00 SENATE CS FOR CS FOR HOUSE BILL NO. 83(FIN) 01 "An Act making appropriations for the operating and capital expenses of the state's 02 integrated comprehensive mental health program; and providing for an effective date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 (SECTION 1 OF THIS ACT BEGINS ON PAGE 2) 01 * Section 1. The following appropriation items are for operating expenditures from the 02 general fund or other funds as set out in section 2 of this Act to the agencies named for the 03 purposes expressed for the fiscal year beginning July 1, 2009 and ending June 30, 2010, 04 unless otherwise indicated. A department-wide, agency-wide, or branch-wide unallocated 05 reduction set out in this section may be allocated among the appropriations made in this 06 section to that department, agency, or branch. 07 Appropriation General Other 08 Allocations Items Funds Funds 09 * * * * * * * * * *  10 * * * * * Department of Administration * * * * *  11 * * * * * * * * * *  12 Legal and Advocacy Services 2,024,500 1,873,200 151,300  13 Office of Public Advocacy 1,723,100 14 Public Defender Agency 301,400 15 * * * * * * * * * *  16 * * * * * Department of Corrections * * * * *  17 * * * * * * * * * *  18 Inmate Health Care 8,394,900 8,020,900 374,000  19 Behavioral Health Care 8,394,900 20 * * * * * * * * * *  21 * * * * * Department of Education and Early Development * * * * *  22 * * * * * * * * * *  23 Teaching and Learning Support 539,800 339,800 200,000  24 Student and School 539,800 25 Achievement 26 * * * * * * * * * *  27 * * * * * Department of Health and Social Services * * * * *  28 * * * * * * * * * *  29 No money appropriated in this appropriation may be expended for an abortion that is not a 30 mandatory service required under AS 47.07.030(a). The money appropriated for Health and 31 Social Services may be expended only for mandatory services required under Title XIX of the 01 Social Security Act and for optional services offered by the state under the state plan for 02 medical assistance that has been approved by the United States Department of Health and 03 Human Services. 04 It is the intent of the legislature that the Department continues to aggressively pursue 05 Medicaid cost containment initiatives. Efforts should continue where the Department 06 believes additional cost containment is possible including further efforts to contain travel 07 expenses. The Department must continue efforts imposing regulations controlling and 08 materially reducing the cost of Personal Care Attendant (PCA) services. Efforts must be 09 continued utilizing existing resources to impose regulations screening applicants for 10 Residential Psychiatric Treatment Center (RPTC) services, especially for out-of-state 11 services. The department must address the entire matrix of optional Medicaid services, 12 reimbursement rates and eligibility requirements that are the basis of the Medicaid growth 13 algorithm. This work is to utilize the results of the Medicaid Assessment and Planning 14 analysis. The legislature requests that by January 2010 the Department be prepared to present 15 projections of future Medicaid funding requirements under our existing statute and regulations 16 and be prepared to present and evaluate the consequences of viable policy alternatives that 17 could be implemented to lower growth rates and reducing projections of future costs. 18 It is the intent of the legislature that the Department of Health and Social Services eliminate 19 the requirement for narrative and financial quarterly reports for all grant recipients whose 20 grants are $50,000 or less. This is an unnecessary burden and is not a requirement of the 21 federal grants. 22 It is the intent of the legislature that the Department of Health and Social Services make a 23 single 'upfront' payment for any grant award that is $50,000 or less and includes a signature of 24 the grantee certifying compliance with the terms of the grant with their approved application. 