960,000 40,260,000 (1,700,000) -4.05%
Maintenance Undistributed
General Fund (78,338,000) (88,638,000) (10,300,000) 13.15%
Special Rev.-Other 78,338,000 88,638,000 10,300,000 13.15%
Total for Program: 0 0 0 --
Office of Medicaid Management
General Fund 46,083,400 47,023,000 939,600 2.04%
Special Rev.-Fed. 3,127,500,000 3,620,000,000 492,500,000 15.75%
Special Rev.-Other 7,750,000 7,750,000 0 0.00%
Total for Program: 3,181,333,400 3,674,773,000 493,439,600 15.51%
AID TO LOCALITIES
General Fund 6,973,180,000 6,765,055,000 (208,125,000) -2.98%
Special Rev.-Fed. 18,118,904,00019,067,013,000 948,109,000 5.23%
Special Rev.-Other 1,855,433,000 3,240,164,0001,384,731,000 74.63%
Total for AID TO LOCALITIES:26,947,517,00029,072,232,0002,124,715,000 7.88%
Administration and Executive Direction
General Fund 869,000 869,000 0 0.00%
Total for Program: 869,000 869,000 0 0.00%
AIDS Institute
General Fund 53,656,000 0 (53,656,000)-100.00%
Special Rev.-Other 34,597,000 88,253,000 53,656,000 155.09%
Total for Program: 88,253,000 88,253,000 0 0.00%
Environmental Health
General Fund 1,500,000 0 (1,500,000)-100.00%
Special Rev.-Fed. 2,208,000 2,540,000 332,000 15.04%
Special Rev.-Other 200,000 6,200,000 6,000,000 3000.00%
Total for Program: 3,908,000 8,740,000 4,832,000 123.64%
Community Health
General Fund 526,588,000 484,451,000 (42,137,000) -8.00%
Special Rev.-Fed. 574,806,000 605,193,000 30,387,000 5.29%
Special Rev.-Other 36,578,000 58,823,000 22,245,000 60.82%
Total for Program: 1,137,972,000 1,148,467,000 10,495,000 0.92%
Laboratories and Research
General Fund 1,071,000 1,071,000 0 0.00%
Special Rev.-Fed. 2,105,000 2,420,000 315,000 14.96%
Total for Program: 3,176,000 3,491,000 315,000 9.92%
Health Care Standards and Surveillance
General Fund 9,535,000 9,185,000 (350,000) -3.67%
Total for Program: 9,535,000 9,185,000 (350,000) -3.67%
Medical Assistance
General Fund 6,134,300,000 6,156,000,000 21,700,000 0.35%
Special Rev.-Fed. 16,424,000,00017,054,000,000 630,000,000 3.84%
Special Rev.-Other 1,231,400,000 2,124,700,000 893,300,000 72.54%
Total for Program: 23,789,700,00025,334,700,0001,545,000,000 6.49%
Medical Assistance Administration
General Fund 108,557,000 114,350,000 5,793,000 5.34%
Special Rev.-Fed. 388,750,000 481,800,000 93,050,000 23.94%
Total for Program: 497,307,000 596,150,000 98,843,000 19.88%
Elderly Pharmaceutical Insurance Coverage
General Fund 401,100,000 0 (401,100,000)-100.00%
Special Rev.-Other 0 484,900,000 484,900,000 --
Total for Program: 401,100,000 484,900,000 83,800,000 20.89%
Office of Continuing Care
General Fund 2,546,000 621,000 (1,925,000) -75.61%
Special Rev.-Fed. 315,000 0 (315,000)-100.00%
Total for Program: 2,861,000 621,000 (2,240,000) -78.29%
Child Health Insurance
Special Rev.-Fed. 726,720,000 921,060,000 194,340,000 26.74%
Special Rev.-Other 280,320,000 470,000,000 189,680,000 67.67%
Total for Program: 1,007,040,000 1,391,060,000 384,020,000 38.13%
Maintenance Undistributed
General Fund (272,338,000) (7,288,000) 265,050,000 -97.32%
Special Rev.-Other 272,338,000 7,288,000 (265,050,000) -97.32%
Total for Program: 0 0 0 --
Office of Medicaid Management
General Fund 5,796,000 5,796,000 0 0.00%
Total for Program: 5,796,000 5,796,000 0 0.00%
CAPITAL PROJECTS
Capital Projects Fund 11,600,000 11,600,000 0 0.00%
Capital Projects Fund-1996
CWA (Bondable) 50,000,000 70,000,000 20,000,000 40.00%
Federal Capital Projects Fund 53,659,000 75,000,000 21,341,000 39.77%
Total for CAPITAL PROJECTS: 115,259,000 156,600,000 41,341,000 35.87%
