AZ State Agency Budget Request Summary

Each Fall state agencies turn in requests for changes in their funding to the Governor’s Office for consideration in his or her proposed budget.  These requests are then evaluated by the executive branch and synthesized into a final budget proposal from the Governor, which is usually released in mid-January.

Here’s an abbreviated snapshot of what ADHS, AHCCCS and ADES turned in this year:

AHCCCS

  • AHCCCS is estimating an average Capitation Rate increase of 3.1% across all lines of business.  They turned in cap rate increases for special populations of 12% for Children’s Rehabilitative Services, 9.6% for behavioral health and a 3.5% decrease for the Comprehensive Medical and Dental Program (a state program for providing quality care for kids in the foster care system); 
  • This request would add $72M from the state General Fund to cover costs for enrollment growth, capitation rate increases and state-federal match rate changes;
  • Maintaining current state funds dedicated to the state’s behavioral health Crisis System ($14M) non-Title XIX services for persons with a serious mental illness ($78.8M) & $5.3M for Supported Housing; and
  • They're asking that behavioral health costs be blended into the acute care and ALTCS (long term care) line items.

Arizona Department of Health Services

  • ADHS is requesting $500K to continue funding for response to public health emergencies;
  • Seeking $750K to maintain minimum standards for health care licensure staff and responses to growing demand for services because of the growth and workload in licensing; and
  • Requesting funds to respond to new responsibilities to oversee the AZ Radiation Regulatory Agency with a 1-time request for $500K for proper handling and disposal of radioactive materials.

Arizona Department of Economic Security

  • Seeking $3.9M to respond to ongoing Adult Protective Services caseload growth;
  • Adding $10M to accommodate a 2% capitation increase & accommodate a caseload increase of 4.9% for persons with Developmental Disabilities in the Arizona Long Term Care System (ALTCS);
  • Addressing DDD structural shortfall by adding $6.4M to cover Long Term Care services for non-XIX services of room & board;
  • Requesting $3.3M for targeted case management services for the state-only DDD clients; and
  • Responding to mandates imposed by Prop 206 on the minimum wage by adding for DDD $11.6M to assure network sufficiency.

Family Planning Services Lose Traction

Contraception and family planning are among the most significant public health interventions of all time- and among the top of the list when it comes to return on investment.

Family planning and contraception are key to reducing teen pregnancies and inter-generational poverty.  It’s no secret that poverty is a key driver for a host of poor health outcomes.  Family planning is also a high return on investment intervention for improving preconception health because it allows women to make more deliberate decisions about the spacing of babies- which improves the health status of mom and baby.  Family planning is also good for businesses, because it allows employees to plan their families in a way that improves their work-life balance, improving attendance and retention.

The Affordable Care Act initially required that health insurance plans cover no-cost contraception services, a big win for public health. A couple of years ago the US Supreme Court ruled that family owned and other closely held companies can opt out of these ACA’s provisions.  The owners of the Hobby Lobby had objected on the grounds of religious freedom.

This week things slipped further, when Attorney General Sessions expanded the religious exemption for employers who object to providing insurance coverage for birth control because of their religious or moral beliefs.  His “religious liberty directive" instructs federal agencies to do as much as possible to accommodate those who claim their religious freedoms are being violated, effectively lifting a burden from religious objectors to prove that their beliefs about marriage or other topics that affect various actions are sincerely held.

Here’s the Attorney General’s guidance and his implementing memo