25 Signature of the grantee would also certify that if a final report certifying completion of the 26 grant requirements is not filed, future grants will not be considered for that grantee until all 27 requirements of prior grants are completed satisfactorily. In the event a grantee is deemed 28 ineligible for a future grant consideration due to improper filing of final reports, the grantee 29 will be informed about the department's procedures for future consideration of grant 30 eligibility. The department will establish procedures to consider retroactivity for specific grant 31 consideration or express that the retroactivity cannot be considered for certain grants during 01 the selection process. 02 It is the intent of the legislature that the Department of Health and Social Services continue 03 the Medicaid Reform work to improve efficiency and slow the need for General Funds in the 04 Medicaid program. Specifically, but not exclusively, the Department is to: 05 1) Complete the evaluation of possible changes to program design, determine waiver changes 06 necessary to secure federal funding and report back to the Second Session of the 26th Alaska 07 Legislature on suggested changes, expected outcomes related to Medicaid sustainability, and 08 resources needed to accomplish the work. 09 2) Develop and implement public provider reimbursement methodologies and payment rates 10 that will further the goals of Medicaid Reform. 11 3) Continue and enhance the State and Tribal Medicaid work and partnership to enhance our 12 ability to provide Medicaid services through Tribal Health Organizations. 13 14 15 16 Alaska Pioneer Homes 13,757,100 13,757,100  17 It is the intent of the legislature that the Department maintain regulations requiring all 18 residents of the Pioneer Homes to apply for all appropriate benefit programs prior to a state 19 subsidy being provided for their care from the State Payment Assistance program. 20 It is the intent of the legislature that all pioneers' homes and veterans' homes applicants shall 21 complete any forms to determine eligibility for supplemental program funding, such as 22 Medicaid, Medicare, SSI, and other benefits as part of the application process. If an applicant 23 is not able to complete the forms him/herself, or if relatives or guardians of the applicant are 24 not able to complete the forms, Department of Health and Social Services staff may complete 25 the forms for him/her, obtain the individuals' or designee's signature and submit for eligibility 26 per AS 47.25.120. 27 Alaska Pioneer Homes 64,300 28 Management 29 Pioneer Homes 13,692,800 30 Behavioral Health 121,233,000 96,736,100 24,496,900  31 AK Fetal Alcohol Syndrome 59,500 01 Program 02 Alcohol Safety Action 1,188,300 03 Program (ASAP) 04 Behavioral Health Medicaid 43,862,400 05 Services 06 Behavioral Health Grants 26,867,300 07 It is the intent of the legislature that the department continue developing policies and 08 procedures surrounding the awarding of recurring grants to assure that applicants are regularly 09 evaluated on their performance in achieving outcomes consistent with the expectations and 10 missions of the Department related to their specific grant. The recipient's specific 11 performance should be measured and incorporated into the decision whether to continue 12 awarding grants. Performance measurement should be standardized, accurate, objective and 13 fair, recognizing and compensating for differences among grant recipients including acuity of 14 services provided, client base, geographic location and other factors necessary and appropriate 15 to reconcile and compare grant recipient performances across the array of providers and 16 services involved. 17 It is the intent of the legislature that the $181.0 increment in the FY10 budget for Behavioral 18 Health Grants be used for the Volunteers of America ARCH residential treatment center for 19 adolescents with substance abuse/dependency and co-occurring disorders. 