Laboratories and Research
Capital Projects Fund 4,000,000 4,000,000 0 0.00%
Total for Program: 4,000,000 4,000,000 0 0.00%
Water Resources
Federal Capital Projects Fund 53,659,000 75,000,000 21,341,000 39.77%
Total for Program: 53,659,000 75,000,000 21,341,000 39.77%
Safe Drinking Water - Clean Water/Clean Air 96
Capital Projects Fund-1996
CWA (Bondable) 50,000,000 70,000,000 20,000,000 40.00%
Total for Program: 50,000,000 70,000,000 20,000,000 40.00%
Preservation of Facilities Purpose
Capital Projects Fund 7,600,000 7,600,000 0 0.00%
Total for Program: 7,600,000 7,600,000 0 0.00%
CONTINGENCY
General Fund 0 13,500,000 13,500,000 --
Fiduciary 850,000,000 950,000,000 100,000,000 11.76%
Total for CONTINGENCY: 850,000,000 963,500,000 113,500,000 13.35%
Laboratories and Research
General Fund 0 13,500,000 13,500,000 --
Total for Program: 0 13,500,000 13,500,000 --
Medical Assistance
Fiduciary 850,000,000 950,000,000 100,000,000 11.76%
Total for Program: 850,000,000 950,000,000 100,000,000 11.76%
ALL FUNDS PERSONNEL
BUDGETED FILL LEVELS
Current Requested
Program 2001-02 2002-03 Change
Suballocation 12 12 0
Administration and Executive
Direction 494 480 (14)
AIDS Institute 214 190 (24)
Environmental Health 423 406 (17)
Community Health 651 649 (2)
Laboratories and Research 658 674 16
Managed Care 169 162 (7)
Health Care Standards and
Surveillance 541 492 (49)
Health Care Financing 129 127 (2)
Institution Management 1,516 1,552 36
Elderly Pharmaceutical
Insurance Coverage 28 28 0
Office of Medicaid Audit and
Fraud Prevention 509 500 (9)
Office of Continuing Care 373 366 (7)
Child Health Insurance 42 41 (1)
Office of Medicaid Management 402 394 (8)
Total General Fund : 2,525 2,418 (107)
Total All Other Funds : 3,636 3,655 19
TOTAL: 6,161 6,073 (88)
BUDGET HIGHLIGHTS
(Executive Budget: pp. 121-132)
As the designated State agency responsible for promoting and
supervising public health activities, ensuring sound and cost
effective quality medical care, and reducing infectious diseases, the
Department of Health (DOH) works towards its goal of ensuring the
highest quality, most appropriate and cost-effective health care for
all New Yorkers. Since State Fiscal Year (SFY) 1996-97, when
authority for the State's Medical Assistance (Medicaid) Program was
transferred from the former Department of Social Services, the
Department of Health has also served as the principal State agency
responsible for interacting with the Federal and local governments,
health care providers, and program participants on behalf of the
Medicaid Program in New York. Transfer of all Medicaid functions to
the Department of Health consolidated for the first time in one agency
the operational and oversight responsibilities for the Medicaid
Program, thereby clarifying State accountability for Medicaid policy
and allowing for greater efficiencies in the administration of health
care programs.
This Agency is included in the Health, Mental Hygiene and
Environmental Conservation appropriation bill.
The Governor recommends All Funds appropriations for the Department
of Health totaling $34,683,334,000, an increase of $2,810,833,500, or
8.82 percent, over State Fiscal Year (SFY) 2001-02, primarily
attributable to an increase in both Special Revenue Fund Federal and
Special Revenue Fund Other. The Governor recommends General Fund
appropriations for the Agency totaling $6,961,009,000, a decrease of
$216,029,600, or three percent below the current fiscal year.
