2016 -booklet cover HB1 reeng w sfca - lfo.louisiana.gov old files/FY17_HB 1 Reengrossed SA_LFO Report.pdfAnalysis of HB 1 Reengrossed w/Senate Amendments Table of Contents Executive

John D. Carpenter, Legislative Fiscal Officer Evan Brasseaux, LFO Staff Director

John D. Carpenter, Legislative Fiscal Officer

Evan Brasseaux, LFO Staff Director

June 3, 2016

LOUISIANA LEGISLATIVE FISCAL OFFICE

Analysis of HB 1 Reengrossed,

with Senate Amendments 2016 RS

Executive Summary

Department Budget Summary

Major Enhancements and Increases

Major Reductions

Budget Issues

House Rule 7.19 Report

Analysis of HB 1 Reengrossed w/Senate Amendments

Table of Contents

Executive Summary 1 Department Budget Summary 6 Major Enhancements & Increases 14 Major Reductions 35 Budget Issues 51 House Rule 7.19 Report 64

Executive Summary LFO 6/3/2016 1

Executive Summary

Legislative amendments resulted in a net SGF increase for the general operating budget of $1.35 B above HB 1 Original. The Table below depicts the FY 17 SGF status of HB 1 as it leaves the Senate Floor. The source of the net SGF growth is a projected revenue increase of $1.26 B associated with additional revenues from the 2016 First Extraordinary Session.

Notes: 1) The Total Available General Fund Revenue and Total Appropriations and Requirements rows do not reflect a contingent appropriation and associated revenue of $17 M for the thirteenth managed care payment pushed into FY 17 from FY 16. 2) Total projected Debt Service expenditures (non-appropriated Constitutional requirements) will be updated to $401,452,087 upon publication of the next Fiscal Status Statement by the Division of Administration. 3) The net General Fund Revenue Less Appropriations and Requirements of ($324,693) will become $3,030,022 once the new Debt Service payment schedule is officially adopted. Bond Security & Redemption Fund (BSRF) House amendments inserted Preamble language that directed the Commissioner of Administration to reduce the appropriations out of statutory dedications and fees and self-generated revenues by the amounts that are allocated for the payment of debt service. The reduction was the relative contribution of each means of finance to the non-appropriated debt service as authorized in the Constitution and applied only to funds credited to the BSRF. Since debt service is currently funded entirely by general fund, by re-directing statutory dedications and self-generated revenue appropriated in HB 1 from their current use to fund debt service, this same amount of general fund (estimated at $100 M) would be available in other areas of the budget, although those funds would not represent new revenues. The Senate stripped this language from the Preamble and the use of these monies is no longer contemplated in HB 1.

Executive BudgetHB 1 & Other

FY 2017 REC 2/10/16

GENERAL FUND REVENUE

Revenue Estimating Conference $8,239,300,000Total Available General Fund Revenue(1) $8,239,300,000

SGF APPROPRIATIONS AND REQUIREMENTS

Non-Appropriated Constitutional RequirementsDebt Service(2) $404,806,802Interim Emergency Board $1,720,862Revenue Sharing $90,000,000

$496,527,664

AppropriationsGeneral(1) $7,565,546,630DOJ $0Ancillary $0Judicial $121,477,570Legislative $55,748,136Capital Outlay $0

Total Appropriations $7,742,772,336

Total Appropriations and Requirements(1) $8,239,300,000

$0

State General Fund Status

Total Non-Appropriated Constitutional Requirements

General Fund Revenue Less Appropriations and Requirements(3)

HB 1 REENG& Other After House Action

FY 2017REC 3/16/16

$9,498,500,000$9,498,500,000

$404,806,802$1,720,862

$90,000,000$496,527,664

$8,887,966,405$4,808,077

$0$143,855,017

$63,522,124$0

$9,100,151,623

$9,596,679,287

($98,179,287)

State General Fund StatusHB 1 REENG

HB 1 REENG & Other After& Other After Senate ActionSenate Action Compared to

FY 2017 HB 1 & Other ORGREC 3/16/16 (Difference)

$9,498,500,000 $1,259,200,000$9,498,500,000 $1,259,200,000

$404,806,802 $0$1,720,862 $0

$90,000,000 $0$496,527,664 $0

$8,792,424,482 $1,226,877,852$0 $0$0 $0

$143,855,017 $22,377,447$66,017,530 $10,269,394

$0 $0$9,002,297,029 $1,259,524,693

$9,498,824,693 $1,259,524,693

($324,693) ($324,693)

State General Fund Status

Executive Summary 2 LFO 6/3/2016

General Government Overview DPSC Corrections Services DPSC Corrections Services identifies additional funding needs of approximately $18.8 M SGF compared to the current budget recommendation in HB 1. The potential shortfall is in large part due to unfunded supplemental needs identified by DPSC of $14.5 M in FY 16 that will impact FY 17 operations. In order to realign its operations to recommended appropriation levels, the department reports that it will make reductions to existing operating activities to address its projected shortfall. These actions include reductions to per diem rates for private prisons, local housing of adult offenders and transitional work programs. The department also plans to eliminate funds associated with equipment purchases, deferred maintenance, increased pharmaceutical utilization needs, increased utility costs, human capital management fees, and dialysis contracts to meet growing demand. Lastly, the department indicates that it will close all existing reentry centers. Note: DPSC moved monies between budget units in the Supplemental Appropriations Bill (HB 1047) to cover these supplemental needs in FY 16 utilizing existing resources. DPSC Youth Services – Office of Juvenile Justice The Office of Juvenile Justice (OJJ) identifies additional funding needs of approximately $19.4 M SGF compared to the current budget recommendation in HB 1. The shortfall remains in part due to ongoing unfunded supplemental needs in the departments existing operating budget as well as a lack of additional funding to open a new facility in FY 17. OJJ has carried deficits in excess of $5 M in each of the past several fiscal years associated with seed funding received from the treasury for which the department was unable to repay due to anticipated but uncollected revenues from Title IV-E (federal monies for states to provide child welfare services. Part E provides federal payments for foster care, adoption assistance and guardianship assistance programs as well as services for youth who are transitioning, or who have already transitioned, out of the foster care system). The department reports that it will postpone the opening of the Acadiana Center for Youth to effectuate a cost savings of $14.2 M. OJJ will reduce capacity at the Bridge City Center for Youth and the Swanson Center for Youth by 24 youth each, allowing the department to close one dormitory at each facility and eliminate funding for 28 vacant positions (14 per facility) to produce a projected savings of $1.8 M. OJJ also intends to reduce funding for contract services and group homes (non-secure care) by approximately $1.3 M by reducing available slots for statewide placements. OJJ will make reductions to probation and parole activities by closing one office and by reducing 28 vacant positions for a savings of approximately $1.9 M. Finally, OJJ will eliminate 2 unspecified positions at its Central Office for an additional $0.1 M savings.

Education Overview

Elementary & Secondary Education The FY 17 Executive Budget includes an adjustment of $14.8 M for an anticipated increase of 2,298 students. Additionally, there is a $3.7 M MOF swap replacing SGF with Lottery Proceeds and SELF funds based on the most recent Revenue Estimating Conference (REC) forecast. FY 17 recommended funding totals $3,649 M; $3,356.6 M SGF, $181.1 M Lottery Proceeds Fund and $109.7 M SELF Fund. The FY 16 MFP included $44.2 M, which was funded in a supplemental appropriation outside of the formula: a 1.375% inflation adjustment ($36.2 M); an increase for the Supplemental Course Allocation ($2.6 M); and an increase for the High Cost Services Allocation ($5.4 M). HR 231 of 2015 urged and requested BESE to incorporate the supplemental funding into the FY 17 resolution. As such, the proposed MFP for FY 17 approved by BESE on March 4th incorporated this adjustment into the formula. This represented standstill funding for the MFP. However, in light of the state fisc, the MFP resolution (SCR 44) was rejected by the Senate Education Committee and pursuant to the Constitution, the MFP will be funded in accordance with the last approved resolution (SCR 55 of 2014); accordingly, the proposed budget eliminates this supplemental MFP funding of $44.2 M. Higher Education The Existing Operating Budget (EOB) as of 12/1/2015 (without OSFA) totals $2.28 B (including $418.9 M SGF and $350 M SAVE). (SAVE was repealed by Act 21 of 2016 First Extraordinary Session). HB 1 with Senate amendments recommends a total budget of $2.23 B, reflecting a net reduction of $48 M; a $93.7 M reduction in SGF and SGF equivalent, a $15.5 M decrease in IAT and Statutory Dedications, and a $61.2 M increase in SGR from fees associated with Act 377 of 2015. Authorized positions totaling 19,483 have been moved off budget.


Act 462 of 2014 required the Board of Regents to develop an outcomes based funding formula for implementation beginning in FY 17. The proposed formula allocates SGF for each institution/system based on a 70% pro-rata share (base funding), 15% cost calculation share and a 15% outcomes share. The pro-rata calculation is based on the 7/1/2016 appropriation levels and provides safeguards to prevent sudden, dramatic changes in the funding level of any postsecondary institution (Act 462). The FY 17 TOPS need is $297.1 M. Executive Budget recommendations totaled $60.2 M but funding was increased to $225.2 M through House actions. Additionally, the House included a supplemental budget recommendation to provide for restoration of the $71.9 M in the event additional revenues are recognized by the REC. The Senate funded TOPS at $141.4 M ($81.2 M SGF and $60.2 M TOPS Fund) with no supplemental budget recommendation.

Health & Hospitals Medicaid Overview HB 1 with Senate amendments provides an additional $552.7 M in SGF ($2.2 B total increase in funding) for Medicaid in FY 17. Total Medicaid funding for FY 17 represents a 27.6% increase from the FY 16 EOB (29.5% increase in SGF). In addition, HB 1 reflects approximately $160 M in SGF savings associated with the implementation of Medicaid expansion for certain individuals up to 138% of the Federal Poverty Level (FPL). Projected SGF savings are largely based on a $249 M reduction in Disproportionate Share Hospital (DSH) payments related to uncompensated care costs. Senate amendments provided significant changes to various House amendments. Specifically, the Senate eliminated $24.8 M in additional funding for rural hospitals added by the House, and eliminated a House amendment that authorized DHH to implement copayment requirements (to the extent authorized under federal law) for individuals receiving certain Medicaid services. In addition, Senate amendments moved $161 M total funding ($60.8 M SGF) in supplementary budget recommendations to the body of HB 1. Information provided by DHH indicates the $161 M in funding moved from the supplementary section of the HB 1 will allow for full funding of all existing waiver slots, and prevent significant cuts to Pediatric Day Healthcare Services. Although these items were not itemized as a cut in the Executive Budget, DHH itemized these services as areas of reduction based on the level of funding provided after House action. In addition, Senate amendments eliminated the line item appropriation for the public private partner hospitals, and reduced the level of supplemental payments and DSH payments by approximately $98.5 M ($60.4 M SGF). Additionally, SGR used as a state match source increased by $18.6 M for the hospital partnership in Houma. (See Public Private Partnership explanation on next page.) The Medicaid budget contains certain significant increases/enhancements in FY 17, including funding projected growth in Bayou Health, funding for an FY 16 Bayou Health payment obligation pushed into FY 17 (1 additional Bayou Health check write added in FY 17), MCO payments for Medicaid expansion for individuals to 138% of the FPL, annualized costs of certain home and community based waivers, increases in projected pharmacy costs and provider rate increases, and funding the backfill of revenues reduced in FY 16 as part of the FY 16 mid-year deficit elimination plan. Significant FY 17 SGF increases are reflected below: $195.3 M - Bayou Health managed care capitation rate payments $167.0 M - Swap non-recurring one-time revenues for SGF $109.2 M - FY 16 pushed check write (June 2016) into FY 17 * $24.3 M - Fee for Service increases (including Pharmacy, PACE, and LT-PCS) $21.3 M - Rate increases (FQHC’s, RHC’s, Hospice, Buy-in, Rural H’s, Nursing F’s) * The $109.2 M enhancement reflected above does not include $17 M in SGF required state match to make the projected 13 th managed care payment. This amount will only be available for expenditure when the Department of Revenue prevails in any suit appeal, or petition associated with an amount paid under protest and held in escrow in accordance with R.S. 47:1576 and transfers such monies to the SGF to be utilized to fund the 13th managed care payment. The total SGF need is $126.2 M to draw down $208.2 M in federal funding for $334.4 M in total payments.


Public Private Partnerships (PPP) HB 1 provides total funding of $983.3 M for Public Private Partnerships in FY 17. This represents a $221 M reduction (18%) compared to the FY 16 EOB as of 12/01/16. Information provided by DHH indicates an original expenditure projection of approximately $1.3 B. This original expenditure projection is assumed to change as DHH assumes and will apply a 25% ($249,541,305) reduction in DSH payments to partner hospitals due to anticipated decreases in uncompensated care costs as a result of Medicaid expansion in FY 17 (not including Lallie Kemp). However, the Commissioner of Administration has stated that the DOA, LSU, and partner hospitals are under negotiations to refinance the partnership agreements, and to further review the 25% DSH reduction estimates. HB 1 does not directly appropriate funding in the Medicaid Program for the individual partner hospitals. Partner hospital reimbursements are paid from the Medicaid Private Providers and Uncompensated Care Costs programs. Therefore, the exact budget by hospital is not known. In addition, the majority of the partnership agreements provide for a finance formula that requires payments to reimburse the hospital providers at 100% of allowable UCC costs

Other Issues

FY 16 Unmet Supplemental Needs The FY 16 Supplemental Bill (HB 1047) provides adjustments for certain supplemental needs that do not require SGF. However, a number of agencies have expenditures in the current year, for which there are insufficient revenues to fully fund. Some of these items were identified in the 1st Special Session as expenditure requirements that would likely have to be absorbed by the respective agencies; others have been identified more recently. These unmet supplemental needs total $71.3 M; a brief discussion of each is identified below. LA Public Defender Board ($3.5 M) - The Public Defender Board reports that the supplemental funding needs which are not included in HB 1047 would be used to end restriction of services (ROS) plans currently enacted in 15 of the 42 local public defender offices statewide. Without these supplemental funds, the 15 districts presently under ROS plans would continue operating with services at reduced levels, which includes taking on fewer cases and placing some cases on a waiting list. The current version of HB 1 does not include funding for this shortfall in FY 17. Governor’s Office of Homeland Security & Emergency Preparedness (GOHSEP) ($10 M) - Supplemental funding needs materialized as a result of damages sustained in the recent Severe Weather and Flooding event DR-4263, which began on 4/2/2016, and includes the required state cost share of the event. Current estimates total $9,589,375 and will increase slightly due to ongoing response efforts. The State of LA, through GOHSEP, negotiated a repayment plan for a total estimated $10 M, payable in three annual installments, and will accrue interest at the rate of one percent. The first payment will be $4.4 M, due 8/1/2016. The final pay plan will be adjusted once actual costs are determined. Projected costs in FY 18 and FY 19 are approximately $2.85 M annually. HB 1 does not include funding for this shortfall in FY 17. Department of Children & Family Services (DCFS) ($10.9 M) - There are additional needs in Child Welfare services due to unrealized savings anticipated from Targeted Case Management (TCM) due to non-approval of the program by the federal Centers for Medicare and Medicaid (CMS). Taylor Opportunity Program for Scholars (TOPS) ($29.1 M) - The appropriation for TOPS is “more or less estimated” and historically any projected payments in excess of the appropriation are provided in a supplemental appropriation bill. In FY 15 supplemental funding needs of approximately $5 M was not provided and was funded out of the FY 16 appropriation. Additionally, the amount of the current year appropriation did not contemplate tuition increases that were implemented by several institutions. Finally, TOPS Fund revenue collections are $3.7 M lower than what is appropriated, which would otherwise require a mean of finance swap with SGF. Institutions will be required to absorb the ($29.1 M) shortfall. HB 1 funds TOPS at $141.4 M, or approximately 47.5% of actual projected need in FY 17. Local Housing of State Adult Offenders (LHSAO) ($7 M) - Total FY 16 supplemental needs totaled $13.8 M, primarily as a result of a $3 M shortfall carried forward from FY 15 and the inability to fully realize projected GEMS savings of $7.3 M. This need was offset by transfers in HB 1047 from the Transitional Work Release Program ($4.8 M) and Local Reentry Services Program ($2.1 M) for a net shortfall of $7 M. Per historical practice of DPSC Corrections Services, this shortfall will be carried forward and paid in FY 17 from the appropriated budget. HB 1 does not include additional funding to address this carry forward expenditure obligation.


