1 Department of Human Services Fiscal Year 2015 Budget Request Agency Budget Briefing March 26, 2014 Pat Quinn, Governor Michelle R.B. Saddler, Secretary Robert Brock, Budget Director

2 DHS Agency Budget Request Fiscal Year 2015 General Revenue Fund – Dollars in billions FY12 Actual Expenditures: $3.415B FY13 Actual Expenditures: $3.498B FY14 Estimated Spending: $3.179B FY15 Appropriation Request: $3.681B

3 DHS Fiscal Year 2015 Budget Request Highlights  The FY15 proposed budget represents a $501.4M GRF increase from FY14 Agency estimated expenditures  This proposal is aimed at providing services to more than 2.8 million customers that we serve annually

4 DHS Fiscal Year 2015 Budget Request Highlights continued…  The Budget request provides an added $700,000 for DHS DASA detoxification Services Outreach  DMH’s FY15 budget request includes annualized costs associated with the Forensic Plan of Correction to ensure that individuals remanded to DHS custody are transferred from jails within the statutory timeframe

5 DHS Fiscal Year 2015 Budget Request Highlights continued…  DHS will be continuing to rebalance the long term care system for individuals with developmental disabilities  As previously announced, DHS is moving forward with its plans to close the Murray Developmental Center in FY15  The proposed budget includes $30M for a partial-year, $1 per hour wage increase for Direct Support Persons who work in Intermediate Care Facilities for Persons with Developmental Disabilities (ICFs/DD) and community- based residential and day services

6 DHS Fiscal Year 2015 Budget Request Highlights continued…  The FY15 request includes the transfer of the AmeriCorp Program from the Division of Family and Community Services to the Department of Public Health  The Division of Family and Community Services is requesting an additional 500 staff in the FY15 budget to remedy historic understaffing  In partnership with the Department of HFS, DHS has requested funds to be made available for the transition of DHS clients into Care Coordination

7 DHS Fiscal Year 2015 Budget Request Highlights continued…  In compliance with the SMART Act, DRS implemented the Electronic Visit Verification (EVV) program. Since implementation, on January 1, 2014, over 24,000, or 86%, of Individual Providers/Personal Assistants have used the telephony system to document hours worked.  Illinois is the first state to combine electronic timekeeping with a payroll processing system alongside a data warehouse for tracking and monitoring service delivery

8 DHS Fiscal Year 2015 Alcoholism and Substance Abuse General Revenue Fund – Dollars in millions FY12 Actual Expenditures = $129.0M FY13 Actual Expenditures = $128.7M FY14 Estimated Spending = $119.6M FY15 Appropriation Request = $120.3M

9 DHS Fiscal Year 2015 Alcoholism and Substance Abuse Budget Request Highlights  The proposed FY15 funding will allow the continuation of Addiction Treatment Services to approximately 70,000 clients  The Budget request provides an added $ 700,000 for DHS DASA Detoxification Services Outreach

10 DHS Fiscal Year 2015 Developmental Disabilities General Revenue Fund – Dollars in billions FY12 Actual Expenditures = $1.107B FY13Actual Expenditures = $1.452B (included funding to eliminate payment backlog) FY14 Estimated Spending = $1.047B FY15 Appropriation Request = $1.135B * FY13, $1.515 including $63.0M from the Healthcare Provider Relief Fund (HPRF) * FY14, $1.417 including $370.0M from the Healthcare Provider Relief Fund (HPRF) *FY15, $1.505B including $370.0M from the Healthcare Provider Relief Fund (HPRF)

11 DHS Fiscal Year 2015 Developmental Disabilities Budget Request Highlights  The FY15 budget request represents the continuation of two significant actions in the State’s efforts to transition services for individuals with developmental disabilities from Long Term Care Facilities to Person Centered, Community Integrated Services: 1) The closure of the Murray Developmental Center, and 2) The implementation of the Ligas Consent Decree

