 |
|
|
Director's Message Dec. 8, 2006
To: All DHS employees From: Bruce Goldberg, Director "We must always change, renew, rejuvenate ourselves; otherwise we harden." ~ Johann Wolfgang von Goethe
This past Monday the Governor released his 2007-09 budget and I want to spend this week's message providing you with the highlights as they pertain to DHS.
In his news conference, Governor Kulongoski made a comment I believe reflects our spirit as DHS employees. "We have the resources to do more, the opportunity to do better and the responsibility to do our best," he said.
Even in recessionary times, I know you responded to a lack of budget resources with personal energy to do your best to vigorously serve the people of our state. Now, with his Hope and Opportunity Budget, the Governor provides the resources to do more and better meet the needs of Oregonians. For the people we serve, and that includes all Oregonians, the Governor's budget holds out the realistic hope for solid opportunities that our state hasn't seen in years.
You can view detail of the Governor's budget at: http://www.oregon.gov/DAS/BAM/GRB0709.shtml
What follows are the details regarding many of the investments in DHS. This is much longer than my usual weekly message, and my sense is that this will be too much information for some and too little for others. I apologize for the length, the acronyms, and the abbreviations, but I felt it important that you have this information.
Salary Package for State Employees
The Governor's budget dedicates $130 million as a "salary package" for state employees, designed to support cost-of-living increases as well as health care cost increases (step increases are funded through agency budgets).
DHS Budget Items
-----Children, Adults and Families Division ERDC: The Governor invests more than $34 million to improve child care support for low-income working families, expanding income eligibility to reach more working parents, raising the provider reimbursement rates and making the co-payments more affordable for working parents.
TANF Reauthorization: The Governor's budget includes $20 million of new investment for a comprehensive re-design of Oregon's Temporary Assistance for Needy Families (TANF) program. The new, outcome-focused program is designed both to ensure the health and well-being of children in TANF families and to help parents achieve self-sufficiency through sustained employment. The Governor's TANF proposal is built on work that DHS and stakeholders have done to propose the new program design, although some minor adjustments may need to be addressed based on available funding.
BRSRates Increase: $1.4 million is included in the recommended budget.
Legal Representation/Review: The budget invests more than $3.0 million to expand legal services for child welfare caseworkers, allowing for legal review in the majority of cases for the first time in Oregon history. This will also free up caseworkers to spend more time with clients. Note: The Governor has also prioritized additional investments in the Judicial branch, aimed in part at enhancing reimbursement for legal services provided to parents and children in the dependency and delinquency systems.
Strengthening support for child welfare workers: Following through on the recommendations from a report the Governor requested to evaluate Oregon's child welfare system, the Governor's budget invests an additional $2.0 million to reduce caseload ratios for child welfare workers and enhance caseworker supervision. Those investments will allow workers to better serve children and families and strengthen the department's focus on making sure kids are safe. This investment will allow the state to reduce the number of cases caseworkers carry and more closely align Oregon caseload standards across child welfare programs with national standards.
Safe and Timely Interstate Placement of Foster Children: $560,000 will allow workers to meet new federal requirements regarding time to complete home studies requested by other states.
-----Other packages impacting CAFD A&D Treatment: The governor's investments in alcohol and drug treatment are specifically targeted to children and families who are at risk, or already involved in the child welfare system due to addiction problems. See what follows.
Re-design of Oregon's mental health system: The Governor's budget invests both in the expansion of community services for people with mental illness and in the construction of a new State Hospital System. Investments include:
More than $80 million (the majority in certificates of participation) to begin the process for replacing Oregon's existing state mental hospital system, including the Salem campus (includes funding to support for project management, property purchases, building design, and very initial phases of construction (most construction will be paid for in 2009-11); package also includes support to replace the existing OSH data systems and improve livability for patients and staff as we build new facilities). Note: The Governor's budget does not propose any changes to Blue Mountain Recovery Center in Pendleton at this time.
$10 million to dramatically enhance Oregon's community mental health services. Those dollars will allow the state to:
2) develop more resources for local hospitals, including those in rural areas, to manage the increasing demand for mental health services;
4) pilot projects targeted at better meeting the mental health treatment needs of individuals with serious mental illnesses being released from local jails; 5) strengthen employment support services for people with mental illness; and
6) stabilize state funding for locally delivered crisis services across the state.
More than $4.0 million to expand statewide access to proven early intervention and treatment services for children, youth and young adults showing early signs of psychosis. (EAST program expansion to 540 more individuals.)
More than $13 million to improve the quality of care delivered at the Salem campus of the Oregon State Hospital. These resources will support the development of more community placements, the hiring of additional staff, and additional training opportunities for existing staff to improve the hospital's ability to serve increasing numbers of psychiatric patients who also are addicted to alcohol and other drugs.