Judicial Budget (HB 616) HB 616, which provides for the judicial branch’s expenses in FY 17, presently has a projected $16 M shortfall according to staff from Supreme Court. Because a majority of the judicial branch’s expenses are constitutionally and statutorily mandated, the Supreme Court reports that the $16 M shortfall can only be absorbed within select programs of the judiciary’s budget. These programs include drug courts, Court-Appointed Special Advocate services (CASA), Child in Need of Care services (CINC), and the ability to take on Family in Need of Services (FINS) cases. The impact of the reduction to these programs is unknown and subject to the discretion of the Judicial Budgetary Control Board, who will allocate the reduction to the programs as it sees fit. Funds Bill (HB 409) HB 409 provides for deposits of state funds into the general fund and other special treasury funds. It nullifies fund transfers previously approved by JLCB as part of mid-year reductions contained in prior year fund transfer bills that have not occurred as of 7/1/2016. Senate amendments direct the Treasurer to transfer and deposit the payment of $20 M received 30 days after the British Petroleum settlement was signed into the Oil Spill Contingency Fund and to transfer and deposit $19.13 M received 60 days after the British Petroleum settlement was signed into the Natural Resource Restoration Trust Fund. The Treasurer will also reverse a transfer of $7 M that was made to the Attorney General from the initial $20 M settlement. These settlements of $39.13 M are current year deposits. The Treasurer is further directed to transfer upon receipt, any future economic settlement proceeds ($19.13 M in FY 17 and $53 M annually beginning in FY 19) in accordance with current law. The bill exempts settlements related to the Deepwater Horizon incident from being deposited into the Department of Justice Legal Support Fund. Finally, the amendments direct the transfer of $7 M from the Attorney General’s Consumer Support Escrow Fund to the state general fund. These funds were used to address the current year shortfall in the Minimum Foundation Program (MFP).

FY 2015 FY 2016 FY 2017 Change

Previous Year Current Year Next Year2017 2016- Percent

Change

Statewide Budget

Actual EOB 12/1/2015


HB 1 Reengrossed w/Sen Am

STATE GENERAL FUND (Direct): $8,714,990,337 $8,560,149,964 $9,498,824,693 $938,674,729

Interagency Transfers 1,554,250,005 1,866,810,009 1,716,699,118 -150,110,891Fees & Self-gen Revenues 3,714,373,566 3,874,676,933 3,903,728,201 29,051,268Statutory Dedications 4,344,847,493 4,113,414,793 3,684,328,236Interim Emergency Board 243,089 0 0 0FEDERAL FUNDS 8,762,251,803 9,957,616,548 11,744,037,628 1,786,421,080

$27,090,956,293 $28,372,668,247 $30,547,617,876 $2,174,949,629

-429,086,557

STATE GENERAL FUND BY:

52,955T.O. 52,453 32,771 -19,682

11.0%

-8.0%0.7%

-10.4%

17.9%7.7%

-37.5%

GRAND TOTAL - Statewide Budget

$18,803,580,248$18,415,051,699 $388,528,549$18,328,704,490 2.1%STATE FUNDS (excludes Federal):1,935Other Charges Positions 1,902 1,906 4 0.2%

STATE GENERAL FUND (Direct): $8,118,488,231 $8,041,802,994 $8,792,424,482 $750,621,488

Interagency Transfers 857,056,408 1,273,863,871 951,378,622 (322,485,249)Fees & Self-gen Revenues 2,088,336,606 2,196,127,927 2,320,776,082 124,648,155Statutory Dedications 2,948,388,327 3,106,059,529 2,576,938,419Interim Emergency Board 243,089 0 0 0FEDERAL FUNDS 8,549,235,560 9,724,140,405 11,610,975,158 1,886,834,753

$22,561,748,221 $24,341,994,726 $26,252,492,763 $1,910,498,037

(529,121,110)


51,807T.O. 50,948 31,264 (19,684)

9.3%

(25.3%)5.7%

(17.0%)

19.4%7.8%

(38.6%)

General Appropriation Bill

1,926Other Charges Positions 1,892 1,896 401 Executive

STATE GENERAL FUND (Direct): $147,985,370 $124,494,110

Interagency Transfers 81,397,640 80,932,058Fees & Self-gen Revenues 156,925,827 125,149,512Statutory Dedications 115,761,413 192,212,823Interim Emergency Board 243,089 0FEDERAL FUNDS 1,253,826,731 1,721,638,229

$1,756,140,070 $2,244,426,732


2,011T.O. 1,888

1.1%

7.9%(11.5%)

5.9%

(4.2%)(3.2%)

0.5%

$123,200,136

75,017,789141,355,786181,516,536

01,797,427,266

$2,318,517,513

1,878

$1,293,974

5,914,269-16,206,274

0-75,789,037

-$74,090,781

10,696,287

10381Other Charges Positions 358 358 0

03 Veterans AffairsSTATE GENERAL FUND (Direct): $5,241,090 $5,571,247

Interagency Transfers 1,263,135 1,606,948Fees & Self-gen Revenues 14,563,275 15,765,052Statutory Dedications 20,037 115,528Interim Emergency Board 0 0FEDERAL FUNDS 36,726,098 38,503,005

$57,813,635 $61,561,780


840T.O. 840

33.4%

(38.1%)(1.8%)

0.0%

(1.4%)(0.7%)

0.2%

$4,177,469

2,596,75216,050,000

115,5280

39,048,575$61,988,324

838

$1,393,778

-989,804-284,948

0-545,570

-$426,544

0


Department Budget Summary 6 LFO 6/3/2016



Change

Statewide Budget




04a StateSTATE GENERAL FUND (Direct): $50,531,130 $52,961,485

Interagency Transfers 213,684 325,000Fees & Self-gen Revenues 25,332,729 26,104,125Statutory Dedications 156,519 514,078Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$76,234,062 $79,904,688


313T.O. 313

(5.1%)

(19.3%)(0.3%)

0.0%

(3.6%)

0.0%

$55,809,470

402,81326,176,288

514,07800

$82,902,649

313

-$2,847,985

-77,813-72,163

00

-$2,997,961

0


04b JusticeSTATE GENERAL FUND (Direct): $14,016,254 $4,808,077

Interagency Transfers 28,422,106 22,615,754Fees & Self-gen Revenues 4,159,720 6,816,714Statutory Dedications 11,693,385 22,098,978Interim Emergency Board 0 0FEDERAL FUNDS 4,890,205 7,546,816

$63,181,670 $63,886,339


467T.O. 479

(37.2%)

(24.8%)(39.2%)

(7.7%)

(2.9%)(20.8%)

0.0%

$7,656,685

30,055,95711,215,39023,953,222

07,771,651

$80,652,905

479

-$2,848,608

-7,440,203-4,398,676

0-224,835

-$16,766,566

-1,854,244


04c Lieutenant GovernorSTATE GENERAL FUND (Direct): $1,341,788 $1,067,306

Interagency Transfers 6,046 618,931Fees & Self-gen Revenues 10,000 10,000Statutory Dedications 0 0Interim Emergency Board 0 0FEDERAL FUNDS 3,981,759 5,488,059

$5,339,593 $7,184,296


7T.O. 7

(17.4%)

88.0%0.0%

(0.4%)0.6%

0.0%

$1,291,957

329,13210,000

00

5,511,341$7,142,430

7

-$224,651

289,7990

0-23,282$41,866

0


04d TreasurySTATE GENERAL FUND (Direct): $0 $0

Interagency Transfers 1,588,495 1,488,674Fees & Self-gen Revenues 8,319,502 8,762,768Statutory Dedications 464,741 811,455Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$10,372,738 $11,062,897


54T.O. 54

4.8%7.7%

(5.4%)

6.2%

0.0%

$0

1,421,1238,139,506

857,59600

$10,418,225

54

$0

67,551623,262

00

$644,672

-46,141


04e Public Service CommissionSTATE GENERAL FUND (Direct): $0 $0

Interagency Transfers 0 0Fees & Self-gen Revenues 0 0Statutory Dedications 8,872,612 9,699,663Interim Emergency Board 0 0FEDERAL FUNDS 136,555 0

$9,009,167 $9,699,663


97T.O. 99

9.0%

9.0%

2.1%

$0

00

8,895,47100

$8,895,471

97

$0

00

00

$804,192

804,192


Deparrtment Budget Summary 7 LFO 6/3/2016



Change

Statewide Budget




04f Agriculture & ForestrySTATE GENERAL FUND (Direct): $24,978,022 $24,908,204

Interagency Transfers 620,030 641,125Fees & Self-gen Revenues 6,089,614 7,296,414Statutory Dedications 29,461,427 32,547,947Interim Emergency Board 0 0FEDERAL FUNDS 7,306,299 9,071,078

$68,455,392 $74,464,768


555T.O. 563

(1.1%)

0.7%0.2%

(3.8%)

10.9%(0.9%)

1.8%

$25,193,802

636,9457,282,424

33,822,4710

8,176,775$75,112,417

553

-$285,598

4,18013,990

0894,303

-$647,649

-1,274,524


04g InsuranceSTATE GENERAL FUND (Direct): $0 $0

Interagency Transfers 0 0Fees & Self-gen Revenues 28,515,878 28,606,463Statutory Dedications 1,355,775 1,445,979Interim Emergency Board 0 0FEDERAL FUNDS 1,080,019 1,309,816

$30,951,672 $31,362,258


243T.O. 225

4.8%1.0%

(28.9%)2.6%

0.0%

$0

027,291,090

1,431,6290

1,842,690$30,565,409

225

$0

01,315,373

0-532,874$796,849

14,350


05 Economic DevelopmentSTATE GENERAL FUND (Direct): $16,491,399 $16,313,034


$43,440,820 $51,632,736


113T.O. 110

(2.0%)

(56.9%)182.6%(27.2%)

11.7%(4.7%)

0.0%

$16,649,775

2,856,1592,967,602

24,997,0690

6,711,410$54,182,015

110

-$336,741

-1,624,3305,420,271

0788,590

-$2,549,279

-6,797,069


06 Culture, Recreation & TourismSTATE GENERAL FUND (Direct): $34,486,802 $32,363,005


$82,074,622 $85,066,598


616T.O. 616

(15.3%)

3.8%(15.9%)

32.3%

(4.1%)(8.0%)

0.0%

$38,190,049

5,830,37930,499,15910,426,959

07,518,319

$92,464,865

616

-$5,827,044

221,187-4,849,916

0-306,448

-$7,398,267

3,363,954


07 Transportation & DevelopmentSTATE GENERAL FUND (Direct): $0 $0


$538,011,141 $594,833,788


4,220T.O. 4,195

0.0%3.1%1.8%

(9.5%)1.3%

0.0%

$0

11,910,00027,328,296

522,100,0170

25,971,119$587,309,432

4,194

$0

0854,119

0-2,474,327$7,524,356

9,144,564





Change

Statewide Budget




08 DPSC Corrections ServicesSTATE GENERAL FUND (Direct): $465,520,037 $464,976,800

Interagency Transfers 4,556,490 5,752,519Fees & Self-gen Revenues 37,710,253 41,575,686Statutory Dedications 54,000 54,000Interim Emergency Board 0 0FEDERAL FUNDS 1,114,366 2,230,697

$508,955,146 $514,589,702


4,716T.O. 4,684

0.5%

19.7%3.5%0.0%

50.7%1.1%

0.0%

$462,515,463

4,807,71940,179,645

54,0000

1,480,697$509,037,524

4,684

$2,461,337

944,8001,396,041

0750,000

$5,552,178

0


08 DPSC Public Safety ServicesSTATE GENERAL FUND (Direct): $8,328,017 $32,261,099


$400,110,218 $476,809,665


2,452T.O. 2,446

0.3%(1.7%)(7.3%)

(2.9%)2.6%

1.3%

$0

38,136,571153,843,013223,599,311

049,181,799

$464,760,694

2,414

$32,261,099

121,740-2,598,820

0-1,420,661

$12,048,971

-16,314,387


08 DPSC Youth ServicesSTATE GENERAL FUND (Direct): $94,973,085 $102,366,865

Interagency Transfers 12,261,736 11,959,959Fees & Self-gen Revenues 471,673 775,487Statutory Dedications 172,000 149,022Interim Emergency Board 0 0FEDERAL FUNDS 1,384,904 891,796

$109,263,398 $116,143,129


877T.O. 996

5.8%

(29.5%)0.0%0.0%

0.0%0.5%

0.0%

$96,781,581

16,959,959775,487149,022

0891,796

$115,557,845

996

$5,585,284

-5,000,0000

00

$585,284

0


09 Health & HospitalsSTATE GENERAL FUND (Direct): $2,159,530,454 $2,892,014,536

Interagency Transfers 284,145,847 292,779,384Fees & Self-gen Revenues 226,661,279 298,710,580Statutory Dedications 985,989,088 470,538,987Interim Emergency Board 0 0FEDERAL FUNDS 5,374,842,723 7,773,822,478

$9,031,169,391 $11,727,865,965


5,613T.O. 5,572

25.3%

(35.3%)65.7%

(21.5%)

33.6%25.3%

1.3%

$2,307,668,324

452,275,885180,307,677599,216,336

05,820,327,443

$9,359,795,665

5,502

$584,346,212

-159,496,501118,402,903

01,953,495,035

$2,368,070,300

-128,677,349

701,448Other Charges Positions 1,430 1,430 0

10 Children & Family ServicesSTATE GENERAL FUND (Direct): $136,927,778 $151,530,273

Interagency Transfers 8,759,707 16,420,568Fees & Self-gen Revenues 11,604,290 17,517,760Statutory Dedications 1,142,707 950,757Interim Emergency Board 0 0FEDERAL FUNDS 495,536,555 508,513,022

$653,971,037 $694,932,380


3,481T.O. 3,409

5.3%

(62.9%)0.0%

(24.3%)

(1.1%)(3.6%)

0.0%

$143,956,513

44,217,73417,517,760

1,255,6610

513,925,201$720,872,869

3,409

$7,573,760

-27,797,1660

0-5,412,179

-$25,940,489

-304,904





Change

Statewide Budget




11 Natural ResourcesSTATE GENERAL FUND (Direct): $11,344,882 $9,129,427

Interagency Transfers 16,074,009 13,975,783Fees & Self-gen Revenues 101,884 343,889Statutory Dedications 25,673,069 25,011,214Interim Emergency Board 0 0FEDERAL FUNDS 6,786,374 14,483,745

$59,980,218 $62,944,058


335T.O. 320

14.1%

(25.7%)0.0%

(13.0%)

(12.3%)(13.1%)

(1.2%)

$8,003,574

18,799,573343,750

28,753,3560

16,522,373$72,422,626

324

$1,125,853

-4,823,790139

0-2,038,628

-$9,478,568

-3,742,142

-40Other Charges Positions 0 0 0

12 RevenueSTATE GENERAL FUND (Direct): $1,375,682 $44,207,089

Interagency Transfers 171,585 243,000Fees & Self-gen Revenues 99,945,473 53,314,548Statutory Dedications 688,751 628,583Interim Emergency Board 0 0FEDERAL FUNDS 274,454 0

$102,455,945 $98,393,220


715T.O. 703

(67.6%)(44.6%)