20 It is the intent of the legislature that $210,000 of this appropriation be used to Combat 21 Alaska's Statewide Heroin Epidemic. 22 Behavioral Health 3,492,000 23 Administration 24 Community Action 1,047,200 25 Prevention & Intervention 26 Grants 27 Rural Services and Suicide 2,135,700 28 Prevention 29 Psychiatric Emergency 7,673,000 30 Services 31 Services to the Seriously 13,099,200 01 Mentally Ill 02 Designated Evaluation and 3,031,900 03 Treatment 04 Services for Severely 11,947,200 05 Emotionally Disturbed 06 Youth 07 Alaska Psychiatric 5,861,900 08 Institute 09 AK Mental Health & Alcohol 884,600 10 & Drug Abuse Boards 11 Suicide Prevention Council 82,800 12 Children's Services 13,514,700 13,184,700 330,000  13 Children's Medicaid 4,185,600 14 Services 15 Children's Services 69,600 16 Management 17 Front Line Social Workers 148,600 18 Family Preservation 150,000 19 Foster Care Augmented Rate 500,000 20 Foster Care Special Need 747,900 21 It is the intent of the legislature that $100,400 of this appropriation be used to provide funding 22 for start-up and operational expenses to the Dillingham Therapeutic Foster Home. 23 Residential Child Care 1,956,300 24 Infant Learning Program 5,756,700 25 Grants 26 Health Care Services 656,000 350,000 306,000  27 Health Planning and 656,000 28 Infrastructure 29 Juvenile Justice 1,055,100 865,900 189,200  30 McLaughlin Youth Center 654,700 31 Fairbanks Youth Facility 103,700 01 Bethel Youth Facility 57,100 02 Probation Services 239,600 03 Public Assistance 13,200 13,200  04 Public Assistance 13,200 05 Administration 06 Public Health 1,096,800 971,800 125,000  07 Nursing 98,300 08 Women, Children and Family 877,700 09 Health 10 Certification and Licensing 120,800 11 Senior and Disabilities 15,358,000 13,902,200 1,455,800  12  Services  13 It is the intent of the legislature that regulations related to the General Relief / Temporary 14 Assisted Living program be reviewed and revised as needed to minimize the length of time 15 that the state provides housing alternatives and assure the services are provided only to 16 intended beneficiaries who are actually experiencing harm, abuse or neglect. The department 17 should educate care coordinators and direct service providers about who should be referred 18 and when they are correctly referred to the program in order that referring agents correctly 19 match consumer needs with the program services intended by the department. 20 General Relief/Temporary 740,300 21 Assisted Living 22 Senior and Disabilities 2,737,900 23 Services Administration 24 Senior Community Based 3,069,400 25 Grants 26 It is the intent of the legislature that funding in the FY 2010 budget for Senior Community 27 Based Grants be used to invest in successful home and community based supports provided 28 by grantees who have demonstrated successful outcomes documented in accordance with the 29 department's performance based evaluation procedures. 30 It is the intent of the legislature that $609,900 of this appropriation be used to hold harmless 31 those regions that will see a reduction in available grants for Family Caregiver, Nutrition, 01 Transportation and Support, and In Home Services due to the State's implementation of a new 02 statewide funding formula. 03 Community Developmental 7,924,800 04 Disabilities Grants 05 Commission on Aging 117,000 06 Governor's Council on 768,600 07 Disabilities and Special 08 Education 09 Departmental Support 1,453,800 1,403,800 50,000  10  Services  11 Commissioner's Office 157,800 12 It is the intent of the legislature that the Department of Health and Social Services complete 13 the following tasks related to fiscal audits required in chapter 66, SLA 2003 of all Medicaid 14 providers: 15 1. Develop regulations addressing the use of extrapolation methodology following an audit of 16 Medicaid providers that clearly defines the difference between actual overpayment of funds to 17 a provider and ministerial omission or clerical billing error that does not result in 18 overpayment to the provider. The extrapolation methodology will also define percentage of 19 'safe harbor' overpayment rates for which extrapolation methodology will be applied. 