-----Addiction Prevention, Intervention and Treatment In his budget, the Governor invests in a continuum of services for children and families aimed at keeping kids safe at home with their families -- from prevention to drug and alcohol treatment. To fund a portion of these investments, the Governor dedicates 2.0 percent of the state's total gross liquor revenues, approximately $17 million, to targeted addiction intervention and treatment services. These services will go to children and families who are at risk, or already involved in the child welfare system due to addiction problems.
Provide more treatment for parents who struggle with substance abuse: The Governor invests more than $10 million of liquor revenues to provide outpatient drug and alcohol treatment to more than 3,400 families. In addition, some of that $10 million will increase the capacity of Oregon's residential treatment and supported housing services for child welfare and TANF families.
Prevent youth substance abuse: The Governor's budget invests $3.0 million of liquor revenues in a youth substance abuse prevention initiative that will provide new tools for communities to take action in the fight against underage drinking and drug abuse.
A&D Treatment Equity: The Governor's budget invests $4.0 million to improve the distribution of A&D treatment funds by adding treatment resources for indigent clients to counties that receive less than the statewide average per capita funding. The counties that will gain from an equitable distribution of funds are: Washington, Deschutes, Clackamas, and Lane make major gains. Columbia, Coos, Jackson, Linn, Marion, Polk and Umatilla make modest gains.
-----Other packages impacting AMHD OHP Standard: The Governor's budget invests $45 million of new tobacco tax revenues to cover from 10,000 to 15,000 more people on OHP Standard, which will also do much to improve access to mental health and substance abuse treatment for those individuals.
-----Division of Medical Assistance Programs Healthy Kids Plan: The Governor's budget brings Oregon's cigarette tax up to the level of Washington state's, which is estimated to generate $180 million to $190 million in additional revenues, after adjusting for reduced tobacco consumption as a result of the increase. The Governor's budget dedicates at least 60 percent of the new revenues to funding health care for kids. The Governor's "Healthy Kids Plan" is a critical first step toward an affordable, universally accessible health care system. It's a plan that provides affordable, comprehensive health coverage options for every child under the age of 19 and, for the first time, it will expand affordable coverage options to working families whose incomes are too high to qualify for help under the state's existing programs. The Plan also will reduce barriers to enrolling children in coverage and keeping them enrolled. And it will maximize the federal dollars available to the state.
Cover more people in Oregon Health Plan: The Governor's budget provides funding for more eligible individuals through the OHP "Plus" program. The Governor's budget also uses $45 million in new tobacco tax revenues to expand health coverage to an additional 10,000-15,000 low-income Oregonians through the Oregon Health Plan "Standard" program.
Increase Fee-for-service rates for physicians, hospitals serving OHP clients: The Governor invests additional tobacco tax revenue to increase reimbursement to physicians and hospitals under the Oregon Health Plan, which will improve Oregon Health Plan clients' ability to get the medical care they need and reduce the cost-shift to Oregonians who have commercial insurance.
-----Other packages impacting DMAP The Governor's budget includes specific recommendations targeting the state's ability to improve the value it receives for its investment in the Oregon Health Plan prescription drug benefit.
The Governor's budget makes investments in provider rates in an effort to reduce cost-shift and work toward a long-term goal of paying OHP providers the cost to deliver services. In addition, the Governor's budget strives to improve equity among the rates being paid OHP providers, increasing rates that are low and lowering rates that are disproportionately high as compared to reimbursement for other providers.
-----Public Health Division Tobacco Prevention Education Program: Governor's budget includes $34 million for TPEP (a $25 million increase) -- restoring funding that had been diverted in 2003/05 and 2005/07 and dedicating 10 percent of new tobacco tax revenue to the program.
Expand School-Based Health Centers: As part of Healthy Kids Plan, the Governor invests an additional $2.0 million to expand school-based health care services and sites, adding 13 new school-based health centers, bringing the total number to 60 centers in 25 counties.
Support Local Health Departments: Governor's budget invests $5 million, doubling the state's support for local public health departments (raising per-capita funding from $.60 to $1.20), strengthening their capacity to protect and promote the public health by responding to communicable disease outbreaks, plan and prepare for public health emergencies, collecting and reporting vital health statistics, and meeting the demands of an increasingly diverse Oregon population.
Assure Safe Drinking Water: Governor's budget invests $2.6 million as part of larger package to expand Drinking Water Program capacity to assure Oregonians are reliably provided safe drinking water.
Expand Family Planning Expansion Project: The Governor's budget invests an additional $2.5 million to expand services provided through the state's Family Planning Expansion Project and to provide a cost-of-living adjustment to providers of those services. The state's investment to expand services in this program is matched nine to one by the federal government, allowing the state to provide family planning services to an additional 26,000 individuals next biennium.