14.4%

0.9%

0.4%

$0

749,80196,209,055

549,45900

$97,508,315

700

$44,207,089

-506,801-42,894,507

00

$884,905

79,124


13 Environmental QualitySTATE GENERAL FUND (Direct): $482,377 $0

Interagency Transfers 212,160 441,000Fees & Self-gen Revenues 20,515 24,790Statutory Dedications 86,717,126 96,773,972Interim Emergency Board 0 0FEDERAL FUNDS 17,043,424 20,148,647

$104,475,602 $117,388,409


681T.O. 677

(100.0%)

0.0%0.0%4.7%

0.7%3.6%

0.0%

$437,665

441,00024,790

92,417,4630

20,000,179$113,321,097

677

-$437,665

00

0148,468

$4,067,312

4,356,509


14 Workforce CommissionSTATE GENERAL FUND (Direct): $8,163,120 $6,530,496

Interagency Transfers 1,263,600 6,245,368Fees & Self-gen Revenues 15,088 272,219Statutory Dedications 94,589,851 109,698,626Interim Emergency Board 0 0FEDERAL FUNDS 142,107,393 160,383,558

$246,139,052 $283,130,267


938T.O. 917

(20.0%)

35.9%0.0%

(0.6%)

(3.8%)(2.4%)

0.0%

$8,163,120

4,595,368272,219

110,374,1660

166,725,300$290,130,173

917

-$1,632,624

1,650,0000

0-6,341,742

-$6,999,906

-675,540


16 Wildlife & FisheriesSTATE GENERAL FUND (Direct): $0 $0


$129,306,376 $191,667,751


753T.O. 773

19.4%(61.8%)

8.2%

8.4%7.0%

0.0%

$0

12,463,5445,266,234

116,075,0570

45,355,687$179,160,522

773

$0

2,419,686-3,254,660

03,793,715

$12,507,229

9,548,488





Change

Statewide Budget




17 Civil ServiceSTATE GENERAL FUND (Direct): $5,183,656 $5,354,654

Interagency Transfers 10,338,735 11,639,313Fees & Self-gen Revenues 785,269 1,091,160Statutory Dedications 2,000,245 2,214,578Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$18,307,905 $20,299,705


161T.O. 171

1.0%

0.6%6.9%4.4%

1.4%

1.2%

$5,302,054

11,569,0451,020,4342,120,685

00

$20,012,218

169

$52,600

70,26870,726

00

$287,487

93,893


18 Retirement SystemsSTATE GENERAL FUND (Direct): $8,925,579 $0

Interagency Transfers 0 0Fees & Self-gen Revenues 0 0Statutory Dedications 6,000,000 0Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$14,925,579 $0


0T.O. 0

$0

00000

$0

0

$0

00

00

$0

0


19 Higher EducationSTATE GENERAL FUND (Direct): $917,965,959 $786,770,212

Interagency Transfers 13,240,786 26,416,875Fees & Self-gen Revenues 1,226,718,796 1,387,996,800Statutory Dedications 196,750,337 175,521,643Interim Emergency Board 0 0FEDERAL FUNDS 84,441,241 79,903,497

$2,439,117,119 $2,456,609,027


19,972T.O. 0

21.1%

(35.3%)4.6%

(67.1%)

(3.8%)(6.7%)

(100.0%)

$649,879,923

40,846,0311,326,707,754

533,675,1650

83,058,059$2,634,166,932

19,483

$136,890,289

-14,429,15661,289,046

0-3,154,562

-$177,557,905

-358,153,522

-19,4830Other Charges Positions 0 0 0

19 Special Schools & Comm.STATE GENERAL FUND (Direct): $39,497,108 $38,920,524

Interagency Transfers 22,935,847 24,039,727Fees & Self-gen Revenues 2,867,523 3,263,033Statutory Dedications 22,615,747 25,107,770Interim Emergency Board 0 0FEDERAL FUNDS 52,342 85,086

$87,968,567 $91,416,140


730T.O. 726

0.0%

(2.3%)6.8%0.0%

(19.0%)(0.4%)

0.3%

$38,904,363

24,615,5913,055,133

25,107,2510

105,086$91,787,424

724

$16,161

-575,864207,900

0-20,000

-$371,284

519


19 EducationSTATE GENERAL FUND (Direct): $3,503,772,003 $3,490,973,708

Interagency Transfers 252,937,711 293,348,967Fees & Self-gen Revenues 38,483,910 57,422,846Statutory Dedications 311,556,056 305,732,761Interim Emergency Board 0 0FEDERAL FUNDS 1,030,764,233 1,121,989,830

$5,137,513,913 $5,269,468,112


516T.O. 481

(1.0%)

(25.9%)0.0%1.5%

2.3%(2.0%)

0.0%

$3,527,878,604

396,112,42957,422,846

301,242,8900

1,096,741,043$5,379,397,812

481

-$36,904,896

-102,763,4620

025,248,787

-$109,929,700

4,489,871





Change

Statewide Budget




19E LSU Health Care Services DivisionSTATE GENERAL FUND (Direct): $3,860,659 $24,664,566

Interagency Transfers 22,694,574 21,883,724Fees & Self-gen Revenues 4,878,873 11,972,658Statutory Dedications 0 0Interim Emergency Board 0 0FEDERAL FUNDS 4,488,695 4,800,336

$35,922,801 $63,321,284


331T.O. 0

(33.7%)

(30.6%)98.4%

0.0%(20.5%)

(100.0%)

$37,222,579

31,543,3836,034,389

00

4,800,336$79,600,687

331

-$12,558,013

-9,659,6595,938,269

00

-$16,279,403

0

-3310Other Charges Positions 0 0 0

20 Other RequirementsSTATE GENERAL FUND (Direct): $457,565,980 $480,237,765


$741,141,372 $752,427,406


0T.O. 0

(0.6%)

2.2%41.6%

(20.5%)

0.0%(6.5%)

$482,919,888

44,673,1898,832,200

262,839,1310

5,046,260$804,310,668

0

-$2,682,123

995,8203,676,080

00

-$51,883,262

-53,873,039


STATE GENERAL FUND (Direct): $228,691,719 $233,191,719 $209,872,547 ($23,319,172)

Interagency Transfers 697,193,597 592,946,138 765,320,496 172,374,358Fees & Self-gen Revenues 1,626,036,960 1,678,549,006 1,582,952,119 (95,596,887)Statutory Dedications 1,301,269,931 935,283,998 1,059,589,817Interim Emergency Board 0 0 0 0FEDERAL FUNDS 213,016,243 233,476,143 133,062,470 (100,413,673)

$4,066,208,450 $3,673,447,004 $3,750,797,449 $77,350,445

124,305,819


1,148T.O. 1,505 1,507 2

(10.0%)

29.1%(5.7%)13.3%

(43.0%)2.1%

0.1%

Other Appropriation Bills

9Other Charges Positions 10 10 021 Ancillary

STATE GENERAL FUND (Direct): $0 $0

Interagency Transfers 423,993,445 556,254,146Fees & Self-gen Revenues 1,477,357,984 1,484,108,024Statutory Dedications 70,189,624 121,000,000Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$1,971,541,053 $2,161,362,170


1,148T.O. 1,507

0.1%(0.9%)

0.0%

(0.6%)

0.1%

$0

555,953,2761,497,117,942

121,000,00000

$2,174,071,218

1,505

$0

300,870-13,009,918

00

-$12,709,048

0


23 JudiciarySTATE GENERAL FUND (Direct): $155,338,908 $143,855,017

Interagency Transfers 0 9,392,850Fees & Self-gen Revenues 0 0Statutory Dedications 6,616,337 10,407,485Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$161,955,245 $163,655,352


0T.O. 0

(10.0%)

0.0%

0.3%

(8.9%)

$159,838,908

9,392,8500

10,371,43400

$179,603,192

0

-$15,983,891

00

00

-$15,947,840

36,051





Change

Statewide Budget




24 LegislatureSTATE GENERAL FUND (Direct): $73,352,811 $66,017,530

Interagency Transfers 0 0Fees & Self-gen Revenues 27,324,676 22,584,095Statutory Dedications 10,001,063 10,000,000Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$110,678,550 $98,601,625


0T.O. 0

(10.0%)

(9.5%)0.0%

(9.0%)

$73,352,811

024,954,06410,000,000

00

$108,306,875

0

-$7,335,281

0-2,369,969

00

-$9,705,250

0


26 Capital Outlay CashSTATE GENERAL FUND (Direct): $0 $0

Interagency Transfers 273,200,152 199,673,500Fees & Self-gen Revenues 121,354,300 76,260,000Statutory Dedications 1,214,462,907 918,182,332Interim Emergency Board 0 0FEDERAL FUNDS 213,016,243 133,062,470

$1,822,033,602 $1,327,178,302


0T.O. 0

623.5%(51.3%)

15.7%

(43.0%)9.6%

$0

27,600,012156,477,000793,912,564

0233,476,143

$1,211,465,719

0

$0

172,073,488-80,217,000

0-100,413,673$115,712,583

124,269,768


STATE GENERAL FUND (Direct): $367,810,387 $285,155,251 $496,527,664 $211,372,413

Interagency Transfers 0 0 0 0Fees & Self-gen Revenues 0 0 0 0Statutory Dedications 95,189,235 72,071,266 47,800,000Interim Emergency Board 0 0 0 0FEDERAL FUNDS 0 0 0 0

$462,999,622 $357,226,517 $544,327,664 $187,101,147

(24,271,266)


0T.O. 0 0 0

74.1%

(33.7%)

52.4%

Non-Appropriated Requirements

0Other Charges Positions 0 0 022 Non-Appropriated Requirements

STATE GENERAL FUND (Direct): $367,810,387 $496,527,664

Interagency Transfers 0 0Fees & Self-gen Revenues 0 0Statutory Dedications 95,189,235 47,800,000Interim Emergency Board 0 0FEDERAL FUNDS 0 0

$462,999,622 $544,327,664


0T.O. 0

74.1%

(33.7%)

52.4%

$285,155,251

00

72,071,26600

$357,226,517

0

$211,372,413

00

00

$187,101,147

-24,271,266



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isting

syste

mto

beco

me

com

plian

twith

the

Affo

rdab

leCa

reAc

t.Co

stsar

esp

litbe

twee

nim

plem

enta

tion

ofan

Ente

rpris

eAr

chite

cture

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m($

10,3

05,4

52)f

orth

em

oder

nizat

ionof

allm

edica

idinf

orm

ation

syste

ms/f

uncti

ons,

and

costs

asso

ciate

dwi

tha

new

enro

llmen

tsys

tem

fore

ligibi

lityde

term

inatio

nsan

dto

main

tain

reco

rds

ofap

plica

nts/e

ligibl

es($

20,2

76,0

43).

Costs

fore

ligibi

lityan

den

rollm

enti

nclud

ede

sign

and

deve

lopm

ent(

$14,

426,

043)

,OTS

staff

($2,

500,

000)

, har

dwar

e an

d so

ftwar

e ($

2,50

0,00

0) a

nd sy

stem

main

tena

nce

($85

0,00

0).

$4,6

23,4

760

305

09-

Med

ical V

endo

rAd

mini

strat

ionHe

alth

&Ho

spita

ls$3

0,58

1,49

4

Fund

ingfo

rthe

3rd

Party

Liabil

ity(T

PL)f

uncti

on.T

heso

urce

offe

dera

lfun

ding

($94

2,50

0)is

fede

ral

Med

icaid

adm

inistr

ative

mat

ch.

LApu

rsue

slia

ble3r

dpa

rties

form

onet

ary

reco

verie

sof

paym

ents

inor

dert

oen

sure

that

Med

icaid

isth

epa

yero

flas

tres

ort.

Info

rmat

ionpr

ovide

dby

DHH

indica

tes

the

curre

nt T

PL co

ntra

ct lap

sed

in De

cem

ber 2

014.

$942

,500

030

509

-M

edica

l Ven

dor

Adm

inistr

ation

Healt

h &

Hosp

itals

$1,8

85,0

00

Prov

idefu

nding

for

desig

n,de

velop

men

t,an

dim

plem

enta

tion

ofa

prov

ider

man

agem

ent

syste

mto

mod

erniz

epr

ovide

renr

ollm

entf

oren

rollin

gne

wan

dre

valid

ating

exist

ingM

edica

idan

dm

anag

edca

repr

ovide

rs.

The

sour

ceof

fede

ralf

unds

($5,

518,

337)

isM

edica

idad

mini

strat

ivem

atch

.Th

isfu

nctio

nis

curre

ntly

prov

ided

unde

r the

curre

nt F

iscal

Inte

rmed

iary c

ontra

ct (M

olina

).

$1,0

39,8

230

305

09-

Med

ical V

endo

rAd

mini

strat

ionHe

alth

&Ho

spita

ls$6

,558

,160


SGF

Tota

lT.

O.

Dept

.Ag

ency

Sch.

#

Maj

or In

crea

ses

or E

nhan

cem

ents

in th

e FY

17

Budg

et C

ompa

red

to th

e FY

16

Budg

et

Expl

anat

ion

106/

2/16

12:0

1 PM

Legi

slat

ive

Fisc

al O

ffice

Fisc

al H

ighl

ight

s 20

16 S

essi

on 2

016

Sess

ion

Thu,

6/2

/16

12:0

0 PM

Fund

ingfo

rpa

ymen

tsto

Rura

lHea

lthCl

inics

.RH

C’s

prov

ideph

ysici

anse

rvice

s,nu

rse

prac

tition

erse

rvice

s,ce

rtifie

dnu

rse

midw

ifese

rvice

s,cli

nical

psyc

holog

ist,a

ndcli

nical

socia

lwor

kers

ervic

es.T

heso

urce

offe

dera

lfun

ds($

1,75

7,90

2)is

Title

19fe

dera

lfina

ncial

parti

cipat

ion.T

heinc

reas

edfu

nding

repr

esen

ts3

sepa

rate

adjus

tmen

tsas

socia

ted

with

apr

ojecte

dinc

reas

ein

Med

icaid

claim

ssp

endin

gfo

rRH

C’si

nFY

17.

Note

:Tot

alan

ticipa

ted

num

bero

fFQH

C’s

inFY

16is

149

(15

new

clinic

sph

ased

inFY

16)

and

FY17

is16

2(1

3ne

wcli

nics

open

edin

FY17

).Th

einc

reas

eis

base

don

the

follo

wing

proje

ction

s:

$779

,353

A

nnua

lizat

ion o

f 5 R

HC’s

enro

lled

in FY

16

$1,4

47,3

70

Pha

se in

of 6

pro

jecte

d ne

w cli

nics i

n FY

17

$5

96,7

62

*M

edica

re E

cono

mic

Inde

x (M

EI) a

djustm

ent (

1% o

n to

tal R

HC p

aym

ents)

$2,8

23,4

85*C

linics

rece

ivean

allinc

lusive

pros

pecti

vera

tepe

rvis

it/enc

ount

er,

which

includ

esan

annu

alM

EIad

justm

ent t

o th

e ra

te.

The

MEI

is a

mea

sure

of p

hysic

ian p

racti

ce co

st inf

lation

.

$1,0

65,5

830

306

09-

Med

ical V

endo

rPa

ymen

tsHe

alth

&Ho

spita

ls$2

,823

,485

Incr

ease

inDi

spro

porti

onat

eSh

are

Hosp

ital(

DSH)

fund

ingfo

rLIN

CCA

(Low

Inco

me

and

Need

yCa

reCo

llabo

ratio

nAg

reem

ent)

paym

ents.

DSH

LINC

AAsp

endin

gis

incre

ased

from

$100

Min

FY16

to$1

77.5

Min

FY17

.Th

eso

urce

ofm

atch

ingfu

nds

isIn

terg

over

nmen

talT

rans

fer(

IGT)

reve

nue

from

non

state

pub

lic fa

cilitie

s. T

he so

urce

of f

eder

al fu

nding

is T

itle 1

9 fe

dera

l fina

ncial

par

ticipa

tion.