12 DHS Fiscal Year 2015 Developmental Disabilities Budget Request Highlights continued …  The proposed budget includes $27M to fund expansion of community services for Ligas Class Members $2.8M to support the transition of an additional 100 individuals out of state-operated centers to community-based settings $2.5M for the transition of DCFS wards to adult services $30M for a partial-year, $1 per hour wage increase for Direct Support Persons who work in Intermediate Care Facilities for Persons with Developmental Disabilities (ICFs/DD) and community-based residential and day services

13 DHS Fiscal Year 2015 Developmental Disabilities Budget Request Highlights continued…  The Ligas expansion is being funded through the federal Balancing Incentive Program (BIP). In addition, BIP funds are being used to: Create 16, 24-hour stabilization capacities for individuals at risk in the community who need temporary residential services due to extreme behavior issues ($3.4M) Expand Service and Support Teams that assist individuals at risk in the community ($2M) Undertake an Employment First Initiative to strengthen access to Supported Employment Opportunities ($2M)

14 DHS Fiscal Year 2015 Family & Community Services General Revenue Fund – Dollars in billions FY12 Actual Expenditures = $.940B FY13 Actual Expenditures = $.891B FY14 Estimated Spending = $.940B FY15 Appropriation Request = $1.201B

15 DHS Fiscal Year 2015 Family & Community Services Budget Request Highlights  In FY15, the AmeriCorp Program will transition from DFCS to DPH  The proposed budget includes funding in the income assistance lines to allow us to maintain the TANF caseload and all other income assistance caseloads  The proposal also includes funding for Child Care to Support the cost of higher quality care for our youngest children Reduce parent co-pays for Child Care Ensure an average of 163,600 children per month continue to have access to Child Care so their parents can maintain employment

16 DHS Fiscal Year 2015 Family & Community Services Budget Request Highlights continued…  The proposed FY15 budget includes an increase for the Teen Reach Program expanding services to an additional 16,000 youth (approximately 30,000 total) These services assist youth in developing life skills necessary to avoid risk taking behavior and lead to great academic success  Emergency and Transitional Housing funding in FY15 is maintained at the FY14 level of $9.4M. Homeless Prevention funding is maintained in FY15 at the FY14 level of $4M. Homeless Youth Services funding is maintained in FY15 at the FY14 level of $4.6M. These programs will continue to be funded from the Affordable Housing Trust Fund and GRF. Supportive Housing Services will continue to be delivered by both DFCS and DMH.

17 DHS Fiscal Year 2015 Family & Community Services Budget Request Highlights continued…  Early Intervention (EI) is proposed to receive an increase of $8M to support a higher number of children participating in the program  Increased investment also reflects new federal regulations regarding use of public and/or private insurance

18 DHS Fiscal Year 2015 Family & Community Services Budget Request Highlights continued…  Illinois Medicaid Redetermination Project (IMRP), also known as the Enhanced Eligibility Verification (EEV) Project, is mandated by the SMART Act IDHS, in partnership with Healthcare and Family Services (HFS) has transitioned to the “hybrid” approach for IMRP. Under this approach, the casework component of the project is now done completely by in-house caseworkers who can make the final eligibility determination, removing some of the duplication that was inherent in the original model.

19 DHS Fiscal Year 2015 Family & Community Services Budget Request Highlights continued…  The Division of Family and Community Services is requesting an additional 500 staff in the FY15 budget to remedy historic understaffing that has caused caseloads to exceed 2,000 cases per worker in some parts of the State, and will better allow DHS to provide timely services to customers in need of SNAP, cash and medical assistance.  The additional headcount will also help DFCS handle the backlog of Long Term Care applications. We are committed to catching up on these applications and ensuring nursing facilities are paid for the care they give.