20 2. Develop training standards and definitions regarding ministerial and billing errors versus 21 overpayments. Include the use of those standards and definitions in the State's audit contracts. 22 All audits initiated after the effective date of this intent and resulting in findings of 23 overpayment will be calculated under the Department's new regulations governing 24 overpayment standards and extrapolation methodology. 25 It is the intent of the legislature that the department develops a ten year funding source and 26 use of funds projection for the entire department. 27 It is the intent of the legislature that the department continue working on implementing a 28 provider rate rebasing process and specific funding recommendations for both Medicaid and 29 non-Medicaid providers to be completed and available to the legislature no later than 30 December 15, 2009. 31 Administrative Support 91,400 01 Services 02 Information Technology 854,600 03 Services 04 HSS State Facilities Rent 350,000 05 * * * * * * * * * *  06 * * * * * Department of Law * * * * *  07 * * * * * * * * * *  08 Criminal Division 12,500 12,500  09 Criminal Justice 12,500 10 Litigation 11 Civil Division 84,500 84,500  12 Human Services and Child 84,500 13 Protection 14 * * * * * * * * * *  15 * * * * * Department of Natural Resources * * * * *  16 * * * * * * * * * *  17 Resource Development 2,273,400 2,273,400  18 Mental Health Trust Lands 2,273,400 19 Administration 20 * * * * * * * * * *  21 * * * * * Department of Revenue * * * * *  22 * * * * * * * * * *  23 Alaska Mental Health Trust 2,650,000 2,650,000  24  Authority  25 Mental Health Trust 2,650,000 26 Operations 27 * * * * * * * * * *  28 * * * * * University of Alaska * * * * *  29 * * * * * * * * * *  30 Statewide Programs and 474,000 100,000 374,000  31  Services  01 Statewide Services 474,000 02 University of Alaska 1,418,800 200,800 1,218,000  03  Anchorage  04 Anchorage Campus 1,418,800 05 University of Alaska 25,000 25,000  06  Fairbanks  07 Fairbanks Campus 25,000 08 * * * * * * * * * *  09 * * * * * Alaska Court System * * * * *  10 * * * * * * * * * *  11 Alaska Court System 1,812,300 1,337,000 475,300  12 Trial Courts 227,000 13 Therapeutic Courts 1,585,300 14 It is the intent of the legislature that, as much as is possible, FY 2011 funding for Therapeutic 15 Courts currently appropriated in other agencies be aggregated in the Therapeutic Courts 16 allocation within the Alaska Court System. 17 (SECTION 2 OF THIS ACT BEGINS ON PAGE 11) 01 * Sec. 2. The following sets out the funding by agency for the appropriations made in sec. 1 of 02 this Act. 03 Funding Source Amount 04 Department of Administration  05 1037 General Fund / Mental Health 1,873,200 06 1092 Mental Health Trust Authority Authorized 151,300 07 Receipts 08 *** Total Agency Funding *** $2,024,500 09 Department of Corrections  10 1037 General Fund / Mental Health 8,020,900 11 1092 Mental Health Trust Authority Authorized 374,000 12 Receipts 13 *** Total Agency Funding *** $8,394,900 14 Department of Education and Early Development  15 1037 General Fund / Mental Health 339,800 16 1092 Mental Health Trust Authority Authorized 200,000 17 Receipts 18 *** Total Agency Funding *** $539,800 19 Department of Health and Social Services  20 1037 General Fund / Mental Health 141,184,800 21 1092 Mental Health Trust Authority Authorized 7,033,000 22 Receipts 23 1180 Alcohol and Other Drug Abuse Treatment & 19,919,900 24 Prevention Fund 25 *** Total Agency Funding *** $168,137,700 26 Department of Law  27 1037 General Fund / Mental Health 84,500 28 1092 Mental Health Trust Authority Authorized 12,500 29 Receipts 30 *** Total Agency Funding *** $97,000 31 Department of Natural Resources  01 1092 Mental Health Trust Authority Authorized 2,273,400 02 Receipts 03 *** Total Agency Funding *** $2,273,400 04 Department of Revenue  