BUDGET BRIEFING

Presentation to the

HEALTHCARE FOUNDATIONOF GREATER KANSAS CITY

March 25, 2011

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OVERVIEWDMH serves 170,000 Missourians annually with serious mental illnesses, developmental disabilities and addictions. At least 50% are Medicaid eligible

On any given day, 95% of all DMH clients are served by over 1,600 contracted providers, who employ over 30,000 Missourians to provide these services.

DMH directly operates 15 facility-based psychiatric hospitals and DD habilitation centers employing over 7,500 staff who serve approximately 1,900 residents or patients.

FY 2011 BUDGET BY PROGRAM CATEGORY

DMH COMMUNITY SERVICES

CATEGORY AMOUNT % TOTAL FTE

CPS Community Programs $224 million 18.6% 35

DD Community Programs $486 million 40.5% 15

ADA Community Programs $115 million 9.6% 56

DD Regional Offices/Community Support $35 million 2.9% 762

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FY 2011 BUDGET BY PROGRAM CATEGORY

DMH FACILITIES

CATEGORY AMOUNT % TOTAL FTE

State Psychiatric Facilities $174 million 14.5% 3,961

DD Habilitation Centers $92 million 7.6% 2,783

Medications for Non-Medicaid Consumers $12 million 1.0%

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FY 2011 BUDGET BY PROGRAM CATEGORY

OTHER PROGRAMS / ADMINISTRATION

CATEGORY AMOUNT % TOTAL FTE

Other (Federal Grants, Mental Health Trust Fund, Overtime Pool, Federal Revolving Funds, etc.)

$44 million 3.6% 26

DMH – All Administration $17 million 1.4% 236

TOTALS $1.199 billion 100% 7,874

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FY 2012 CORE REDUCTIONSGENERAL REVENUE (GR)

CORE REDUCTIONSAPPROPRIATION

S FTE

CPS Inpatient Redesign $3,844,996 368.80

DD/CPS Facility FY 2011 Expenditure Restrictions Made Permanent $4,057,107 67.71

ADA/CPS/DD FY 2011 2% Provider Rate Reductions Made Permanent $7,700,000

DD Regional Offices – Elimination of District Administrators and Business Office Consolidation $818,374 24.37

DD Habilitation Center Transitions to Community Services $225, 768 7.40

Department Wide E&E Reductions (travel, professional services, equipment) $134,603

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FY 2012 CORE REDUCTIONSGENERAL REVENUE (GR)

CORE REDUCTIONSAPPROPRIATION

S FTE

SUBTOTAL GR CORE REDUCTIONS $16,780,848 468.28

DD Habilitation Center GR Replacement With Federal Funds $23,225,784 782.74

GRAND TOTAL GR CORE REDUCTIONS(Not Including Fringe) $40,006,632 1,251.02

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FY 2012 CORE REDUCTIONSSIGNIFICANT FEDERAL & OTHER FUND

CORE REDUCTIONSAPPROPRIATION

S FTE

Expiring Grants(Children’s System of Care, Drug Free Schools, ADA Strategic Prevention Framework)

$5,932,301 1.20

Reduced Federal Funding in ADA Access to Recovery Grant $2,800,000

Medicaid FFP Rate Adjustment (FED Share 63.59% to 63.41%) $1,148,209

ADA Treatment Funding From Inmate Revolving Fund $485,781

TOTAL FEDERAL & OTHER FUND CORE REDUCTIONS

(Not Including Fringe)$10,366,281 1.20

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FY 2012 NEW DECISION ITEMS

NEW DECISION ITEM GR FED & OTHER TOTAL FTE

ADA/CPS/DD Medicaid Cost-to- Continue & Caseload Growth(Includes $6.37 million FED for Inpatient Redesign Community Placements)ADA: $1,396,825 GRCPS: $5,202,854 GRDD: $13,633,280 GR

$20,232,959 $41,433,460 $61,666,419

DD Habilitation Center FED Replacement of General Revenue $23,225,784 $23,225,784 782.74

Increased DMH Facility Food Costs (2.5% Inflationary Increase) $126,601 $126,601

Increased DMH Facility Medical Care Costs (5.1% Inflationary Increase)

$503,491 $503,491

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FY 2012 NEW DECISION ITEMS

NEW DECISION ITEM GR FED & OTHER TOTAL FTE

Increased DMH Facility and Community Medication Costs (same as DSS 5.83% pharmacy inflation)

$1,133,020 $1,133,020

Overtime Cost-to-Continue (two state holidays cut from FY 2011 budget but necessary legislation did not pass)

$1,123.688 $1,123,688

Sexual Offender Rehabilitation & Treatment Services (SORTS) Cost-to-Continue

$1,384,046 $1,384,046 33.05

SORTS Fulton Expansion $1,596,674 $1,596,674 34.98

ADA Tobacco Prevention Grant $388,743 $388,743

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FY 2012 NEW DECISION ITEMS

NEW DECISION ITEM GR FED & OTHER TOTAL FTE

ADA and Lafayette County Children’s Tax Partnership $136,649 $136,649

Additional Legal Counsel for Eastern Region $62,000 $62,000 1.00

CPS Additional Local Tax Match Authority from Lincoln County $136,649 $136,649

Federal Transfer Authority to GR (One-Time Funds, Non-Count) $1,256,854 $1,256,854

Medicaid FFP Rate Adjustment (State Share 36.405% to 36.59%) $1,116,129 $32,080 $1,148,209

TOTAL NEW DECISION ITEMS $27,217,508 $65,415,365 $92,632,873 851.77

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FY 2011 – FY 2012BUDGET COMPARISON

GENERAL REVENUE FEDERAL OTHER TOTAL FTE

$562,326,162 $633,713,469 $42,948,339 $1,238,987,970 7,441.49

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FY 2011

FY 2012

GENERAL REVENUE FEDERAL OTHER TOTAL FTE

$575,426,388 $578,775,972 $44,827,524 $1,199,029,884 7,873.94