WIC Farmers Market: Governor's budget invests $100,000 to continue the increase funded in 2005-07 and enhance services through the program by $50,000 to serve an additional 1,027 WIC participants.
Healthy Teen Survey: Governor's budget fully funds the survey.
EMS/Trauma System: The Governor invests more than $2 million to begin much-needed improvements in the state's EMS/Trauma services across the state to assure that patients needing emergency medical care receive optimal professional care and treatment.
Radiation Protection: The GRB includes a proposed fee increase to enhance the department's ability to protect the public's health and safety.
-----Seniors and People with Disabilities Nursing Facility Staffing: The Governor's budget makes targeted investments to ensure that Oregon's most vulnerable seniors in nursing facilities receive the highest quality of care. To that end, the Governor invests $3.0 million to increase Oregon's minimum Certified Nurse Assistant staffing levels and to initiate a quality improvement initiative in cooperation with Oregon's nursing facilities.
Transfer AAA Equity: Governor's budget includes $5.7 million to phase in a 95% calculated equity for transfer AAAs.
DD Provider Rates: Governor invests $12 million to improve developmental disabilities service provider ability to remain solvent and provide services to clients. The Governor is proposing to maximize the resources invested by delaying implementation of an increase to both the DD provider rates and OPE rate to 9/1/08, at which point DD provider rates will increase by $1.00 and the OPE rate will go from 28 percent to 37 percent. The Governor recognizes that the DD provider community is asking for more resources than his budget is able to afford, but believes this to be a critical first step to shoring up this particular provider network.
Juvenile PSRB -- DD component: Governor invests $2 million to phase in the integration of juveniles with developmentally disabilities into the PSRB process.
Independent Status of HCC: Governor's budget invests $160,000 to facilitate Home Care Commission transition to an independent commission.
SHIBA Transfer: The budget strengthens the state's Senior Health Insurance Benefits Assistance Program (SHIBA), investing $825,000 for the state to expand its volunteer network to help the nearly 540,000 Medicare-eligible Oregonians navigate the federal Medicare program and choose the Medicare drug plans that best meet their individual needs. -----Other issues impacting SPD DD Service Element 45: The Governor's budget eliminates this service element, with the expectation that the 70 individuals currently utilizing these services move into community-based care settings.
One SOCP group home closure: The Governor's budget proposes closing one State Operated Community Program. The reduction of one home would be made by holding open three vacancies if possible. It has not yet been decided which group home will close; however, once that decision is made, the closure will impact the direct care staff at that site. The Governor's office is beginning discussions with AFSCME union leadership about transition planning for those employees, but believes it might be possible to totally avoid layoffs through attrition/turnover of staff. If employee transition is needed, the Governor's goal is to transition as many individuals as possible into other suitable employment opportunities. Strategies under discussion include: requiring state agencies to give preferential hiring treatment to transitioning employees; exploring retirement strategies for long-term employees; working with the state Employment Department to make career and job search materials easily accessible; and others.
Phase-out of DD service delivery at Eastern Oregon Training Center: The Governor's budget proposes to transition the 38 individuals with developmental disabilities currently residing at the Eastern Oregon Training Center into community group homes or foster care settings. This facility was built to serve up to 70 individuals, but caseload has been steadily declining for the past several years. In fact, there have been no new permanent admissions to this program since 1999 (note: however, the program housed a "crisis" center through 2004 that admitted people for short stays, but was moved in 2004 to Salem).
Although the care needs of the individuals at EOTC are similar to the needs of individuals the state currently serves in community group homes or foster care settings, the cost to serve individuals at EOTC is nearly double the cost to serve them in communities. Costs per person at EOTC average $24,000 per person per month. When calculating all the costs in the community including residential, vocational, transportation and case management services, the average cost is $10,000 per person per month. Efforts will be made to locate individuals in communities where there are family members or other significant arrangements. The goal is to begin to transition individuals out of EOTC in the summer of 2007, with the last resident leaving by May 1, 2008.
The phase-out of EOTC services will also impact the 190 positions (approximately 183 staff) currently employed there. The Governor's office is beginning discussions with SEIU leadership about transition planning for employees at EOTC. The Governor 's office goal is to transition as many individuals as possible into other suitable employment opportunities. Strategies under discussion include: requiring state agencies to give preferential hiring treatment to transitioning employees; exploring retiring strategies for long-term employees; working with the Employment Department to make career and job search stations available on site at EOTC; and others.
-----Other Investments in DHS DHS Infrastructure: The Governor invests nearly $6.0 million in DHS to strengthen the management and administration of the department. These dollars are a critical first step toward implementing the recommendations of the comprehensive operational review the Department has been engaged in since November 2005. This investment strengthens the Department's fiscal and operation accountability, improving its capacity to serve Oregonians and fulfill its mission. |
|