05 1094 Mental Health Trust Administration 2,650,000 06 *** Total Agency Funding *** $2,650,000 07 University of Alaska  08 1037 General Fund / Mental Health 300,800 09 1092 Mental Health Trust Authority Authorized 1,617,000 10 Receipts 11 *** Total Agency Funding *** $1,917,800 12 Alaska Court System  13 1037 General Fund / Mental Health 1,337,000 14 1092 Mental Health Trust Authority Authorized 475,300 15 Receipts 16 *** Total Agency Funding *** $1,812,300 17 * * * * * Total Budget * * * * * $187,847,400 18 (SECTION 3 OF THIS ACT BEGINS ON PAGE 13) 01 * Sec. 3. The following sets out the statewide funding for the appropriations made in sec. 1 of 02 this Act. 03 Funding Source Amount 04 General Funds 05 1037 General Fund / Mental Health 153,141,000 06 ***Total General Funds*** $153,141,000 07 Federal Funds 08 ***Total Federal Funds*** $0 09 Other Non-Duplicated Funds 10 1092 Mental Health Trust Authority Authorized 12,136,500 11 Receipts 12 1094 Mental Health Trust Administration 2,650,000 13 1180 Alcohol and Other Drug Abuse Treatment & 19,919,900 14 Prevention Fund 15 ***Total Other Non-Duplicated Funds*** $34,706,400 16 Duplicated Funds 17 ***Total Duplicated Funds*** $0 18 (SECTION 4 OF THIS ACT BEGINS ON PAGE 14) 01 * Sec. 4. The following appropriation items are for capital projects and grants from the 02 general fund or other funds as set out in section 5 of this Act by funding source to the 03 agencies named for the purposes expressed and lapse under AS 37.25.020, unless otherwise 04 noted. 05 Appropriation General Other 06 Allocations Items Funds Funds 07 * * * * * * * * * *  08 * * * * * Department of Health and Social Services * * * * *  09 * * * * * * * * * *  10 MH Continuing Bring the 2,200,000 2,200,000 11 Kids Home Initiative 12 Denali Match (HD 1-40) 13 MH Deferred Maintenance 750,000 750,000 14 and Accessibility 15 Improvements (HD 1-40) 16 MH Housing - Home 1,050,000 500,000 550,000 17 Modification and Upgrades 18 to Retain Housing (HD 19 1-40) 20 * * * * * * * * * *  21 * * * * * Department of Natural Resources * * * * *  22 * * * * * * * * * *  23 Mental Health Trust 350,000 350,000 24 Facilities Maintenance (HD 25 1-40) 26 * * * * * * * * * *  27 * * * * * Department of Revenue * * * * *  28 * * * * * * * * * *  29 Alaska Housing Finance  30  Corporation  31 MH AHFC Beneficiary and 1,750,000 1,750,000 01 Special Needs Housing (HD 02 1-40) 03 MH AHFC Emergency 200,000 200,000 04 Assistance Grants for 05 Mental Health Trust 06 Beneficiaries (HD 1-40) 07 MH AHFC Homeless 10,000,000 500,000 9,500,000 08 Assistance Progam (HD 09 1-40) 10 (SECTION 5 OF THIS ACT BEGINS ON PAGE 16) 01 * Sec. 5. The following sets out the funding by agency for the appropriations made in sec. 4 of 02 this Act. 03 Funding Source Amount 04 Department of Health and Social Services 05 1037 General Fund / Mental Health 1,250,000 06 1092 Mental Health Trust Authority Authorized Receipts 300,000 07 1139 Alaska Housing Finance Corporation Dividend 250,000 08 1197 Alaska Capital Income Fund 2,200,000 09 *** Total Agency Funding *** $4,000,000 10 Department of Natural Resources 11 1092 Mental Health Trust Authority Authorized Receipts 350,000 12 *** Total Agency Funding *** $350,000 13 Department of Revenue 14 1002 Federal Receipts 2,000,000 15 1037 General Fund / Mental Health 500,000 16 1092 Mental Health Trust Authority Authorized Receipts 700,000 17 1108 Statutory Designated Program Receipts 1,000,000 18 1139 Alaska Housing Finance Corporation Dividend 7,750,000 19 *** Total Agency Funding *** $11,950,000 20 * * * * * Total Budget * * * * * $16,300,000 21 (SECTION 6 OF THIS ACT BEGINS ON PAGE 17) 01 * Sec. 6. The following sets out the statewide funding for the appropriations made in sec. 4 of 02 this Act. 03 Funding Source Amount 04 General Funds 05 1037 General Fund / Mental Health 1,750,000 06 ***Total General Funds*** $1,750,000 07 Federal Funds 08 1002 Federal Receipts 2,000,000 09 ***Total Federal Funds*** $2,000,000 10 Other Non-Duplicated Funds 11 1092 Mental Health Trust Authority Authorized 1,350,000 12 Receipts 13 1108 Statutory Designated Program Receipts 1,000,000 14 1139 Alaska Housing Finance Corporation Dividend 8,000,000 15 ***Total Other Non-Duplicated Funds*** $10,350,000 16 Duplicated Funds 17 1197 Alaska Capital Income Fund 2,200,000 18 ***Total Duplicated Funds*** $2,200,000 19 (SECTION 7 OF THIS ACT BEGINS ON PAGE 18) 01  * Sec. 7. PURPOSE. In accordance with AS 37.14.003 and 37.14.005, the appropriations 02 made by this Act are for the state's integrated comprehensive mental health program. 