Additionally, the Governor recommends Special Revenue Funds Federal
appropriations for the Agency totaling $22,968,192,000, an increase
of $1,444,460,000, or 6.7 percent over last year. The Executive
further recommends Special Revenue Fund Other of $3,629,898,000, an
increase of $1,427,402,100, or 64.8 percent, primarily due to a shift
from General Fund spending.
The adjusted appropriation for the Department of Health includes
recommended deficiency appropriations for the General Fund in Aid to
Localities totaling $471,800,000. The proposal allocation of those
funds is as follows: the Medicaid Program, $179,600,000; the Early
Intervention (EI) Program, $70,000,000; the Elderly Pharmaceutical
Insurance Coverage (EPIC) Program, $40,700,000; the General Public
Health Works Program, $48,900,000; the West Nile Encephalitis
Outbreak, $21,900,000; the Immunization Program, $3,700,000; and
$107,000,000 for the HCRA Transfer Fund/Medical Assistance Account to
offset Medicaid General Fund spending.
The Executive proposes to sweep $31,500,000 from various Special
Revenue Other (SRO) accounts within the agency to offset General Fund
spending in SFY 2002-03. Specifically, the Executive proposes to
sweep:
-- $9,000,000 from the Emergency Medical Services (EMS) Account;
-- $3,000,000 from the Professional Medical Conduct Account;
-- $1,000,000 from the Environmental Laboratory Reference and
Accreditation Program (E-LAP);
-- $13,500,000 from the Spinal Cord Injury Research Fund; and
-- $5,000,000 from the Occupational Health Clinics Account.
Other actions proposed by the Executive that would further offset
General Fund spending throughout the agency include:
-- a $4,000,000 General Fund offset related to an increase in the
Article 28 Mortgage Loan Fee, from .2 percent to .3 percent.
This fee increase would be changed administratively; and
-- a $6,000,000 General Fund offset realized by exceeding the
recoupment target in the Quality of Care Account.
State Operations
The Executive recommends a total All Funds appropriation for State
Operations of $4,491,002,000, which reflects an increase of
$531,277,500, or 13.4 percent over SFY 2001-02. This increase is
primarily due to increased Federal funds. The Executive proposes
General Fund State Operations appropriations totaling $195,954,000,
a net decrease of $7,904,600, or 3.9 percent. The Executive also
recommends Special Revenue Funds Federal totaling $3,901,179,000, an
increase of $496,351,000, or 14.6 percent.
The Executive proposes the attrition of 50 positions throughout the
agency in SFY 2002-03, which would generate a General Fund savings of
$1,500,000. The Executive also proposes to shift the funding of 10
positions from the General Fund to the Health Care Reform Act of 2000
(HCRA 2000) to generate savings of $647,000. In addition, the
Executive proposes to adopt stringent turnover requirements, which
would generate an additional $1,500,000 in General Fund savings.
The Executive further proposes to combine the AIDS newborn screening
program with the genetic newborn screening program in the Wadsworth
Center for Laboratories and Research. The $5,000,000 proposed for
this initiative is deemed by the Executive to be sufficient to meet
the full spending needs of both programs. Of the $5,000,000,
$1,800,000 is associated with costs related to the AIDS newborn
screening program and $3,200,000 is associated with costs related to
the genetic screening program.
Other notable changes proposed by the Executive in State Operations
include:
-- a new $3,000,000 General Fund increase in the Administration
and Executive Direction Program related to a time and activity
system;
-- a new $1,300,000 Maintenance Undistributed appropriation in the
Statewide Planning and Research Cooperative System (SPARCS) for
compliance with Federal data security standards; and
-- a new $150,000 Maintenance Undistributed appropriation in the
Center for Environmental Health Program, to be suballocated to
the Department of Agriculture and Markets, for the protection
of drinking water supplies.
Institutional Management
As part of the major health care package (S.6084/A.9610) passed in
January 2002, the Roswell Park Cancer Institute will receive
$60,000,000 in additional funding in SFY 2002-03 from the HCRA 2000.