$00

306

09-

Med

ical V

endo

rPa

ymen

tsHe

alth

&Ho

spita

ls$7

7,55

8,78

6

Fund

ingfo

rMed

icare

Part

A&

Part

Bpr

emium

s.Th

eso

urce

offe

dera

lfun

ds($

23,4

25,6

13)i

sTi

tle19

fede

ralf

inanc

ialpa

rticip

ation

.Th

einc

reas

eis

relat

edto

proje

cted

enro

llmen

tinc

reas

ein

the

Med

icare

Savin

gsPr

ogra

m(M

SP)a

nda

proje

cted

incre

ase

inbo

thPa

rtA

(hos

pital

insur

ance

)and

Part

B(m

edica

lins

uran

ce)p

rem

iums,

asM

edica

repr

emium

sch

ange

annu

ally

inJa

nuar

y.Th

eM

SPpa

ysth

eM

edica

repr

emium

s for

low

incom

e M

edica

re b

enef

iciar

ies.

Part

A pr

emium

to in

crea

se fr

om $

411

to $

425;

and

enr

ollee

s fro

m 8

,421

(7/2

016)

to 8

,499

(6/2

017)

Part

B pr

emium

to in

crea

se fr

om $

121.

80 to

$12

3.70

; and

enr

ollee

s fro

m (7

/201

6) to

177

,120

(7/2

017)

$263

,419

,521

E

OB fo

r Med

icare

pre

mium

s$3

01,0

44,9

83

Pro

jecte

d FY

17

cost

for M

edica

re p

rem

iums

$37

,625

,462

F

Y 17

Bud

get A

djustm

ent

$14,

199,

849

030

609

-M

edica

l Ven

dor

Paym

ents

Healt

h &

Hosp

itals

$37,

625,

462


SGF

Tota

lT.

O.

Dept

.Ag

ency

Sch.

#

Maj

or In

crea

ses

or E

nhan

cem

ents

in th

e FY

17

Budg

et C

ompa

red

to th

e FY

16

Budg

et

Expl

anat

ion

116/

2/16

12:0

1 PM

Legi

slat

ive

Fisc

al O

ffice

Fisc

al H

ighl

ight

s 20

16 S

essi

on 2

016

Sess

ion

Thu,

6/2

/16

12:0

0 PM

Incr

ease

sfu

nding

for

‘Claw

back

’pay

men

tsth

atar

em

ade

byM

edica

idto

the

Med

icare

Prog

ram

asre

quire

dby

the

Cent

ers

forM

edica

re&

Med

icaid

Serv

ices

(CM

S)on

am

onth

lyba

sisto

cove

rthe

state

ssh

are

ofth

eco

stof

the

Med

icare

Pres

cript

ionDr

ugPr

ogra

m,P

artD

.As

ofJa

nuar

y20

06,d

uale

ligibl

esre

ceive

pres

cript

iondr

ugbe

nefits

from

Med

icare

only.

The

amou

ntth

atea

chsta

tepa

ysis

base

don

the

amou

ntth

esta

tewo

uldpa

yif

adu

aleli

gible

Med

icaid

enro

llee

would

have

cont

inued

tore

ceive

their

pres

cript

iondr

ugbe

nefit

unde

rMed

icaid.

Dual

enro

llees

are

enro

lled

inbo

thM

edica

idan

dM

edica

re.

The

budg

et a

djustm

ent is

bas

ed o

n th

e fo

llowi

ng ca

lculat

ion:

FY 1

6 EO

B

$1

39,0

31,5

15FY

17

Proje

ction

$

141,

287,

838

$

2,25

6,32

3 No

te:T

heFY

17es

timat

eis

base

don

a.5

%en

rollm

entg

rowt

hof

enro

llees

and

aninc

reas

ein

the

mon

thly

clawb

ack p

rem

ium p

aym

ents

for 4

mon

ths i

n FY

17.

$2,2

56,3

230

306

09-

Med

ical V

endo

rPa

ymen

tsHe

alth

&Ho

spita

ls$2

,256

,323

Fund

ingfo

rpro

jecte

dpr

ivate

prov

iders

med

icali

nflat

ionan

den

rollm

entg

rowt

h.Th

eso

urce

offe

dera

lfu

nds

($7,

451,

207)

isTi

tle19

fede

ralf

inanc

ialpa

rticip

ation

.Th

ead

justm

ent

isba

sed

onpr

ojecte

dut

ilizat

iongr

owth

inM

edica

idfe

e-fo

r-ser

vice

(pop

ulatio

nex

clude

dfro

mBa

you

Healt

h).

The

incre

ase

isba

sed

ontre

ndfa

ctors

appli

edto

certa

inca

tego

ries

ofse

rvice

(am

bulat

ory

surg

ical

cent

ers,

case

man

agem

ent,

dura

blem

edica

lequ

ipmen

t,Ea

rly&

Perio

dicSc

reen

ingDi

agno

stic

&Tr

eatm

ents

ervic

es,

Early

Step

s,Fa

mily

Plan

ning,

Hem

odial

ysis,

Hom

eHe

alth,

Hosp

itals,

Lab

and

XRa

y,Ph

ysici

an,a

ndTr

ansp

orta

tion.

Aninf

lation

perc

enta

gegr

owth

was

appli

edto

FY16

proje

cted

spen

ding

for

thes

eca

tego

ries,

rang

ing f

rom

3%

to 4

.5%

.

$4,5

16,6

810

306

09-

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ical V

endo

rPa

ymen

tsHe

alth

&Ho

spita

ls$1

1,96

7,88

8

Incr

ease

sfu

nding

($19

5,26

3,30

4SG

F,$5

2,37

9,54

8St

atut

ory

Dedic

ation

&$3

84,5

21,5

58Fe

dera

l)fo

rM

anag

edCa

reOr

ganiz

ation

(MCO

)pay

men

tsin

FY17

.The

sour

ceof

fede

ralf

unds

isTi

tle19

fede

ral

finan

cialp

artic

ipatio

n.Th

einc

reas

esre

pres

ents

capit

ation

rate

paym

ents

toBa

you

Healt

hm

anag

edca

reor

ganiz

ation

s.In

form

ation

prov

ided

byDH

Hre

flects

fund

ingad

justm

ents

toth

eBa

you

Healt

hpa

ymen

tba

sean

ticipa

ted

forF

Y17

.Ad

justm

ents

includ

een

rollm

entg

rowt

h(3

%or

28,8

05),

utiliz

ation

and

unit

cost

trend

adjus

tmen

tsfo

rser

vices

cove

red

unde

rthe

MCO

’s(fo

rexa

mple

hosp

itals

ervic

es,l

aban

dX-

ray,

hom

ehe

alth,

phys

ician

serv

ices)

,an

nuali

zatio

nof

new

serv

ices

carv

edin

toBa

you

Healt

h(c

omm

unity

hosp

ice,P

DHC,

and

EPSD

T-PC

S),S

hare

dSa

vings

Payo

uts,

and

asp

ecial

ized

beha

viora

lhe

alth

cost

trend

adju

stmen

t.

$195

,263

,304

030

609

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edica

l Ven

dor

Paym

ents

Healt

h &

Hosp

itals

$632

,164

,410


SGF

Tota

lT.

O.

Dept

.Ag

ency

Sch.

#

Maj

or In

crea

ses

or E

nhan

cem

ents

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e FY

17

Budg

et C

ompa

red

to th

e FY

16

Budg

et

Expl

anat

ion

126/

2/16

12:0

1 PM

Legi

slat

ive

Fisc

al O

ffice

Fisc

al H

ighl

ight

s 20

16 S

essi

on 2

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Sess

ion

Thu,

6/2

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0 PM

Fund

ing($

196,

912

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$1,4

22,6

94sta

tuto

rilyde

dicat

edM

edica

lAss

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ceTr

ustF

und,

&$2

,671

,877

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ral)

fora

dditio

nalp

aym

ents

fort

heDe

ntal

Bene

fitsPl

an(M

anag

edCa

re)d

ueto

apr

ojecte

dinc

reas

ein

enro

llmen

t(m

embe

rmon

ths)

.The

sour

ceof

fede

ralf

unds

isTi

tle19

fede

ralf

inanc

ialpa

rticip

ation

.The

dent

albe

nefit

man

aged

care

plan

prov

ides

Med

icaid

cove

red

dent

alse

rvice

sto

allBa

you

Healt

hen

rolle

es a

nd le

gacy

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icaid

fee-

for-s

ervic

e en

rolle

es th

at re

ceive

full b

enef

its.

$154

,477

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F

Y 17

Pro

jectio

n$1

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86,4

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FY

16 E

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$4

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gory

M

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te

F

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Esti

mat

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xpen

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n

8,0

46,1

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$15.

48

$

124,

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Adult

s

3

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$

1.96

$7,2

45,5

24CH

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ge 0

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1,4

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15

$15

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$22

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rdab

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an

36,

777

$1

8.28

$67

2,28

6 FY

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Proje

ction

s

1

3,20

1,18

3

$154

,477

,959

$196

,912

030

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edica

l Ven

dor

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ents

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h &

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itals

$4,2

91,4

83

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ional

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rpro

jecte

dinc

reas

ein

utiliz

ation

ofLo

ngTe

rmPe

rson

alCa

reSe

rvice

s(L

T-PC

S).

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sour

ceof

fede

ralf

unds

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735,

165)

isTi

tle19

fede

ralf

inanc

ialpa

rticip

ation

.Th

ead

justm

enti

sba

sed

ona

proje

cted

incre

ase

inne

tenr

ollm

ent/r

ecipi

entg

rowt

hof

75ind

ividu

alspe

rmon

thin

FY17

.LT

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state

plan

serv

ice, u

nlike

a w

aiver

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is n

ot ca

pped

on

a se

t num

ber o

f slot

s.$1

99,2

36,8

94 F

Y 17

Pro

jecte

d ex

pend

iture

s$1

93,2

37,5

93 F

Y 16

EOB

$

5,99

9,30

1

$2,2

64,1

360

306

09-

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ical V

endo

rPa

ymen

tsHe

alth

&Ho

spita

ls$5

,999

,301


SGF

Tota

lT.

O.

Dept

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ency

Sch.

#

Maj

or In

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ses

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ents

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e FY

17

Budg

et C

ompa

red

to th

e FY

16

Budg

et

Expl

anat

ion

136/

2/16

12:0

1 PM

Legi

slat

ive

Fisc

al O

ffice

Fisc

al H

ighl

ight

s 20

16 S

essi

on 2

016

Sess

ion

Thu,

6/2

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12:0

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Annu

alize

dco

stas

socia

ted

with

96ne

wen

rolle

esad

ded

inFY

16to

the

Prog

ram

fort

heAl

lInc

lusive

Care

fort

heEl

derly

(PAC

E)at

the

Bato

nRo

uge

and

New

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nssit

esan

da

phas

e-in

of11

4ad

dition

alen

rolle

esin

FY17

.Th

eso

urce

offe

dera

lfun

ds($

3,99

2,28

2)is

Title

19fe

dera

lfina

ncial

parti

cipat

ion.

PACE

prog

ram

sco

ordin

ate

and

prov

ides

allne

eded

prev

entiv

e,pr

imar

yhe

alth,

acut

ean

dlon

gte

rmca

rese

rvice

sso

that

older

adult

scan

cont

inue

living

inth

eco

mm

unity

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ispr

ogra

mpr

ovide

sser

vices

acro

ssall

care

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gson

a24

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rbas

isea

chda

yof

the

year

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cted

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ead

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ents

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dget

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ction

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mar

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taile

don

Page

1of

the

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uctio

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ction

.$1

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3,45

6 F

Y 17

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jecte

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pend

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s (inc

lusive

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es)

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039,

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FY

16 E

OB

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SUB

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aton

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ge &

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ites

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FY

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st (4

pha

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r mon

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874,

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ew P

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908,

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afay

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Site

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412,

274

Tot

al In

crea

se fo

r FY

17

$2,4

19,9

920

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09-

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endo

rPa

ymen

tsHe

alth

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spita

ls$6

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Fund

ingfo

rpay

men

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Fede

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Quali

fied

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are

serv

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inur

ban

and

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atar

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nside

red

med

ically

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rser

ved

asde

signa

ted

byth

efe

dera

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vern

men

t.Th

eso

urce

offe

dera

lfun

ds($

4,26

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Title

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lfina

ncial

parti

cipat

ion.

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incre

ased

fund

ingre

pres

ents

3se

para

tead

justm

ents

asso

ciate

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thpr

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dinc

reas

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pend

ingfo

rFQH

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nFY

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ote:

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icipa

ted

num

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fFQH

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149

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new

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ndFY

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162

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new

clinic

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ned

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incre

ase

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sed

onth

efo

llowi

ng p

rojec

tions

:$2

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A

nnua

lizat

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FY 1

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cted

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FY 1

7 $

668,

178

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mic

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x (M

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djustm

ent (

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n to

tal F

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paym

ents)

$6,8

52,2

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ente

rsre

ceive

anall

inclus

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ctive

rate

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nter

,whic

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nual

MEI

adjus

tmen

t to

the

rate

. Th

e M

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a m

easu

re o

f phy

sician

pra

ctice

cost

inflat

ion.

$2,5

86,0

260

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endo

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alth

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for

413

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Title

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parti

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age

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thly

cost

perr

ecipi

entf

orSu

ppor

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aiver

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ppro

ximat

ely $

662

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944

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al), n

ot in

clusiv

e of

acu

te se

rvice

s.$4

66,4

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09-

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rPa

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alth

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spita

ls$1

,235

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Dept

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or In

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17

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ompa

red

to th

e FY

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Budg

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Expl

anat

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146/

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16 S

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Annu

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nding

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app

roxim

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$88

0 ($

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l).$6

20,0

570

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09-

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alth

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spita

ls$1

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ingfo

rNew

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aiver

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ceof

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undin

g($

16,4

81,3

80)i

sTi

tle19

fede

ral

finan

cial

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age

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thly

cost

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for

aNO

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iver

isap

prox

imat

ely $

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0 ($

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00 a

nnua

l) no

t inclu

sive

of a

cute

serv

ices.

$23,

436,

006

($

8,84

4,74

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F) -

Fund

ing re

quire

d to

fund

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FY 1

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xpen

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on $

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5,85

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($1,

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ertifi

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1

$9,9

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alth

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ordin

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Title

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ation

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eCS

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mpr

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ecial

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rvice

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risk.

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nce

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rious

wrap

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ndag

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stha

tpro

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tinte

nsive

case

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agem

ent.

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ning

12/1

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llbeg

inpa

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anad

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ts.Th

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enti

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PMPM

cost

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ately

$309

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and

a$1

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cost

to va

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p ar

ound

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ncies

. $

5,20

6,32

0

CSo

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ctor a

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- 2,

400

kids *

$309

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* 7 (m

onth

s in

FY 1

7)$1

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0

Wra

p ar

ound

age

ncy a

dmin

costs

- 2,

400

kids *

$1,0

35 P

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*7 (7

mon

ths i

n FY

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$6,

080,

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rojec

ted

fee-

for-s

ervic

e pa

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ts to

pro

vider

s$2

8,67

5,09

2

$10,

821,

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edica

l Ven

dor

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ents

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h &

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itals

$28,

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rinc

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inanc

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rticip

ation

.Th

ead

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enti

sba

sed

onpr

ojecte

dph

arm

acy

price

grow

th($

6,35

6,68

8M

)an

dre

place

men

tof

reba

tere

venu

es($

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M)

antic

ipate

dto

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duce

din

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.In

form

ation

prov

ided

byDH

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icate

spr

ojecte

dph

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acy

expe

nditu

regr

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isdr

iven

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neric

drug

price

grow

than

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ecial

ized

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icatio

nsba

sed

onna

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ytre

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rted

inth

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tiona

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pend

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ecas

t Sum

mar

y. T

he in

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se a

djusts

for p

harm

acy r

ebat

e re

ducti

ons i

n FY

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6.3%

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wth

in FY

17

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ervic

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$

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ojecte

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ate

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tal R

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on

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000

Proje

cted

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ral R

ebat

e Re

ducti

on

$33

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$41

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$15,

109,

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030

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edica

l Ven

dor

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ents

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h &

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itals

$41,

856,

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Sch.

