Key HHS Legislative Appropriations Request (LAR) Update: the Budget
The Department of State Health Services (DSHS)’s LAR contained a trauma funding surprise. The Legislative Budget Board and Governor’s Office of Budget Planning held an LAR Hearing for Health and Human Services on September 22nd. Prior to the hearing, THOT’s advocacy director spotted a trauma funding error, and spoke with DSHS about the Trauma Facility and EMS funding request in the baseline budget for FY 2018/19. DSHS’ request was substantially lower than the previous year – only about $14.6 million a year was requested compared to previous years’ funding for closer to $58 million. DSHS looked into the issue, and reported that they made an error with the LBB budget instructions on how to handle one-time funding, resulting in them leaving $44 million a year out of the base request that should be in there for the Trauma Facility and EMS strategy.
The LBB requested that all one-time funding items from the previous session’s budget riders be zeroed out to allow the Legislature the ability to determine their continuation. This policy impacted the increase in the trauma add on, as well as the safety-net and rural add on.
Overall, DSHS’s initial baseline request included $25 million in reductions.
On September 30, a revision to the LAR was submitted for the omitted amount noted above ($44.3 mill). In addition, DSHS also requested that the trauma increase ($32.2 mill), rural ($10 mill) and safety-net add ons ($64.3 mill) be considered as part of their base request. DSHS noted that theses strategy funds are for Medicaid entitlement services and should be excluded from the General Revenue limit.
The Health and Human Services Commission (HHSC) also laid out its appropriations request on September 22nd. HHSC’s baseline LAR included the requested four percent reduction or $179.8 million in general revenue for the agency.
Program eliminations include $10 million for In- Home Family Support Program, $1 million for Lifespan Respite, and $5 Million for relocation specialist functions. Reductions include $1.7 million for Child Care Licensing, $3 million for Blindness, Education, Screening, and Treatment and Comprehensive Rehabilitation, $51 million for reductions to administrative areas at HHSC, $18 million for WIC program formula rebates, and $9.8 million in Indigent Health Care Reimbursement for UTMB. HHSC also anticipated saving about $54 million from non-entitlement Medicaid waiver reductions, and $26.4 million by reducing provider rates for Medicaid and CHIP dental programs by 2.75 percent.
The Texas Legislative Budget Board (LBB) and leadership are continuing the state budgeting process in preparation for the upcoming legislative session. The LBB (a ten-member Board, co-chaired by the Lieutenant Governor and Speaker of the House, provides the Texas Legislature with recommended legislative appropriations for all agencies of state government) sent legislative appropriations request (LAR) instructions to all state agencies.
On June 30th, the Governor and legislative leadership sent a letter to state agencies, institutions of higher education, board and commission chairs regarding the development of the 2018-19 biennial budget. The letter calls for all entities to reduce their budgets by four percent from the base appropriation levels. The Foundation School Program, public safety resources in the border region, debt services, state pensions, Child Protective Services, behavioral health service programs, Medicaid, CHIP, foster care program and adoption subsides were all exempted from the call for a four percent reduction.
Between July and August, state agencies developed strategic plans and their LARs, and submitted them to the LBB and Governor’s Office of Budget, Planning and Policy. LAR submissions can be viewed here: LAR submissions.
Starting in September and running through December, the LBB and Governor’s Office of Budget Planning and Policy are holding scheduled hearings on each agency’s LAR and preparing budget recommendations for the Legislature. These recommendations form the starting point for the serious budget work. The 85th Regular Legislative Session begins on January 10, 2017.