It is anticipated that the Roswell Park Cancer Institute will receive
an additional $45,000,000 in SFY 2003-04 above the expected HCRA 2000
allocation. There is a commitment to fund $45,000,000 for Roswell
Park Cancer Institute in SFY 2004-05 from an extension of HCRA.
The Department of Health currently maintains five direct care
institutions: Helen Hayes Hospital in West Haverstraw and four nursing
homes for the care of veterans and their dependents, Oxford, New York
City, Montrose and Western New York. The Executive proposes a
$3,933,000 funding increase for the Montrose Veterans' Nursing Home,
which is a new, 252-bed facility in the lower Hudson Valley that
opened in mid October 2001. Additionally, the Executive proposes a
$2,225,000 increase for Helen Hayes Hospital and a $1,025,000 increase
for Oxford Veterans' Nursing Home, associated with increased
operational costs.
Aid to Localities
The Executive recommends All Funds Aid to Localities appropriations
totaling $29,072,232,000, an increase of $2,124,715,000, or 7.9
percent over the SFY 2001-02 funding level. This increase is
primarily attributable to an increase in Special Revenue Fund Federal
and Special Revenue Funds Other.
The Executive proposes General Fund appropriations totaling
$6,765,055,000, a decrease of $208,125,000, or 3.0 percent from SFY
2001-02. The Executive also recommends a Special Revenue Fund Federal
appropriation totaling $19,067,013,000, an increase of $948,109,000,
or 5.2 percent. The proposed $1,384,731,000 increase in Special
Revenue Funds Other is largely the result of a shift from General Fund
spending.
For the Early Intervention (EI) Program, the Executive recommends an
appropriation of $210,000,000 for SFY 2002-03. In SFY 2001-02, the
Executive is requesting a deficiency appropriation of $70,000,000 to
meet a cash deficiency of $60,00,000, which is attributed to increased
services provided to infants and toddlers with disabilities. The
proposed SFY 2002-03 appropriation anticipates both enrollment growth
and an increased use in services that the Executive expects to offset
in part by taking new audit and fraud prevention actions in the EI
program. Such actions are expected to save the EI program $5,000,000
in SFY 2002-03.
The Executive proposes a $40,700,000 deficiency appropriation in the
Elderly Pharmaceutical Insurance Coverage Program (EPIC) in SFY 2001-
02. As part of the recently enacted health care package
(S.6084/A.9610), the expansion of the Elderly Pharmaceutical Insurance
Coverage (EPIC) Program will now be funded from HCRA 2000 funds,
rather than the General Fund, at a level consistent with current
program growth. In addition, the health care package cut pharmacy
reimbursement to mirror that of the Medicaid program by reducing
reimbursement for all pharmacists to the Average Wholesale Price (AWP)
minus 10 percent. This action is expected to generate a $25,000,000
savings to the EPIC program in SFY 2002-03. The Plan also changed the
drug rebate methodology, again to mirror the Medicaid program, to
generate $6,600,000 in savings to the EPIC program in SFY 2002-03.
The Plan also requires private health insurers to match membership
files, starting April 1, 2002, with EPIC enrollees files to facilitate
the coordination of benefits. This action is expected to generate a
$2,000,000 savings to the EPIC program in SFY 2002-03.
The Executive recommends an appropriation of $209,500,000 in SFY 2002-
03 in the General Public Health Works Program to support local public
health activities. The Executive is currently proposing a deficiency
appropriation of $48,900,000 for this program, as well as a separate
$21,900,000 deficiency appropriation to pay for activities related to
the West Nile encephalitis outbreak.
In addition, the Executive proposes to shift the lead poisoning
prevention program and a portion of the abstinence program, a total
of $4,600,000 in current year General Fund spending, to the Maternal
and Child Health Federal Block Grant.
In the AIDS Institute, appropriations totaling $53,656,000 were
transferred from the General Fund to HCRA 2000, as part of the health
care workforce bill (S.6084/A.9610) that passed in January 2002. As
a result of this action, all Aid to Localities General Fund programs
in the AIDS Institute will now be funded through HCRA 2000.