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cem

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Budg

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ompa

red

to th

e FY

16

Budg

et

Expl

anat

ion

156/

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12:0

1 PM

Legi

slat

ive

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al O

ffice

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al H

ighl

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s 20

16 S

essi

on 2

016

Sess

ion

Thu,

6/2

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12:0

0 PM

Addit

ional

fund

ingto

incre

ase

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iemra

tese

ffecti

ve7/

1/20

16.T

heso

urce

offe

dera

lfund

s($1

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)is

Title

19fe

dera

lfina

ncial

parti

cipat

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ct32

7of

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date

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ospit

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entis

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ase

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spita

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es (F

Y 13

& F

Y 15

). Th

e es

timat

ed F

Y 17

Acu

te re

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e inc

reas

e is

$76.

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ay.

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94

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ides

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rnu

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epr

ovide

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The

sour

ceof

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utor

yDe

dicat

ionis

reve

nue

from

the

Med

icaid

Trus

tFun

dfo

rthe

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rly($

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31).

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sour

ceof

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unds

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Title

19fe

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parti

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base

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cted

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eof

$8.6

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ay(a

vera

geda

ilyra

teof

$164

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.

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ursi

ng H

omes

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pice

Roo

m/B

oard

FY

17

Med

icaid

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ing H

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Days

:

6,

893,

784

417,

196

Proje

cted

Per D

ay in

crea

se

$

8.69

$

8.26

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otal

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ease

$59,

906,

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$3,

446,

039

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alth

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ides

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ingfo

ran

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ional

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ds($

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595)

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ral

finan

cial

parti

cipat

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ents

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you

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lypa

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ligat

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mid-

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icit s

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quire

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ake

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Depa

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rpr

otes

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ines

crow

inac

cord

ance

with

R.S.

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fers

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iesto

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edto

fund

the

13th

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aged

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ent.

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tota

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need

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draw

down

$208

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dera

l fund

ing fo

r $33

4.4

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men

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$109

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030

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l Ven

dor

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ents

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$317

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ides

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ran

incre

ase

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spice

rate

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ral

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cial

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cipat

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oxim

ately

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form

ation

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ided

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icate

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ase

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sed

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rate

sche

dule

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blish

edby

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or M

edica

re &

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icaid

Serv

ices.

The

incre

ase

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sed

on th

e fo

llowi

ng p

rojec

tion:

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90

F

Y 17

pro

jecte

d Ho

spice

pay

men

ts (in

cludin

g ut

ilizat

ion g

rowt

h an

d 1.

6% ra

te in

crea

se)

$4,5

37,7

84

F

Y 16

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for H

ospic

e pa

ymen

ts

$866

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FY

17 In

crea

se

$326

,906

030

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edica

l Ven

dor

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ents

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h &

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itals

$866

,206


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Tota

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ency

Sch.

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Budg

et C

ompa

red

to th

e FY

16

Budg

et

Expl

anat

ion

166/

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12:0

1 PM

Legi

slat

ive

Fisc

al O

ffice

Fisc

al H

ighl

ight

s 20

16 S

essi

on 2

016

Sess

ion

Thu,

6/2

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12:0

0 PM

Addit

ional

fund

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rMed

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nsion

toind

ividu

alsup

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8%of

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fede

ralp

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tylev

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ford

able

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adjus

tmen

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lects

man

aged

care

prem

iumpa

ymen

tsfo

ran

estim

ated

375,

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enro

llees

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Y 17

. Th

e so

urce

of f

eder

al fu

nds i

s Title

19

fede

ral fi

nanc

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artic

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n.

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GF

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al

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men

ts

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39,

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357,

374

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ional

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ase)

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este

d inf

orm

ation

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rding

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ct to

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ional

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strict

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reas

e). T

he L

FO h

as re

ques

ted

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mat

ion re

gard

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e im

pact

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rvice

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strict

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h &

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itals

$1,4

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rrep

aym

ento

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dsto

the

fede

ralF

ood

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tritio

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rvice

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ncy.

InFY

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the

FNS

agen

cyiss

ued

a$9

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imag

ainst

the

LAW

omen

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ants

&Ch

ildre

n(W

IC)

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ram

for

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ento

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eral

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gotia

ted

ase

ttlem

entw

ithFN

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repa

yth

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allow

ance

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part

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ese

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ent,

DHH

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mak

ea

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cash

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ent

toFN

San

dim

plem

ent

vend

orim

prov

emen

tsto

the

WIC

Prog

ram

asth

ateq

uals

the

rem

aining

$6.1

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.Th

e$2

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Mca

shpa

ymen

twill

be re

paid

in 3

insta

llmen

ts of

$68

3,33

3 be

ginnin

g in

FY 1

7.

$683

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032

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blic H

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Healt

h &

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itals

$683

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ease

sFe

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lfun

dsfro

mph

arm

aceu

tical

reba

tes

ondr

ugpu

rcha

ses

thro

ugh

the

LAHe

alth

Acce

ssPr

ogra

m(L

AHA

P),

form

erly

know

nas

AIDS

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Assis

tanc

ePr

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ms

(ADA

P).

LAHA

Pas

sists

unins

ured

and

insur

edind

ividu

alswi

thHI

Vwi

thdr

ugco

stsan

deli

gible

insur

ance

plan

prem

iums

aswe

llas

cost

shar

ing(i.

e.co

-pay

men

ts,co

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ranc

esan

dde

ducti

bles)

asso

ciate

dwi

thdr

ugs

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healt

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uran

ceco

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ge.T

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ogra

mis

fund

edwi

thfe

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lfun

dsfro

mth

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anW

hite

HIV/

AIDS

Prog

ram

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alth

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urce

san

dSe

rvice

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mini

strat

ion(H

RSA)

.In

FY17

,OP

His

proje

cting

colle

cting

anad

dition

al$9

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inph

arm

aceu

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tes.

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reba

tefu

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are

expe

nded

onse

rvice

sfo

rind

ividu

alswi

th H

IV.

FY 1

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$25

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FY 1

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$35

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$

9.9

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e Co

llecti

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rojec

ted

Incr

ease

$00

326

09-

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spita

ls$9

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Dept

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ency

Sch.

#

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or In

crea

ses

or E

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e FY

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Budg

et C

ompa

red

to th

e FY

16

Budg

et

Expl

anat

ion

176/

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slat

ive

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al O

ffice

Fisc

al H

ighl

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s 20

16 S

essi

on 2

016

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ion

Thu,

6/2

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0 PM

Incr

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sSG

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the

even

ttha

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ofth

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16Re

gular

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enac

ted.

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esth

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nual

adm

inistr

ation

fee

fort

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ogra

mfro

m$3

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from

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llbe

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ndup

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arian

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ithin

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Safe

Drink

ingW

ater

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ram

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inth

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fice

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imat

ely$9

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r $50

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ural

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ed b

y a p

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f HB

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ional

SGF

forO

ffice

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heLF

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d inf

orm

ation

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rding

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ct on

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asse

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istry

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ivert

ode

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prior

itizat

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here

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ider

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tope

rform

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eas

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ts,wh

ichis

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ated

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plete

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fore

the

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rovid

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atch

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the

allow

able

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rals

hare

tosu

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func

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com

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d $1

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ichis

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quire

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ase

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ueste

d inf

orm

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ct to

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ance

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ts fo

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ls$3

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Repla

ces

$30,

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eted

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itleIV

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nding

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ipate

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ajor

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et

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196/

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thor

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pres

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fort

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depa

rtmen

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not

requ

ired

SGF

until

FY16

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which

$20

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sbe

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ichis

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ntial

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lfu

nd.

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depa

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ase

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ajor

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$30,

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nce

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ase

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includ

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orm

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ojects

and

upgr

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ms.

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e FY

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Budg

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206/

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mini

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and

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tota

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tion

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nal in

form

ation

see

“Cor

recti

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ervic

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educ

tions

Impa

ct” is

sue

write

-up.

-$3,

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-$3,

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ducti

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llcre

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or a

dditio

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form

ation

see

“Cor

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educ

tions

Impa

ct” is

sue

write

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-$1,

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nter

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ction

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s-$

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ency

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tions

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e FY

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et C

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red

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e FY

16

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et

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anat

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76/

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ive

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al O

ffice

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s 20

16 S

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on 2

016

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ion

Thu,

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DPSC

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ction

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vices

repo

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atth

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Fre

ducti

onwi

llcre

ate

prog

ram

mat

icim

pacts

for

the

depa

rtmen

t. F

or a

dditio

nal in

form

ation

see

“Cor

recti

on S

ervic

es R

educ

tions

Impa

ct” is

sue

write

-up.

-$1,

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681

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308

A-El

ayn

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Corre

ction

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nter

DPSC

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ction

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s-$

1,11

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1

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vices

repo

rtsth

atth

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ducti

onwi

llcre

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mat

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pacts

for

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rtmen

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or a

dditio

nal in

form

ation

see

“Cor

recti

on S

ervic

es R

educ

tions

Impa

ct” is

sue

write

-up.

-$1,

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041

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A-Ad

ult P

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tion

& Pa

role

DPSC

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s-$

1,35

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9

-$21

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ajor

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uctio

ns fo

r DPS

C Co

rrect

ions

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vice

s-$

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nof

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iesfro

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edOi

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tinge

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ciate

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ter

Horiz

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Prev

iously

the

LAOi

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sth

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ency

for

Deep

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edm

atte

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utdu

ring

FY16

the

Coas

tal

Prot

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n Au

thor

ity (C

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bec

ame

the

lead

agen

cy.

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e Po

lice

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licSa

fety

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ices

-$16

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or R

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tions

for D

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ic S

afet

y Se

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es-$

16,5

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73

The

Offic

e of

Juve

nile

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ce (O

JJ) w

ill all

ocat

e th

e re

ducti

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s foll

ows:

Redu

ceSe

cure

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(Fac

ilitie

s)by

$16.

1M

-Aca

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thwi

llno

tope

nas

plann

edin

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st20

16($

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tyCe

nter

for

Yout

hwi

llre

duce

the

num

ber

ofyo

uth

serv

edby

24,

leavin

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facil

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pacit

yof1

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llreq

uire

the

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reof

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inatio

nof

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oxim

ately

14va

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posit

ions

($0.

9M

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dSw

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forY

outh

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ceth

enu

mbe

rof

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city

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ately

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nt p

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cePr

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role

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batio

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all 3

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lOffic

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-$19

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ajor

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uctio

ns fo

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uth

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ices

-$19

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red

to th

e FY

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et

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86/

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slat

ive

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al O

ffice

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on 2

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ion

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ces

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man

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ority

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ct to

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man

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LADe

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cil(L

ADDC

).Th

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cece

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spr

ovide

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mat

ionon

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ices,

good

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chno

logies

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activ

ities

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ders

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dho

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cate

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s.In

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tracts

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tals

$323

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172,

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from

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5 - $

499,

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FY 1

6 - $

495,

439

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per

reso

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cent

er)

FY 1

7 - $

323,

325

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-$17

2,11

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ct to

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-$87

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cted

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red

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ted

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mat

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pact

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rvice

s.-$

216,

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man

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-$21

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5


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The

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seve

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ividu

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venu

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prop

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fund

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09-

LA E

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spon

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nding

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Redu

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este

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09-

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Tota

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Dept

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Sch.

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Budg

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Expl

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ion

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Redu

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LAHu

man

Serv

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red

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ted

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mat

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e im

pact

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5

-$19

0,61

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10

Maj

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tions

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-$49

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horit

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cted.

$00

360

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ren

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mily

Ser

vices

Child

ren

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mily

Serv

ices

-$29

,076

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tions

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ren

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pact

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5


SGF

Tota

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ese

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ssed

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ntitie

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ndOt

her

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-$6,

626,

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tvar

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dedic

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asfo

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21,9

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($33

,353

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ndry

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celle

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220)

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nd,

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rsEc

onom

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men

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00,6

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ban

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itality

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$201

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utific

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.Neig

hbor

hood

Fund

,($8

24)F

riend

sof

NORD

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,($2

7,34

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ssier

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uanc

yFu

nd,(

$339

,912

)Bea

utific

ation

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ityPa

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$3,4

00,0

00)C

asino

Supp

ortS

ervic

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nd ($

2) R

ehab

ilitat

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Blin

d/Vi

suall

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paire

d Fu

nd.

$00

945

20-

Stat

e Ai

d to

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l Gov

t.En

tities

Othe

rRe

quire

men

ts-$

3,82

4,22

5

-$15

,325

,000

0M

ajor

Red

uctio

ns fo

r Oth

er R

equi

rem

ents

-$25

,775

,423

Maj

or R

educ

tions

of F

Y 20

17-$

571,

914,

749

0-$

1,09

8,94

2,48

6


FY 17 Major Budget Issues

Budget Issues LFO 6/3/2016

51

DEPT/AGY: Executive / LA Public Defender Board (LPDB) ISSUE: Restoration of LA Public Defender Board Funding in HB 1 The LPDB has received a full restoration of funds reduced in HB 1 Original as a result of increased SGF revenues raised during the First Extraordinary Session of 2016. The restoration increases the LPDB’s budget by approximately $20.97 M, from $12.84 M to $33.81 M. A majority of this restoration ($20.31 M) is derived from the statutorily dedicated LA Public Defender Fund, which receives revenues via direct SGF deposits, raising the fund’s balance from $12.33 M to $32.64 M. The LA Public Defender Fund primarily provides monies for the LPDB’s annual operating expenses. In discussions with LPDB staff, the board has indicated that between 62.5% and 65% of the LA Public Defender Fund, or between $20.4 M and $21.22 M, will be disbursed to the 42 district defender offices. This allocation would represent a disbursement of approximately $485,700 to $505,200 being sent to the district defender offices on average. The board indicates that this allocation to the district offices is greater than in past years, and is an effort to restore full services in district defender offices that have enacted restriction of services (ROS) plans in the current fiscal year. Furthermore, the board indicates that the remainder of the funds would be allocated for the board’s statewide programs and administrative costs. The LPDB has reported that it intends to reduce its administrative expenses by approximately $600,000, from $2.6 M to $2 M, resulting in a balance between $9.42 and $10.24 M to fund statewide programs. Presently, the LPDB carries out statewide indigent capital defense services, statewide indigent appellate services associated with non-capital cases, and juvenile delinquency representation services in Orleans Parish. DEPT/AGY: Culture, Recreation & Tourism (CRT) ISSUE: LA Tourism Promotion District (LTPD)

Historical Pass-throughs Act 1038 of 1990 created the LTPD as a special statewide taxing district and political subdivision of the state which levies three one hundredths of 1 cent of the sales and use tax for the purpose of assisting the state for out-of-state advertising and promoting tourism in LA. Historically this fund generates approximately $20 M in revenue for CRT annually. The following pass-throughs were funded within CRT’s base budget during FY 16: Audubon Golf Trail $93,000 Scenic Byways and the Atchafalaya National Heritage Area $265,110 Total $358,110 Additionally, funding for the following initiatives were part of the department’s base budget during FY 16 and were transferred to other agencies within the department via IAT, the Lieutenant Governor and LTPD Direct: Lt. Governor, Administrative – ENCORE! (Retire LA) $329,083 Lt. Governor, Grants – Volunteer LA $50,000 Office of Secretary (Administrative Program) $1,000 Office of the Secretary (Operating Costs & OMF) $995,186 Office of the State Library (Book Festival) $25,000 Office of the State Library (Operating Cost) $405,363 Office of State Museum (LA Sports Hall of Fame Museum) $552,786 Office of State Museum (Operating Cost) $670,763 Office of State Parks (Kent House) $56,683 Office of Cultural Development (Arts Grants) $1,500,000 Office of Cultural Development (Cultural Economy Initiative) $254,500 Office of Cultural Development (Operating Cost) $190,442 Total $5,030,806 Total Pass-throughs and Programs $5,388,916 Note: The Lieutenant Governor and CRT indicate changing expenditure priorities may impact decisions to fund these in the same manner or amounts as previous years. The department indicates funding of these pass-throughs will be at the discretion of the Lieutenant Governor and the Secretary of the CRT. DEPT/AGY: Transportation & Development (DOTD) ISSUE: DOTD State Transportation Funding State Gas Tax: The 16-cent per gallon state gasoline and special fuels (gas) tax is a flat, non-indexed tax. The state gas tax has a current day buying power of approximately 7 cents.