20 DHS Fiscal Year 2015 Mental Health General Revenue Fund – Dollars in millions FY12 Actual Expenditures = $477.0M FY13 Actual Expenditures = $460.1M FY14 Estimated Spending = $505.8M FY15 Appropriation Request = $597.6M

21 DHS Fiscal Year 2015 Mental Health Budget Request Highlights continued…  The FY15 budget request includes annualized costs associated with the Forensic Plan of Correction to ensure that individuals remanded to DHS custody are transferred from jails within the statutory timeframe.  Ongoing costs associated with the implementation of the Williams and Colbert Consent Decrees  To date, 880 Williams Class members have transitioned to the community, with an estimated 400* clients to transition in FY15  The Division of Mental Health is also partnering with the Department of Aging and DHS’ Rehabilitation Services on the implementation of Colbert *This number may change based on the Plaintiff’s formula

22 DHS Fiscal Year 2015 Mental Health Budget Request Highlights continued…  The FY15 budget includes $44.2M in funding shift from Other State Funds to the General Revenue Fund due to insufficient resources  $16M from the DHS Community Services Fund  $28.2M from the Community Mental Health Medicaid Trust Fund Continued funding of the Individual Care Grant (ICG) program to ensure continued and expanded access for children & adolescents who require intensive treatment services

23 DHS Fiscal Year 2015 Rehabilitation Services General Revenue Fund – Dollars in millions FY12 Actual Expenditures = $619.8M FY13 Actual Expenditures = $613.4M FY14 Estimated Spending = $640.4M FY15 Appropriation Request = $686.3M *FY13, FY14, and FY15 include funding from the HSP Medicaid Trust Fund

24 DHS Fiscal Year 2015 Rehabilitation Services Budget Request Highlights  The Home Services Program includes an overall all funds increase of $39.3M (6.2%) over FY14. Nearly $32.0M of the increase is to invest in the wages for Personal Assistants and Individual Maintenance Home Health providers.  The FY15 Introduced Budget reflects a $30.1M Care Coordination appropriation for customers in the Home Services Program transitioning to managed care Since its implementation in 2013, over 7,000 customers in the Home Services Program have been receiving coordinated care from one of the State's Managed Care providers. In FY15, an additional 5,700 customers will be eligible for the dual Medicaid-Medicare Alignment Program

25 DHS Fiscal Year 2015 Rehabilitation Services Budget Request Highlights continued…  The proposed budget maintains a $246.0M shift off GRF to reinvest Federal Financial Participation generated from the Home Services Program into the Medicaid Trust Fund in order to offset program liability.  Nearly $3.6M is included in the Introduced Budget to support the Balancing Incentive Program for the development of innovative community employment projects.

26 DHS Fiscal Year 2015  Summary Impact of an Across the Board Reduction to General Revenue Funds of 24.4% from FY15 Request DHS DivisionFY14 Change from FY14 % Change from FY14FY15 Request 24.4% Reduction to Request % Cut from Request Head Count Reduction Admin & Program Support$172,782.9($21,558.3)-12.5%$186,388.8($45,478.9)-24.4%(178.6) Alcoholism and Substance Abuse$119,573.8($14,919.4)-12.5%$120,301.2($29,353.5)-24.4%(3.7) Developmental Disabilities$1,046,739.7($130,602.8)-12.5%$1,135,506.4($277,063.6)-24.4%(1,023.4) Family & Community Services$939,979.7($117,282.3)-12.5%$1,200,663.1($292,961.8)-24.4%(1,045.1) Mental Health$505,847.8($63,115.2)-12.5%$597,621.1($145,819.5)-24.4%(673.8) Rehabilitation Services$394,398.5($49,209.5)-12.5%$440,253.5($107,421.9)-24.4%(184.7) DHS Total$3,179,322.4($396,687.5)-12.5%$3,680,734.1($898,099.2)-24.4%(3,109.3)

27 DHS Fiscal Year 2015 The DHS Budget Briefing Book will not be available in printed form, but the material can be reviewed or downloaded from the DHS Website at May we entertain questions about the Appropriation Request?