Other notable changes proposed by the Executive in Aid to Localities
include:
-- a new $2,500,000 General Fund appropriation for the health and
social services sexuality-related program;
-- an additional $1,600,000 in funding to the Healthy Women
Partnerships Program for SFY 2002-03 to increase breast and/or
cervical screening services; and
-- a $1,925,000 decrease in funding for the adult care facility
Quality Incentive Payment (QUIP) program.
Medical Assistance (Medicaid) Program
The Executive recommends an All Funds Medicaid appropriation in Aid
to Localities of $25,334,700,000, which is an increase of
$1,545,000,000, or 6.5 percent, resulting from an increase in both
Federal funds and Special Revenue Funds Other.
The Executive estimates General Fund disbursements in the Department
of Health will be $6,134,300,000 in SFY 2001-02. This total includes
the requested deficiency appropriation of $179,600,000. The Executive
attributes the deficiency to: the Legislature's rejection of the
Executive's proposed Medicaid cost-containment package in SFY 2001-02,
$138,900,000; additional litigation and Federal mandate requirements,
$25,600,000; and the implementation of the new Disaster Relief
Medicaid/Family Health Plus Program, $15,100,000.
For State Fiscal Year 2002-03, the Executive proposes a total General
Fund Medicaid appropriation of $6,156,000,000, a net increase of
$21,700,000, or 0.4 percent over the SFY 2001-02 adjusted
appropriation. The Executive estimates an increase in Medicaid
General Fund expenditures in SFY 2002-03 of $441,800,000 associated
with year-to-year program growth. In addition, the Executive
increases the General Fund Medicaid appropriation by $81,000,000 to
reflect the loss of a portion of the nursing home Inter-Governmental
Transfer (IGT), and by $17,800,000 for costs associated with
litigation and Federal mandate requirements.
These increases in General Fund Medicaid spending are offset by
$364,700,000 in SFY 2002-03 due to the passage of a health care
package (S.6084/A.9610) in January 2002, prior to the release of the
Executive Budget. Specifically, the bill: re-establishes the six
percent assessment on residential health care facilities for
$288,600,000 in savings; mandates the generic substitution of brand
name pharmaceuticals unless a physician secures prior approval from
the Department, for $2,500,000 in savings; increases the Inter-
Governmental Transfer (IGT) on public hospitals and updates the base
year from 1995 to 2000 for savings of $18,700,000; and extends the
Medicaid Upper Payment Limit (UPL) benefit to outpatient services for
$54,900,000.
Medicaid General Fund spending is further decreased in the Executive
Budget by $73,400,000, transferring both the Working Disabled 1619-B
Program and the Medicaid Physicians Services Program from the General
Fund to the HCRA 2000 Tobacco Control and Insurance Initiatives Pool.
The Executive also proposes a $81,000,000 Medicaid General Fund
savings related to Bad Debt and Charity Care, $72,000,000; various
pharmacy initiatives, $1,500,000; and savings generated from the
Office of Alcoholism and Substance Abuse Services (OASAS) from a new
community-based detox program, $7,500,000.
Health Care Reform Act of 2000 (HCRA 2000)
In actions taken in January 2002, prior to the release of the
Executive Budget, the Legislature passed a major health care package
(S.6084/ A.9610) that significantly adds to HCRA 2000. In addition,
portions of the package, mentioned below, take action to provide
savings in the Medicaid/Health budget. Specifically, the bill re-
establishes the six percent assessment on residential health care
facilities for three years, which would generate a State share savings
of $288,600,000 in SFY 2002-03. The bill also mandates the generic
substitution of brand name pharmaceuticals under the Medicaid Program
unless a physician secures prior approval from the Department, which
would generate a $2,500,000 State Share savings in SFY 2002-03, and
increases the Inter-Governmental Transfer on public hospitals and
updates the base year from 1995 to 2000, which would offset General
Fund spending by $18,700,000 in SFY 2002-03. In addition, the bill
extends the Medicaid Upper Payment Limit (UPL) benefit to outpatient
services, which would create a $54,900,000 General Fund savings in SFY
2002-03.