52

Historically, gas tax revenues have grown approximately 2.5% per year since 1992 but the rate has slowed substantially over the past decade. Construction and operating inflation substantially exceed the growth rate of the gas tax. (Note: The rate was increased from 8 cents to 16 cents in 1984.) In 1984 the average price per gallon was $0.94 and individuals paid approximately 17% per gallon for road infrastructure with the 16-cent state gas tax. The average price per gallon for regular gasoline in LA as of 2/26/2016 was $1.56. Due to the tax being flat, and not indexed to inflation, the current tax equates to individuals paying approximately 10.3% per gallon for road infrastructure (an increase of approximately 3% over the year as gasoline prices have fallen). Federal Highway Trust Fund (Federal Gas Tax): The federal program is funded by the Fixing America's Surface Transportation Act (FAST Act). FAST Act is the first federal law in over 10 years to provide long-term funding certainty for surface transportation, authorizing monies over fiscal years 2016 through 2020 for the Department's highway, highway and motor vehicle safety, public transportation, motor carrier safety, hazardous materials safety, rail, research, technology and statistics programs. The federal Highway Trust Fund (HTF) is funded with an 18.4-cent per gallon federal gasoline tax and 24.4-cent per gallon federal diesel tax. Like the state gas tax, it has lost ground to inflation since its last increase in 1993. TIMED Program Bond Debt Service Payments - $143.2 M for FY 17: The TIMED Program was established by Act 16 of the 1989 1st Extraordinary Session and designated 16 specific road/bridge projects. The original plan called for a designated funding stream in the form of a 4-cent per gallon gas tax on top of the existing 16-cent per gallon state gas tax, providing for a pay-as-you-go construction program. By utilizing a pay-as-you-go-program, the projected completion date for the program was 2031. In 2002, the DOTD set out to accelerate the program by bonding the remainder of the program in an effort to complete construction of all projects around FY 13. Due to rising construction costs and inaccurate cost estimates at the outset of the program, the program will only have sufficient funding to complete 14 of the original 16 road and bridge projects. 13 of the 14 funded projects are now complete. The 14th project, a final segment-widening on US 165 (Fort Buhlow Bridge), is 96% complete. The projected FY 16 4-cent per gallon gas tax collections for the TIMED Program are not sufficient to cover the debt service payments of the 13 completed projects and the 1 currently under construction. Approximately $18.4 M of the 16-cent per gallon gas tax revenues will be needed to pay TIMED Program debt service payments in FY 16, the 7th consecutive year in which the state gas tax will be used to make the TIMED debt service schedule whole. The portion of the 16-cent gas tax necessary in future years to fund TIMED debt service payments will continue escalating. Based upon estimates by DOTD, the department will use approximately 2.1 cents of the 16-cent per gallon state gas tax at its peak usage in FY 43, which equates to $77.9 M, or approximately 15.6% of the current 16-cent per gallon tax receipts. The growing use of TTF - Regular funds to pay TIMED debt service may impact DOTD’s ability to match federal transportation funds (generally required at 10-20%) in the capital outlay budget and will result in decreased funds available for the department’s operating budget. Currently, the total projected TIMED Program costs are $5.24 B (includes LA 3241 and Florida Avenue Bridge projects), while total revenues for the program will be $4.65 B by the pay-off date of the debt in FY 45. DOTD is in the process of determining the best financing mechanism for completing the final 2 constitutionally required road/bridge projects. DEPT/AGY: Public Safety & Corrections (DPSC)/Corrections Services ISSUE: Reductions Impact DPSC Corrections Services reports that the department remains underfunded by $18.8 M. The potential shortfall is in large part due to unfunded supplemental needs identified by DPSC of $14.5 M in FY 16 that will impact FY 17 operations. Note: To resolve the FY 16 supplemental needs, DPSC moved monies between budget units in the Supplemental Appropriations Bill (HB 1047) to cover these expenditures utilizing existing resources. The department presents the plan detailed below to address the projected shortfall.

• Per Diem Reduction at Winn and Allen Correctional Centers from $31.95 to $22.39 ($9 M).

• Equipment Purchases ($4.6 M) - This funding provides for deferred maintenance. The agency has not been funded for acquisitions and major repairs over the last 7 years. Table 1 on the next page provides the savings allocated by institution/program.



53

Table 1

Agency Name FY 17 LA State Penitentiary $672,135 Avoyelles Correctional Center $711,294 LA Correctional Institute for Women $572,745 Dixon Correctional Institute $603,600 Hunt Correctional Center $654,276 David Wade Correctional Center $179,220 Rayburn Correctional Center $630,635 Adult Probation & Parole $607,650

Total $4,631,555

• Pharmaceutical Supplies ($2.9 M) - The department has experienced increased demand as well as an increased cost for specialty drugs, specifically cancer and hepatitis. The current level of funding is $5.1 M.

• Utility Rate Increase Funding ($1.1 M) - Funding that provided for the utility rate

increase is eliminated. The department projects an increased use in technology (electronic monitoring/technical security) for equipment (includes shaker fencing, cameras and lighting).

• Human Capital Management ($1 M) - Funding to provide for a statewide adjustment.

Human Capital Management is the current human resources entity for the department and cabinet agencies.

• Dialysis Contract – Total Savings ($0.3 M) - An offender dialysis program operated at

one of the state institutions has experienced an increase in the number of offenders requiring dialysis. This funding increase is eliminated.

Local Housing of Adult Offenders (LHOA) DPSC – Corrections reports that the current funding recommendation for the LHOA in HB 1 will result in an estimated FY 17 funding shortfall of $15.3 M SGF. The impact of this shortfall will result in the following:

• Closure of All Reentry Centers ($5.9 M)

• Per Diem Reduction ($9.4 M) – DPSC Corrections proposes per diem reductions as follows: reduction from $24.39 to $22.39 for local housing of adult state offenders, and from $12.39 to $8.25 for Transitional Work Programs.

DEPT/AGY: Health & Hospitals (DHH)/Medical Vendor Payments (MVP) ISSUE: Medicaid Disallowance – Hospital Partner Advanced Lease Payments LA Medicaid received a letter from Centers for Medicare & Medicaid (CMS) on 12/23/2014 indicating a disallowance in the amount of $311,576,411 as a result of non-allowable provider related donations related to advanced lease payments. The federal portion reimbursed by the federal government to LA Medicaid tied to this disallowance total ($311.5 M) is $189,999,295, and represents the amount the state is responsible to re-pay the federal government. The letter indicates that the disallowance is “related to the cooperative endeavor agreements (CEA’s) that required substantial advanced lease payments by the participating hospitals that were linked to increased Medicaid payments to the same privately owned hospitals.” There are certain restrictions related to provider related donations from private entities that are then used as a state match source for the purposes of federal match. CMS determined that increased Medicaid payments to partner hospitals were conditioned on the advanced lease payments, and considered a non bona fide provider related donation. CMS further indicates these advanced lease payments were not a usual or customary industry payment arrangement. Note: The letter indicates that base lease payments built into the CEA’s appear to comport with normal business practice (are not a component of the disallowance). Note: Information provided by the DHH indicates the state filed an appeal in February of 2015 to the federal Departmental Appeals Board, and awaits a final administrative appeals decision. The estimated timeline for such decision is not indicated. DHH indicates CMS has requested multiple extensions to respond to the department’s appeal. DHH’s further action and level of state liability will ultimately depend on CMS’s formal response, or negotiations to settle the case.



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DEPT/AGY: Health & Hospitals (DHH)/Medical Vendors Payments (MVP) ISSUE: Medicaid Outlook The FY 17 Medicaid budget contains approximately $34.5 M in replacement revenues used as a state match source. These sources of revenue likely will need to be replaced with SGF or an alternate revenue source in FY 18. FY 18 Replacement Revenues The FY 17 Medicaid budget contains approximately $34.5 M in replacement revenues, down from approximately $189 M (Amnesty revenues and Overcollections Fund revenues) used in the FY 16 Budget. These FY 17 sources of revenue include monies from the Medicaid Trust Fund for the Elderly and the Health Trust Fund revenues. These fund sources are appropriated in Payments to Private Providers Program, and collectively will draw $56.8 M in federal match for a total of $91.3 M in Medicaid claims payments. DEPT/AGY: Health & Hospitals (DHH)/Medical Vendor Payments (MVP) ISSUE: Medicaid Overview HB 1 provides an additional $552.7 M in SGF ($2.2 B total increase in funding) for Medicaid in FY 17. Total Medicaid funding for FY 17 represents a 27.6% increase from the FY 16 Existing Operating Budget (29.5% increase in SGF). In addition, HB 1 reflects approximately $160 M in SGF savings associated with the implementation of Medicaid expansion for certain individuals up to 138% of the Federal Poverty Level (FPL). Projected SGF savings are largely based on a $249 M reduction in Disproportionate Share Hospital (DSH) payments related to uncompensated care costs. Senate amendments provided significant changes to various House amendments. Specifically, eliminated $24.8 M in additional funding for rural hospitals added with House Floor (HF) amendments, and eliminated a HF amendment that authorized the DHH to implement co payment requirements (to the extent authorized under federal law) for individuals receiving certain Medicaid services. In addition, Senate amendments moved $161 M total funding ($60.8 M SGF) in supplementary budget recommendations to the body of the HB 1. Information provided by the DHH indicates the $161 M in funding moved from the supplementary section of the HB 1 will allow for full funding of all existing waiver slots, and prevent significant cuts to Pediatric Day Healthcare Services. Although these items were not itemized as a cut in the Executive Budget, DHH itemized these services as areas of reduction based on the level of funding provided for at Reengrossed (after House action). In addition, Senate amendments eliminated the line item appropriation for the public private partner hospitals, and reduced the level of supplemental payments and DSH payments by approximately $98.5 M ($60.4 M SGF). Additionally, SGR used as a state match source increased by $18.6 M for the hospital partnership in Houma. See Public Private Partnership explanation below. The Medicaid budget contains certain significant increases/enhancements in FY 17, including funding projected growth in Bayou Health, funding for an FY 16 Bayou Health payment obligation pushed into FY 17 (1 additional Bayou Health checkwrite added in FY 17), MCO payments for Medicaid expansion for individuals to 138% of the FPL, annualized costs of certain home and community based waivers, increases in projected pharmacy costs and provider rate increases, and funding the backfill of revenues reduced in FY 16 as part of the FY 16 mid-year deficit elimination plan. Significant FY 17 SGF increases are reflected below:

$195.3 M - Bayou Health managed care capitation rate payments $167.0 M - Swap non-recurring one-time revenues for SGF $109.2 M - FY 16 pushed checkwrite (June 2016) into FY 17 * $24.3 M - Fee for Service increases (including Pharmacy, PACE, and LT-PCS) $21.3 M - Rate increases (FQHC’s, RHC’s, Hospice, Buy-in, Rural H’s, Nursing F’s)

* The $109.2 M enhancement reflected above does not include $17 M in SGF required state match to make the projected 13 th managed care payment as a result of this amount only being available for expenditure when the Department of Revenue prevails in any suit appeal, or petition associated with an amount paid under protest and held in escrow in accordance with R.S. 47:1576 and transfers such monies to the SGF to be utilized to fund the 13th managed care payment. The total SGF need is $126.2 M to draw down $208.2 M in federal funding for $334.4 M in total payments. Public Private Partnerships (PPP) Funding HB 1 provides total funding of $983.3 M for Public Private Partnerships in FY 17. This represents a $221 M reduction (18%) compared to the FY 16 EOB as of 12/01/2015. Information provided by DHH indicates an original expenditure projection of approximately $1.3 B. This



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original expenditure projection is assumed to change as DHH assumes and will apply a 25% ($249,541,305) reduction in DSH payments to partner hospitals due to anticipated decreases in uncompensated care costs as a result of Medicaid expansion in FY 17 (not including Lallie Kemp). However, the Commissioner of Administration has stated that the DOA, LSU, and partner hospitals are under negotiations to refinance the partnership agreements, and to further review the 25% DSH reduction estimates. HB 1 does not directly appropriate funding in the Medicaid program for the individual partner hospitals. Partner hospital reimbursements are paid from the Medicaid Private Providers and Uncompensated Care Costs programs. Therefore, the exact budget by hospital is not known. In addition, the majority of the partnership agreements provide for a finance formula that requires payments to reimburse the hospital providers at 100% of allowable UCC costs The Cooperative Endeavor Agreements (CEAs) for each of the partnerships have specific stipulations in regard to termination of these partnerships. For 6 of these partnerships, the CEAs include a clause that allows the private partner to terminate the contract without cause provided they give LA 60 days notice of their intent. The private partners that have this option include Children Hospital (New Orleans), Biomedical Research Foundation (Shreveport/Monroe), Southwest LA Hospital Association (Lake Charles), Lafayette General Hospital System (Lafayette), Our Lady of Angels (Bogalusa), and Our Lady of the Lake (Baton Rouge). CHRISTUS and Rapides Healthcare System (Alexandria) and Southern Regional Medical Corporation (Houma) CEAs do not have specific language in the CEA that allows the private partner to terminate the contract without cause. However, there are several stipulations that allow either of these 2 partners to terminate the contract provided they give advanced notice. The CEAs for CHRISTUS and Southern Regional have a stipulation that if “inadequate” funding is received by the private partner from the state, the CEA can be terminated after the private partner has given the state 90-180 days notice (see Chart 1 below).

Chart 1

These CEAs stipulate the payment methodology and specific amounts that are required based on the agreed upon Medicaid/Medicare Cost Report and the cost analysis worksheet that the partner submits to the state. Based on conversations with entities involved with these CEAs, the Legislative Fiscal Office has been informed that since these private partners are expecting to be reimbursed for all costs associated with their service (as required by the CEA), any funding below this level could be interpreted as “inadequate.”

Overview of Private Public Partnerships Options to Terminate Without Cause

Private Partner LSU Hospital Termination Without Cause Option

# Days Needed to Exit CEA without Cause

LA Children's Medical Center and University Medical Center Management Corporation (UMCMC)

Medical Center in New Orleans Yes 60 Days

Biomedical Research Foundation of Northwest LA and BRF hospital Holdings, L.L.C.