03  * Sec. 8. ENTERPRISE INFORMATION TECHNOLOGY PROJECTS. The sum of 04 $459,724 is appropriated to the Office of the Governor for the Department of Health and 05 Social Services behavioral health data sharing partnership from the following sources in the 06 amounts stated: 07 SOURCE AMOUNT 08 Federal funds $ 25,540 09 General fund 434,184 10  * Sec. 9. NONGENERAL FUND RECEIPTS. (a) Alaska Mental Health Trust Authority 11 authorized receipts (AS 37.14.036) or administration receipts (AS 37.14.036) that exceed the 12 amounts appropriated by this Act are appropriated conditioned upon compliance with the 13 program review provisions of AS 37.07.080(h). 14 (b) If Alaska Mental Health Trust Authority authorized receipts (AS 37.14.036) or 15 administration receipts (AS 37.14.036) fall short of the estimates appropriated in this Act, the 16 affected appropriation is reduced by the amount of the shortfall in receipts. 17  * Sec. 10. SALARY AND BENEFIT ADJUSTMENTS. (a) The appropriations made in sec. 18 1 of this Act include amounts for salary and benefit adjustments for public officials, officers, 19 and employees of the executive branch, Alaska Court System employees, employees of the 20 legislature, and legislators and to implement the terms for the fiscal year ending June 30, 21 2010, of the following ongoing collective bargaining agreements: 22 (1) Alaska Public Employees Association, for the confidential unit; 23 (2) Alaska State Employees Association, for the general government unit; 24 (3) Alaska Public Employees Association, for the supervisory unit; 25 (4) Alaska Vocational Technical Center Teachers' Association - National 26 Education Association, for employees of the Alaska Vocational Technical Center; 27 (5) Public Safety Employees Association, for regularly commissioned public 28 safety officers; 29 (6) Public Employees Local 71, for the labor, trades, and crafts unit; and 30 (7) Marine Engineers' Beneficial Association. 31 (b) The operating budget appropriations made to the University of Alaska in this Act 01 include amounts for salary and benefit adjustments for the fiscal year ending June 30, 2010, 02 for university employees who are not members of a collective bargaining unit and for 03 implementing the monetary terms of the collective bargaining agreements including the terms 04 of the agreement providing for the health benefit plan for university employees represented by 05 the following entities: 06 (1) Alaska Higher Education Crafts and Trades Employees; 07 (2) University of Alaska Federation of Teachers; 08 (3) United Academics; 09 (4) United Academics-Adjuncts. 10 (c) If a collective bargaining agreement listed in (b) of this section is not ratified by 11 the membership of the respective collective bargaining unit, the appropriations made by this 12 Act that are applicable to that collective bargaining unit's agreement are reduced 13 proportionately by the amount for that collective bargaining agreement, and the corresponding 14 funding source amounts are reduced accordingly. 15 (d) Appropriations made in sec. 1 of this Act for salary and benefit adjustments as 16 described in (a) and (b) of this section are for the benefit of the state's integrated 17 comprehensive mental health program only and do not necessarily affect every group of 18 noncovered employees or every collective bargaining unit listed in (a) and (b) of this section. 19 * Sec. 11. This Act takes effect July 1, 2009.