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Department of Health and Hospitals

• The overall FY04 budget growth for the Department of Health and Hospitals is approximately 10% (including over $340 million in Medicaid financing mechanisms) from a department budget of $5.450 billion in December 2002 to $5.976 billion budgeted in the enrolled General Appropriation Bill.
   

• The growth in "real" funding for the administration, reimbursement and/or direct provision of health care services by the department is $232 million, or 4%, with an increase of 51 positions. (These figures exclude financing mechanisms.)
   
• The department will experience, from the funding levels described above, a portion of the 0.8% cut in discretionary spending amounting to a cut of approximately $5 million state funds and $20 million in total funding in a manner to be determined by the department and as approved by the Division of Administration.

Medicaid Administration and Services

• The total budget for Medicaid Administration and Services for FY04 is $5.013 billion, including $341 million in financing mechanisms that will generate over $240 million in state matching funds.
   
• The Legislature provided $4.5 billion for the delivery of medical services to Medicaid enrollees and the uninsured in FY04, thereby stabilizing funding in FY04 with a $184 million or 4% increase over FY03.
   
• Specifically, the increases/decreases in Medicaid's programs for medical services range from approximately +13% to -21%:
  • The Payments to Private Providers Program is increasing by $278 million (10%) to $3.193 billion.
  • The Payments to Public Providers Program is increasing by $53 million (10%) to $584 million.
  • The Medicare Buy-Ins Program is increasing by $13 million (13%) to $117 million.
  • The Uncompensated Care Costs Payments Program is decreasing by $160 million (-21%) to $606 million.
     
• The new state optional plan service known as Personal Care Attendants (PCA) is the result of the Barthelemy case and received $28.2 million in funding. Language in HB1 directs DHH to seek court approval to provide PCA services through a cost controlled waiver program rather than as a state plan option with potentially unlimited enrollment. Further, action taken in HB1 delayed implementation of the program by directing DHH to make preparations to deliver PCA services starting October 1, 2003, rather than July 1, 2003, if the court does not permit the waiver alternative.

Public Health Services

• In FY04, the budget for the Office of Public Health (OPH) will increase by $27 million (10% over the FY03 level) to total $294 million.
   
• The largest portion of this increase is t$16 million associated with the consolidation of the ChildNet program in OPH. ChildNet is a program for at-risk infants and toddlers age 3 and under offering physical, speech, occupational, and other therapies.

Mental Health Services

• In FY04, the budget for the Office of Mental Health (OMH) and the three Mental Health Areas will increase by $6 million (3% over the FY03 level) to total $252 million.

Developmental Disabilities Services

• In FY04, the budget for the Office for Citizens with Developmental Disabilities (OCDD) and the various Developmental Disabilities Centers (DD Centers) will increase by $9 million (4% over the FY03 level) to total $232 million.

Addictive Disorders Services

• In FY04, the budget for the Office for Addictive Disorders (OAD) will remain virtually constant increasing only by $0.3 million (0.4%, over the FY03 level) to total $69 million.

LSU Health Sciences Center - Health Care Services Division

• Due to the use of short-term financing mechanisms in the Medicaid program and the federally imposed cap on federal matching funds for the provision of health care services for the uninsured, the LSU Health Sciences Center - Health Care Services Division (HCSD) faced a reduction of $98 million in FY04 in the early phases of the appropriation process.
   
• The Senate added $36 million in State General Fund to the FY04 General Appropriation Bill to partially offset this reduction.
   
• HCSD will restructure services provision across its facilities in FY04 in response to the $50 million budget reduction from its FY03 base budget.
   
• Further, Act 432 (FY03 Supplemental Appropriation Act, originally HB 1968) restored $14 million to HCSD's restricted account. This provides a revenue source to HCSD which otherwise would have been utilized in FY03.
   
• Assuming constant earnings in non-state funded revenues, HCSD's projected budget is $798.4 million for FY04, or -7.1% below the most recent FY03 projections of $859.7 million.
   
• The use of restored restricted accounts funds to further offset reductions in FY04 will produce a net projected budget reduction of -5.5% for FY04.
   
• HCSD is currently working to develop a budget for FY04 that will be presented to the LSU Board of Supervisors for approval at its July 2003 meeting.
   
• Under the management authority granted in Act 906 of the 2003 Regular Session, HCSD will be able to offset, to a degree, reduced revenues by charging non-indigent patients for care, reduce services up to 35% to correspond to anticipated revenue collections, and E. A. Conway Medical Center in Monroe was transferred to the LSU Health Sciences Center - Shreveport on July 1, 2003.
   
• HCSD's FY04 budget contains $33 million for the costs of providing medical services to state and local inmates at its nine facilities.

LSU Health Sciences Center - New Orleans

• HSC-NO will receive an additional $6.6 million in the Tobacco Tax Health Care Fund to support the Louisiana Cancer Research Center in FY04. Also, $8.25 million in unspent funds from FY03 will be carried forward into FY04. This will bring the total in the fund for HSC-NO to $26.3 million.

LSU Health Sciences Center - Shreveport

• The LSU Health Sciences Center - Shreveport (HSC-S) will have to closely monitor expenditures in FY04 at University Hospital.
   
• Due to the use of short-term financing mechanisms in the Medicaid program and the federally imposed cap on federal matching funds for the provision of health care services for the uninsured, HSC-S faced a total budget problem of $14.6 million in the early phases of the appropriation process.
   
• The Senate added $5.1 million State General Fund and $3.7 million in additional Medicaid claims in the FY04 General Appropriation Bill to partially offset this reduction.
   
• Further, Act 432 (FY03 Supplemental Appropriation Act, originally HB 1968) restored $3 million to HSC-S's restricted account.
   
• These actions leave HSC-S with a remaining budget problem of roughly $2.8 million.
   
• HSC-S's FY04 budget contains $5 million for the costs of providing medical services to state and local inmates at University Hospital.
   
• Under the provisions of Act 872 and Act 906 of the 2003 Regular Session, E. A. Conway Medical Center in Monroe was transferred to the HSC-S on July 1, 2003.
   
• HSC-S will receive an additional $2.6 million in the Tobacco Tax Health Care Fund to support its Cancer Center in FY04. This will bring the total in the fund for HSC-S to $7 million.