HSC Shreveport and EA Conway Medical Center

Yes 60 Days

Southwest LA Hospital Association (SLHA) dba Lake Charles Memorial Hospital (LCMH)

W.O. Moss Regional Medical Center

Yes 60 Days

Lafayette General Hospital System and University Hospital and Clinics

University Medical Center (UMC)

Yes 60 Days

Our Lady of Angels and Franciscan Missionaries of Our Lady Health System ("FMOLHS")

Washington St. Tammany Medical Center ("Bogalusa")

Yes 60 Days

Our Lady of the Lake (OLOL) Earl K. Long (Baton Rouge)

Clinical Services – Yes; CEA can terminate from inadequate funding

Clinical Services (w/out cause) - 90 days CEA from inadequate funding - 180 days

CHRISTUS Health Central LA and Rapides Healthcare System Huey P. Long

No, but can terminate from inadequate funding from the state

No without cause option, but 180 days for inadequate funding

Southern Regional Medical Corporation and Hospital Service District #1 of Terrebonne Parish

Leonard J Chabert Medical Center

No, but can terminate from inadequate funding from the state

No without cause option, but 90 days for inadequate funding (after 3 years, 60 days)



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In the event a private partner seeks to terminate the contract, the CEA dictates both parties are involved in a “wind-down” period where both parties begin the transition of operations while ensuring services will be provided to the public. If negotiations between LSU and private partners are not successful, LSU and the state will have 60-180 days to 1) contract operations to an outside private entity to assume operations with the State providing operating capital for operations, 2) hire new public employees and assume operations within the 60 days with the State providing operating capital for operations, and 3) LSU would seek approval from the Legislature to close facility. The CEA between BRF and LSU requires a committee of 6 (LSU, BRF, & DOA: 2 members each) to over see the transition and requires LSU to name successor corporation and members of the Board. Private Partner Lease Payments The state receives lease payments from the private partners to use state hospital facilities. This includes Children’s Hospital, Our Lady of the Lake, Biomedical Research Foundation, University Hospitals and Clinics, Southwest LA Hospital Association, and Our Lady of Angels. In the event a partnership is terminated, the lease payments from the partner would cease and as a result the state funding would be lowered. The adopted Revenue Estimating Conference forecast includes $190 M of lease payments for the current year and $160 M for FY 17 (Table 2 below). Based on testimony provided by the private partners, the state would be expected to reimburse these partners for any prepaid rental payments (advanced lease payments), equipment acquisitions made by the private partner, and/or any capital expenditures made by the private partners. University Medical Center CEO, Greg Feirn, has stated in committee that there is nearly $385 M worth of prepaid rental and capital improvements made by Children’s Hospital at the new UMC Hospital that the state would be obligated to reimburse to Children’s Hospital.

Table 2

Overview of Lease Payments Deposited into the State Treasury

2012-13 Actual

2013-14 Actual

2014-15 Actual

2015-16 Appropriated

Total Lease Payments Received* $283,379,817 $132,852,741 $135,560,763 $190 M**

* Source: Treasurer’s reports ** Revenue Estimating Conference Adopted Forecast DEPT/AGY: Health & Hospitals (DHH)/Aging & Adult Services (OAAS) ISSUE: Community-Based Waivers & Other Community Services The Community Choices Waiver (replaced the Elderly & Disabled Adult - EDA Waiver) allows for services to be provided in a home or community-based setting for a qualifying person who would otherwise require care in a nursing facility. In addition to personal care services, the waiver provides a variety of other services that assist people to remain in their homes and communities. Due to the increased demand for these services, there is a Request for Services Registry (waiting list).

FY 17 Funded Slots: 5,303 (200 slots for Pitts vs. Greenstein settlement) FY 16 Funded Slots: 5,303 Slots Filled as of 12/31/2015: 4,463 Slots Funded but not Filled: 840 Registry and/or Waiting List: * 33,278 Average Cost/Capped Cost: $26,533 ($41,799 cap) FY 16 EOB Expenditures: $109,608,993 FY 17 Budget: $118,505,013 Population Served: Ages 21 +, Medicaid eligibility, and meet nursing facility level of care

criteria

The Adult Day Health Care (ADHC) Waiver provides certain services for 5 or more hours per day in a licensed and Medicaid enrolled ADHC facility. Services offered include assistance with activities of daily living, health and nutrition counseling, social services, and exercise programs. There is an ADHC Request for Services Registry that lists the people who requested these services along with the request date.

FY 17 Funded Slots: 825 FY 16 Funded Slots: 825 Slots Filled as of 12/31/2015: 661 Slots Funded but not Filled: 164 Registry and/or Waiting List: * 3,989 Average Cost/Capped Cost: $24,438 ($42,223 cap) FY 16 EOB Expenditures: $10,589,073 FY 17 Budget: $12,091,881 Population Served: Ages 22 +, Medicaid eligibility, and meet nursing facility level of care

criteria



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The Long Term Personal Care Services (LT-PCS) Program** provides help with activities of daily living for people who qualify for assistance under the program guidelines. The program also provides personal care workers to help people in their homes. Care provided includes help with bathing, toileting and grooming activities; eating and food preparation; performance of incidental household chores; assistance getting to medical appointments; and grocery shopping.

Slots Filled as of 12/31/2015: 11,408 Average Cost/Capped Cost: $13,968 ($19,035 cap) FY 16 EOB Expenditures: $193,237,593 FY 17 Budget: $199,236,894 Population Served: Ages 21 + who receive Medicaid benefits, nursing facility level of care

and imminent risk criteria of nursing home admission Program for All Inclusive Care for the Elderly (PACE) Program** coordinates and provides all needed preventive, primary, acute and long-term care services so that older people can continue living in the community. The emphasis is on enabling senior citizens to remain in their communities while enhancing their quality of life.

Slots Filled as of 12/31/2015: 365 Average Cost/Capped Cost: $33,079 ($54,288 cap) FY 16 EOB Expenditures: $13,039,775 FY 17 Budget: $17,543,456 Population Served: Ages 55 +, live in PACE provider service area, nursing facility level of

care, and meet Medicaid financial eligibility The State Personal Assistance Services (SPAS) Program** provides personal assistance services to people with significant disabilities to assist them with activities of daily living. The primary service provided with SPAS funding is Personal Assistance Services. The Office of Aging & Adult Services has contracted with the ARC of Louisiana to administer both the Community & Family Support program and the State Personal Assistance Services Program for a total of $633,229.

Slots Filled as of 12/31/2015: 49 Registry and/or Waiting List: * 111 Average Cost/Capped Cost: $17,152 FY 16 EOB Expenditures: $840,452 FY 17 Budget: $840,452 Population Served: Ages 18 - 60, a significant disability, capable of hiring, firing, and

supervising the persons who provide personal assistance services The LA's Traumatic Head & Spinal Cord Injury (TH/SCI) Trust Fund Program** provides services in a flexible, individualized manner to LA citizens with traumatic head or spinal cord injuries. The program enables individuals to return to a reasonable level of functioning and independent living in their communities. Services are provided on a first-come, first-served basis. Expenditures shall not exceed $15,000 for any 12-month period or $50,000 in total lifetime expenditures per individual.

Slots Filled as of 12/31/2015: 702 Registry and/or Waiting List: * 275 Average Cost/Capped Cost: $8,500 ($15,000 cap) FY 16 EOB Expenditures: $2,895,812 FY 17 Budget: $2,895,812 Population Served: An individual must meet the definition of traumatic head injury or

spinal cord injury. *Registry and/or Waiting List as of 12/31/2015 **Programs without designated slots, the reported data represent the number of participants. DEPT/AGY: Health & Hospitals (DHH)/ Citizens with Developmental Disabilities ISSUE: Community-Based Waivers for the Developmentally Disabled The New Opportunities Waiver (NOW) is offered on a first-come, first-served basis. There is a Developmental Disability Request for Services Registry (RFSR) that lists individuals who meet the LA definition for developmental disability and their request date.

FY 17 Funded Slots: 9,032 FY 16 Funded Slots: 9,032 Slots Filled as of 12/31/2015: 8,676 Slots Funded but not Filled as of 12/31/2015: 156 Registry and/or Waiting List:* 13,605 Average Cost/Capped Cost (Actual): $52,320 Expenditures Forecast (12/31/2015): $449,163,213 Population Served: Ages 3 + who have a developmental disability that manifested

prior to age 22 The Children’s Choice Waiver offers supplemental support to children with developmental disabilities who currently live at home with their families, or who will leave an institution to return home. Children’s Choice is an option offered to children on the Request for Services Registry (RFSR) for the New Opportunities Waiver (NOW) as funding permits. Families choose to either apply for Children’s Choice, or remain on the RFSR for the NOW.



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FY 17 Funded Slots: 1,475 FY 16 Funded Slots: 1,475 Slots Filled as of 12/31/2015: 1,212 Slots Funded but not Filled as of 12/31/2015: 237 Registry and/or Waiting List:* 7,346 Average Cost/Capped Cost (Actual): $10,389 ($16,410 waiver cap only) Expenditures Forecast (12/31/2015): $12,501,666 Population Served: Ages Birth - 18 who meet the federal definition for a

developmental disability *Also subset of individuals under 19 from the NOW waiver and the number is included in the NOW registry. The Support Services Waiver has reserved capacity for individuals who were receiving state general funded vocational and rehabilitation services as of 3/31/2006 or who were listed as waiting for those services prior to 5/31/2006. The Supports Waiver is intended to provide specific, activity focused services rather than continuous custodial care.

FY 17 Funded Slots: 2,050 FY 16 Funded Slots: 2,050 Slots Filled as of 12/31/2015: 1,683 Slots Funded but not Filled as of 12/31/2015: 367 Registry and/or Waiting List:* 1,363 Average Cost/Capped Cost (Actual): $7,752 Expenditures Forecast (12/31/2015): $12,560,155 Population Served: Ages 18 +

The Residential Options Waiver (ROW) offers services designed to support individuals to move from ICFs/DD and nursing facilities to community-based settings, and to serve as an alternative to being institutionalized. ROW was approved by CMS on 10/1/2009.

FY 17 Funded Slots: 210 FY 16 Funded Slots: 210 Slots Filled as of 12/31/2015: 28 Slots Funded but not Filled as of 12/31/2015: 182 Registry and/or Waiting List:* 0 Average Cost/Capped Cost (Actual): $26,983 Expenditures Forecast (12/31/2015): $1,222,809 Population Served: Ages Birth to end of life who have a developmental disability

which manifested prior to the age of 22 *Registry and/or Waiting List as of 12/31/2015

DEPT/AGY: Higher Education ISSUE: Higher Education Funding Overview The EOB as of 12/1/2015 (without OSFA) totals $2.28 B (including $418.9 M SGF and $350 M SAVE). HB 1 with Senate amendments recommends a total budget of $2.23 B, reflecting a net reduction of $48 M; a $93.7 M reduction in SGF, a $15.5 M decrease in IAT and Statutory Dedications, and a $61.2 M increase in SGR from fees associated with Act 377 of 2015.

Table 3

Institution/SystemFY 16 Existing

Operating Budget (EOB)

HB 1 Reengrossed w/ Senate Amendments

% Change FY16 EOB to HB 1 Reengrossed w/ Senate

Amendments

Higher Education - State General Fund Equivalent Summary by Institution and System (FY 16 Existing Budget to HB 1 Reengrossed with Senate Amendments)

based on potential Formula Funding by Regents

LSU System Total $371,709,494 $318,395,775 -14%

SU System Total $44,474,795 $36,585,441 -18%

UL System Total $217,495,183 $196,018,587 -10%

LCTCS System Total $115,508,742 $106,833,790 -8%

LOSFA Administration $3,261,171 $3,013,161 -8% Scholarships* $29,842,486 $29,582,900 -1% TOPS $200,091,126 $81,229,202 -59%LOSFA Total $233,194,783 $113,825,263 -51%

Board of Regents $15,213,434 $13,001,521 -15%

LUMCON 2,283,493 $2,109,835 -8%Statewide Total $999,879,924 $786,770,212 -21%*Maintains static funding of $26.4 M for GO Grants as mentioned in the Executive Budget.



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The first column in Table 3 on Page 58 shows the FY 16 SGF equivalent (SGF + Higher Education Initiatives Fund) budget by budget unit and system. The second column entitled “HB 1 Reengrossed” shows the $786.8 M SGF allocation to higher education including $81.2 M for TOPS. However, the amounts that the LSU System, Southern System, University of LA System, and LA Community & Technical College System will receive are unknown at this time. Based on the pro-rata distribution of SGF available, a total of $657. 3 M (including the $9 M for Ag Centers and Pennington) will be utilized to fund the systems. The distribution of SGF is as follows: Board of Regents (BOR) - $13 M; LA Universities Marine Consortium - $2.1 M, Office of Student Financial Assistance (admin) - $32.6 M, TOPS - $81.2 M and the 4 management boards - $657.3 M. The final amounts appropriated to the management boards will be determined when the Board of Regents distributes funds based on the formula funding process. HB 1 does not allocate specific amounts of SGF to individual institutions. Instead, the bill assigns all SGF to the BOR for allocation by the Board after passage of the appropriations bill. The table assumes the SGF requirements related to the GO Grant Scholarship Program within the LOSFA will be fully funded at $26.4 M. The table serves to illustrate the potential impacts of the SGF reductions or enhancements to systems. The allocation by institution will be determined by the BOR once the board receives the appropriated amount for FY 17 and determines the allocation based on the funding formula. Act 462 of 2014 required the BOR to develop an outcomes based funding formula for implementation beginning in FY 17. The proposed formula allocates SGF for each institution/system based on a 70% pro-rata share (base funding), 15% cost calculation share and a 15% outcomes share. The pro-rata calculation is based on the 7/1/2015 appropriation levels and provides safeguards to prevent sudden, dramatic changes in the funding level of any postsecondary institution as required in Act 462. The cost calculation is based on weighted factors including SREB peer group salary data, course offerings, enrollment of Pell grant students, research, degree level, space utilization, and support services. The outcomes metrics are based on completer degree levels, transfers, completers in high demand fields (4 & 5 star jobs), time-to-award, and completion of students receiving the Pell grant. Senate amendments removed $6.1 M in equity formula funding for LCTCS, $300,000 for Baton Rouge Community College; and provided $4 M for Pennington Biomedical Research Center, $4 M for the LSU Ag Center, and $1 M for the Southern Ag Center. The amendments further deleted the $500,000 in SGF for a tier 1 university transportation center grant for LSU A&M to study transportation infrastructure in hot climates including extreme weather conditions in the event the institution is awarded the grant. Table 3 is intended to GENERALLY illustrate the potential SGF allocation by budget units and systems in the proposed budget. Taylor Opportunity Program for Students (TOPS) The FY 16 funding totals for TOPS is $265.2 M ($200.1 M SGF and $65.1 M Statutory Dedications). HB 1 has a budget amount for TOPS of $141.4 M ($81.2 M SGF and $60.2 Statutory Dedications). FY 17 projected need for TOPS is $297.1 M. The Executive Budget proposal only included $60.2 M from the TOPS Fund. HAC amendments restored $236.8 M in SGF to fully fund the Taylor Opportunity Program for Students (TOPS). House Floor amendment reduced SGF by $71,930,619. SFC amendments further reduced TOPS by $83,659,300. As a result of this reduction, TOPS is funded at approximately 48% of the total program cost. SB 470 Enrolled is currently awaiting the signature of the governor. The bill would change the mechanism for the distribution of awards in the event insufficient funds are available. The bill requires that all students that receive an award are allocated an equitably reduced award amount. The projected average award amount for FY 17 is $5,718 for 51,194 students. Based on the current TOPS funding level of $141.5 M, the average award amount would be $2,733 (48% of fully funded award amount), a decrease of $2,986 per student per award. DEPT/AGY: Higher Education/ LSU System ISSUE: LSU Health Sciences Center – Shreveport (HSC-S) Structural Funding Issue For FY 17 the continued financial viability of the medical school is uncertain. Historically, LSU HSC-S has struggled with a structural operating deficit. The FY 16 Mid-Year Deficit Reduction Plan 2 did not contain a SGF reduction to the medical school, but did contain a $4.1 M reduction to the partner, the Biomedical Research Foundation of Northwest LA (BRF). Additionally, HB 1 further reduces state support and includes other adjustments that impact the school’s revenue generating capacity.