In other savings actions, the bill also requires insurance companies
to cover appropriate medical and therapeutic services in the Early
Intervention (EI) Program. Although no savings are anticipated in SFY
2002-03 for this initiative, it is anticipated that this action would
generate $60,000,000 in General Fund savings by the end of SFY 2004-
05.
In the Elderly Pharmaceutical Insurance Coverage (EPIC) Program, the
bill cuts pharmacy reimbursement to mirror that of the Medicaid
program by reducing reimbursement for all pharmacists to the Average
Wholesale Price (AWP) minus 10 percent. This action would generate a
savings of $25,000,000 in SFY 2002-03 to the EPIC program. In
addition, the bill changes the drug rebate methodology in the EPIC
program, which would generate $6,600,000 in SFY 2002-03 in savings to
the EPIC program. The bill also requires private health insurers to
match membership files, starting April 1, 2002, with EPIC enrollees
files to facilitate the coordination of benefits. This action is
expected to generate a savings of $2,000,000 in SFY 2002-03.
The bill also provides for the transfer of the expansion of the
Elderly Pharmaceutical Insurance Coverage (EPIC) program, as well as
of certain public health programs, from the General Fund to the HCRA
2000 to provide General Fund relief of $211,900,000 in SFY 2002-03.
The bill also removes various obstacles to enrollment in the Child
Health Plus, Family Health Plus, and Medicaid programs. Specifically,
the bill eliminates the face-to-face interview during the
recertification process for the Medicaid program; directs the
Commissioner of Health to develop a simplified recertification form
for persons renewing coverage in the Child Health Plus, the Family
Health Plus, and the Medicaid Program; allows persons who are applying
for community-based Medicaid to self-attest to their resource level;
provides a grace period (60 days) during the recertification process
for persons renewing Child Health Plus B coverage; allows individuals
to self-attest to income during the recertification process in the
Child Health Plus B program; and includes the use of an ambulance as
an added service under the Child Health Plus benefit package.
The bill also provides $2,700,000 to support administrative costs in
SFY 2002-03 related to a Medicaid Buy-In Program for the working
disabled. The program would provide Medicaid coverage for disabled
persons, up to 250 percent of the Federal Poverty Level (FPL), and
with assets up to $10,000, effective April 1, 2003. Workers with
incomes above 150 percent of the FPL will pay a premium for coverage
based on a sliding fee scale. In addition, the bill provides $900,000
in SFY 2002-03 for Medicaid coverage up to 250 percent of the FPL to
uninsured and underinsured women diagnosed with breast cancer or
cervical cancer who are screened through the Center for Disease
Control's program, effective October 1, 2002.
Article VII
In an Article VII bill, the Executive proposes:
-- authorizing the transfer of the Working Disabled 1619-b program
from the General Fund to the Health Care Reform Act of 2000.
The scheduled allocation amounts proposed by the Executive are
$6,400,000 in Calendar Year (CY) 2002 and $4,300,000 from
January 1, 2003 to June 30, 2003 from the HCRA 2000 Tobacco
Control and Insurance Initiatives Pool;
-- authorizing the transfer of the Medicaid Physicians Services
Program from the General Fund to the Health Care Reform Act of
2000. The scheduled allocation amounts proposed by the
Executive are $52,000,000 in CY 2002 and up to $43,000,000 from
January 1, 2003 to June 30, 2003 from the HCRA 2000 Tobacco
Control and Insurance Initiatives Pool;
-- directing all of the cigarette tax receipts from the 39 cent
increase to be deposited into the HCRA 2000 Tobacco Control and
Initiatives Pool;
-- increasing the HCRA 2000 allocations by $15,700,000 for the
period January 1, 2002 to December 31, 2002, and $9,000,000 for
the period January 1, 2003 to June 30, 2003 for the Elderly
Pharmaceutical Insurance Coverage (EPIC) Program.
Capital Projects
The Executive recommends an All Funds Capital Projects appropriation
of $156,600,000, an increase of $41,341,000 or 35.9 percent over SFY
2001-02 due to an increase in the Capital Projects Fund - 1996 Clean
Water/Clean Air (CWA) (Bondable) and the Federal Capital Projects
Fund.
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