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Fiscal Year 2016 The FY 16 total budget for LSU HSC-S is $117.4 M. The medical school did not receive a direct mid-year reduction. However, the medical school still has a projected $3.1 M operating shortfall. In addition to state support for operations, the medical school receives self-generated revenue (SGR) from the Biomedical Research Foundation of Northwest LA (BRF) for providing services to the hospital. On average, the medical school receives $6.7 M per month from BRF. The services provided include physicians’ services, resident support, police, allied health services and shared services. BRF receives payments from the Department of Health & Hospitals (DHH) for the operation of the hospital and then sends payment to LSU HSC-S for the services provided. As a result of this operating arrangement and payment structure, the medical school will receive a reduction in provider payments of $4.1 M. The mid-year provider payment reduction further reduces the available fund balance ($48.6 M). To the extent the operating deficit of $3.1 M for FY 16 is static, LSU HSC-S would end FY 16 with $41.4 M available in restricted fund balance ($48.6 M current balance - $3.1 M operating deficit - $4.1 M mid-year reduction). Fiscal Year 2017 State support for LSU HSC-S is projected to decrease by $36.8 M or 42% in FY 17. This reduction includes non-recurring payments of $32.7 M for operating expenses ($31 M) and reduced legacy costs ($1.7 M) and a pro-rata SGF cut of $4.1 M based on the $94.8 M SGF equivalent reduction to all Higher Education (excluding TOPS). Legacy costs are projected to be $18 M in FY 17 and based on the pro-rata SGF reduction of $4.1 M, would be 77% funded. Furthermore, even if the medical school begins FY 17 with the restricted fund balance of $41.4 M (after the operating shortfall & FY 16 mid-year partnership reductions) it will likely exhaust this balance within the first quarter of the new fiscal year. HB 1 funding related to the public/private partnerships within the DHH is not appropriated by hospital, so the exact funding level to the LSU HSC-S partner hospitals is unknown at this time. It is possible the medical school would have to reduce physicians and medical residents to the extent the partnerships are not fully funded. In February 2016, the potential cuts based on the worst case scenario regarding FY 16 and FY 17 budgets anticipated a reduction of faculty physicians by 161 from 304 to 143 (53%) and medical residents by 352 from 550 to 198 (64%). The medical school would maintain operation of the 6 core departments required for accreditation (Psychiatry, Surgery, Pediatric, Obstetrics & Gynecology, Family Medicine and Internal Medicine). The faculty and resident layoffs would come from specialty departments such as neurology, radiology, and anesthesiology among others. The impact to the instruction of medical students and supervision of residents would ultimately depend on the number of faculty that leave, allocation of the partner reductions to the school and the available fund balance at the end of FY 16. As a result the faculty, resident and program reductions mentioned above may take place sometime in FY 17. The exact impact is indeterminable at this time since the FY 17 reductions will depend on budget adjustments to HB 1 as it moves through the legislative process. Accreditation The Southern Association of Colleges & Schools Commission on Colleges (SACSCOC) is the regional body for the accreditation of degree-granting higher education institutions in the Southern states and reaffirms a school’s accreditation every 10 years. LSU HSC-S was affirmed in December 2014, however SACSCOC raised concerns that the school could not meet the financial stability requirements. The structural operating deficit and declining fund balance have serious implications for the accreditation of the medical school and SACSCOC began monitoring the school in 2015. In FY 16 LSU HSC-S received $51 M in additional state resources for legacy costs ($20 M) and operating expenses ($31 M). This state support seemed to provide assurances and in December 2015, SACSCOC took no action on the medical school. However, the school could be monitored again after SACS meets in December 2016 depending on the funding situation. LSU estimates that reserves of approximately $50 to $55 M are required in order to meet SACSCOC guidelines which the school currently does not have. As part of accreditation standards, the institution is required to finish teaching all students in the program. There are currently 471 medical students with an average of 118 students in each year of medical school. The reductions to the institution and partner in FY 17 affect the school’s ability to provide instruction and may impact SACSCOC accreditation.



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DEPT/AGY: Education (DOE) ISSUE: Elementary & Secondary Education Funding Reduction Impacts FY 17 recommended funding for the Department of Education (DOE) (not including the MFP) totals $1,632 M ($147.9 M SGF, $290.3 M IAT, $57.4 M SGR, $14.8 M Statutory Dedications, and $1,121 M Federal) for a net reduction of $68.3 M. The DOE has not identified the allocation of all the reductions. A brief description of the budget unit, the amount of the reduction allocated, as well as potential impacted activities are as follows: State Activities ($2.3 M) provides for state assessments and school accountability as well as support for local school districts and professional development activities. Funding is reduced for 11 positions (2 in Administration and 9 in District Support). Support Services and Field Services will be reduced; contracts not associated with student assessments will be reduced or eliminated and funding for travel and supplies will be reduces. The DOE has not identified how these reductions will be allocated. Subgrantee Assistance ($9.4 M) provides flow through funds to local educational agencies and schools. The Student Scholarships for Educational Excellence Program (SSEEP) will be reduced $5.9 M- The SSEEP (voucher program) allows selected students to attend participating non public schools with tuition expenses paid by the state. Tuition is reimbursed at a rate that shall not exceed the combined state and local per pupil amount of the district in which the student resides. FY 16 funding is $42 M. There were 7,110 students enrolled in the first quarter as of 9/21/2015 for an annualized cost of $41.7 M. Reductions to this program would result in students returning to public schools which would subsequently increase the MFP costs but at a lower per pupil amount. As a result there would likely be a savings to the state since DOE is paying higher tuition costs for a significant portion of the voucher students. Based on actual 1st quarter expenditures it is estimated that the state will pay $8.3 M more to the voucher schools than it would have paid through the MFP in the current year. For further discussion of the program costs, see “Cost Analysis for SSEEP” issue write-up. The DOE has indicated it will reduce the tuition amount paid in order to retain the existing number of slots available. However, given the annual attrition rate of 20% (the number of students who leave the program each year) combined with the fact that 32 (26%) of the participating schools will not be accepting new students in the 2016-2017 school year, it is very possible that the number of participants in the program will remain sufficiently low enough to maintain the seats for remaining students at the current tuition rate. That information will not be available until the DOE has completed the application and enrollment process. Families received initial award letters at the beginning of April and have until the end of May to register with a second application and enrollment round ending at the end of June with registration by mid July. The Cecil J. Picard LA 4 Early Childhood Program is the primary preschool program in the state, serving approximately 16,300 children. It provides up to 10 hours of early childhood education and before and after activities daily to 4 year olds from disadvantaged families. The Nonpublic Schools Early Childhood Development Program (NCSED) provides low-income families the opportunity to attend state-approved private preschools and childcare centers and serves approximately 1,500 preschool children annually. Current funding is $4,580 per child. For FY 16, the LA 4 Program is funded at $76.9 M ($9.4 M SGF and $67.5 M IAT) and the NCSED is funded at $7.4 M (SGF) for total LA 4 Program funding of $84.3 M. The original source of the IAT is TANF funds from the Department of Children & Family Services (DCFS). FY 17 funding includes a MOF swap replacing TANF funds with $27.4 in SGF. Total funding remains at a standstill level, however the ratio of SGF has increased from 12% to 48% and TANF funding has been reduced from 88% to 52%. Special School District ($1.4 M) provides special education and related services to approximately 500 children with exceptionalities enrolled in state operated programs (Office of Children with Developmental Disabilities, Office of Behavioral Health, Dept. of Corrections, and the Office of Juvenile Justice). Reduces funding for 22 positions (14 filled and 8 vacant). The positions include 12 educator, paraeducator, and instructional coach positions as well as 2 administrative positions; also reduces funding for travel. The reduction will result in the elimination of services to private pay facilities; instead, local school districts will be required to provide these services.



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Special Schools & Commissions FY 17 recommended funding for Board of Elementary & Secondary Education (BESE) and the special schools is recommended at $91.3 M which represents a net reduction of $423 K. The most significant SGF impacts to the special schools and the 1,400 students they serve are listed on the next page. LA School for the Deaf & Visually Impaired ($558 K) provides educational services to approximately 488 students in residential and outreach programs. The reduction eliminates funding for 6 vacant positions, out of state travel and operating services. LA School for the Math Science & the Arts ($265 K) provides educational services to approximately 300 high achieving students in residential and online programs. The reduction eliminates funding for 5 positions. New Orleans Center for the Creative Arts ($293 K) provides specialized arts training to 625 students through a combination of MFP funds and direct state support. The reduction is associated with contracts and operating services. DEPT/AGY: Education ISSUE: Minimum Foundation Program (MFP) The Minimum Foundation Program (MFP) provides for an equitable distribution of state funds to local school districts. The MFP is the major source of state funding to local schools. For FY 16, the MFP is funded at $3.678 B; $3.391 B in SGF and $287.16 M in Statutory Dedications from the Support Education in LA First Fund ($109.7 M) and Lottery Proceeds Fund ($177.4 M). The FY 17 Executive Budget includes an adjustment of $14.8 M for an anticipated increase of 2,298 students. Additionally, there is a $3.7 M MOF swap replacing SGF with Lottery Proceeds funds ($3.7 M) and SELF funds ($0.05 M) based on the most recent Revenue Estimating Conference (REC) forecast. FY 17 recommended funding totals $3.64 B; $3.35 B SGF, $181.1 M Lottery Proceeds Fund and $109.7 M SELF Fund. The FY 16 MFP included $44.2 M, which was funded in a supplemental appropriation outside of the formula: a 1.375% inflation adjustment ($36.2 M); an increase for the Supplemental Course Allocation ($2.6 M); and an increase for the High Cost Services Allocation ($5.4 M). HR 231 of 2015 urged and requested BESE to incorporate the supplemental funding into the FY 17 resolution. As such, the proposed MFP for FY 17 approved by BESE on March 4 incorporated this adjustment into the formula. This represented standstill funding for the MFP. However, in light of the state’s fiscal status the MFP resolution (SCR 44) was rejected by the Senate Education Committee. Pursuant to the Constitution, the MFP will be funded in accordance with the last approved resolution (SCR 55 of 2014); accordingly, the proposed budget eliminates this supplemental MFP funding of $44.2 M. Level 1: Maintains the weights for Career and Technical Education units (6%), Special Education/Other Exceptionalities (150%) and Special Education/Gifted and Talented (60%), and Low Income/English Learner (22%). Maintains the calculation of local share necessary to maintain a state and local allocation ratio of 65% to 35%. Level 2: Maintains the provisions of incentives for local effort. Level 3: Continues the pay raises for certificated and support personnel initiated in 2001-2002 and 2006-2007 through 2008-2009; the 10-year phase out of the hold harmless funding; and a $100 per pupil funding amount for increasing mandated costs of health insurance, retirement and fuel. Level 4: Supplementary Allocations: These new funding initiatives were added in the FY 15 MFP. FY 17 proposed allocations are. 1) Career Development Allocation ($6.3 M) to support the development of technical courses

required for statewide credentials in city and parish school systems and other public schools in the amount of 6% of the base per pupil cost for each qualifying student course enrollment; a minimum amount of $25,000 will be provided for each city and parish school system and a minimum of $10,000 will be provided for other public schools with students enrolled in grades 9 through 12.

2) High Cost Services Allocation ($4 M) currently provides additional funds to public school

systems and schools which substantiate that the prior year cost of services for students with disabilities exceeds three times the most recent state average total expenditure per pupil amount; allocation amounts are limited by the amount budgeted for this initiative and are to be distributed equitably to school systems and other public schools proportional to the total of qualifying applications submitted.



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3) Supplemental Course Allocation ($7.8 M) to provide for the cost of secondary course choices

specifically approved by BESE. For each school system and other public schools funded through the formula, the allocation shall equal $35 for each student enrolled in grades 7-12 as of February 1st. Provides for the redistribution of uncommitted funds as of a date set by DOE.

Also Level 4 includes the Foreign Language Associate Program Salary & Stipends Allocation. The supplemental allocation is $21,000 per teacher. Of this, $20,000 shall be allocated to the school where the teacher is employed for support of the total cost of the teacher salary and $1,000 to be used for the costs of the VISA sponsorship incurred by CODOFIL, pursuant to BESE regulations. The cap of 300 teachers is retained. Allocations for Other Public Schools: Continues funding methodology for the LSU and Southern University Lab Schools, Type 2 Charter Schools, Office of Juvenile Justice Schools, the Recovery School District, NOCCA and LSMSA. Pay Raise Requirements: The FY 15 MFP revised language requiring schools to use at least 50% of any increased funding to supplement and enhance full time certificated staff salaries and retirement benefits for schools with an average teacher salary below the SREB average. New language required school systems to sustain 2013-2014 pay raises if there is a net increase in the Levels 1 and 2 cost allocation. If the school system had established plans to sustain or increase the pay raises prior to the development of this formula, the provision does not apply. DEPT/AGY: LSU Health Care Services Division ISSUE: Legacy Costs The HCSD’s legacy appropriation is $2.3 M below the projected level of legacy expense liability. See illustration below. Legacy Cost Expenditures $23,159,697 Legacy Appropriation after HAC $20,843,412 Legacy Cost Shortfall ($2,316,285)

However, these legacy costs are mandatory expenditures that will require HCSD to find available funds from other sources. HCSD has stated it will use the revenues generated from their contract with the private partners for administrative services and by reducing support services, using one-time funding, and attrition. Note: Prior to these private partnerships, these legacy expenditures were allowable expenses on the cost report to receive federal match funding. CMS has since ruled these expenses are unallowable since these hospitals are no longer associated with the system.

TO: The Honorable Taylor F. Barras, Speaker of the House of Representatives Honorable Members of the House of Representatives FROM: John D. Carpenter, Legislative Fiscal Officer Evan J. Brasseaux, LFO Staff Director DATE: June 3, 2016 SUBJECT: House Rule 7.19, HB 1 Reengrossed with Senate Amendments, FY 17 Financing Replacement Pursuant to House Rule 7.19, the Legislative Fiscal Office (LFO) is required to submit a report to the House of Representatives, which indicates whether the appropriation bill appropriates one-time money within the Reengrossed version of House Bill 1 (HB 1). The LFO is providing this information for HB 1 – Reengrossed with Senate Amendments and a discussion of the FY 18 financing decisions that will have to be made as a result of the current structure of the FY 17 proposed operating budget. If you have any questions about any of the information presented in this memo, please contact me by email at [email protected] or by phone at 225-342-7233. HR 7.19 One-Time Money List Pursuant to HR 7.19(C)(2), appropriations from one-time money for ordinary recurring expenses may not exceed the projected growth of the state general fund from the fiscal year for which the appropriation is proposed and the subsequent fiscal year according to the most recent official forecast. The threshold calculation is the difference between the official SGF revenue forecast adopted by the Revenue Estimating Conference on March 16, 2016, for FY 17 of $ 9,498.5 B and for FY 18 of $ 9,740.0 B, which equates to $241.5 M of SGF revenue growth. The amount of one-time funds, as defined by HR 7.19, allowed to be appropriated in HB 1 for FY 17 expenditure is approximately $241.5 M. There is no ($0) one-time money as defined in House Rule 7.19 in HB 1 Reengrossed with Senate Amendments after all adopted legislative amendments to HB 1 and HB 409 (Funds Bill - with regard to FY 17), FY 18 Replacement Financing Decision List Although HR 7.19 contains a definition of “one-time money,” the rule itself is not indicative of the financing decisions that will have to be made in FY 18 relative to the current structure of the FY 17 proposed operating budget. Due to this issue, the LFO is not only providing the HR 7.19 list to comply with the House Rule, we are also providing you with a detail of significant potential FY 18 financing replacements that will have to made as a result of the proposed FY 17 budget. See discussion of Medical Vendor Payments below regarding resources being utilized in FY 17 that will likely require another revenue source in FY 18. The $34.5 M of financing needs are in addition to any other continuation budget requirements not yet resolved in the FY 17 budget. These additional funding requirements will likely result in an FY 18 anticipated funding shortage that could exceed $34.5 M. The $34.5 M of potential financing replacement in FY 18 is a significant reduction compared to the amount of FY 17 financing replacement of approximately $826.4 M. Agency – Medical Vendor Payments The current budget recommendation as reflected in HB 1 Reengrossed with Senate Amendments includes an appropriation of $34.5 M drawn from fund balances of the Medicaid Trust Fund for the Elderly and the Health Trust Fund. These funds are expected to be essentially depleted after the draw down of monies in FY 17, resulting in a need to identify replacement revenues for FY 18.

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! STATE OF LOUISIANA Legislative Fiscal Office BATON ROUGE Post Office Box 44097 Capitol Station John D. Carpenter Baton Rouge, Louisiana 70804 Legislative Fiscal Officer Phone: 225.342.7233 Fax: 225.342.7243 !!

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