Adult and Family Services
Services to Children and Families
Health Division
Mental Health and Developmental Disability Services Division
Senior and Disabled Services Division
Vocational Rehabilitation
Office of Alcohol and Drug Abuse Programs
Office of Medical Assistance Programs

Adult and Family Services

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Reduction in the maximum age of children served through day care programs. Children older than age 12 will generally no longer be eligible for day care services.

• Expansion of day care services for families enrolled in secondary education.

• Elimination of 190 field and 27 central office positions, for a savings of $20.4 million.

• Elimination of the Motor Vehicle Accident Fund program. This change was consistent with an Attorney General's opinion.

• Reduction in funding for Emergency Assistance (excluding funding for domestic violence-related services) by $4 million General Fund.

• Funding of $100,000 General Fund and $200,000 Total Funds for a statewide Food Stamp outreach campaign.
  

• Elimination of most case management services for Food Stamp clients, to accommodate anticipated increases in the caseload of the non-public assistance Food Stamp Program.
  

• DHS to prepare a comprehensive assessment that includes a comparative analysis of Temporary Assistance for Needy Families (TANF) programs and alternatives to determine policy choices and costs related to serving multiple-barrier clients.

• A Department of Administrative Services (DAS) study to examine possible consolidation of the Department's child-support programs with those located at the Department of Justice. DAS will report its findings to the November 2002 Emergency Board.
  

2001-2003 legislatively adopted budget

Client benefits and purchased services

$590.6 million Total Funds in child support collections and recoveries are not included in the state budget.

Services provided by DHS

Administration

2001-2003 major revenue sources

FEDERAL FUNDS Title IV-A (TANF) Food Stamps Title IV-D Title XIX (Medicaid) Title XX Refugee Program OTHER FUNDS Child Support Recoveries Tobacco Tax Title VI (Child Care) General Fund

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Services to Children and Families

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Reduction of 31 percent in flexible funds for System of Care. The final phase of System of Care is being implemented as part of an agreement with the Juvenile Rights Project.

• Reduction of 50 percent in Family Support Team flexible funds. These funds support client drug-and-alcohol outpatient treatment and other services.

• Contracted family treatment and support programs have been reduced by 5 percent. This includes funding for parent training, family sex abuse treatment, intensive family services, and intensive home-based services.

• Elimination of funding for some non-statewide programs including: Friends of the Children, Mental Health Partners Program and the Grants Pass Coalition.

• A reduction of $1,976,004 in anticipation of savings from Department reorganization.

• Reduction of 10 percent in the agreements with Portland State University for staff training and research projects.

• A restructure of administration, as regional offices and a variety of non-case carrying positions were eliminated. This resulted in the abolishment of 29 positions.

• Workload increases for Adoption Assistance, Foster-Care programs, Target Children (severely disabled children for whom there are no existing resources) and Supportive Remedial Day Care.

• Full implementation of the Targeted Case Management Program for in-home services. This increases federal revenue and results in General Fund savings.

• Transfer of the Child Abuse Multidisciplinary Intervention Program to the Department of Justice effective January 1, 2002.

• Development of oversight for outdoor youth programs. A limited duration half-time position and funding for an advisory board have been provided.
  

2001-2003 legislatively adopted budget

Client benefits/purchased services

Services provided by DHS

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
Branch staff (includes Child Protective Services)	1,775	$99.6	$260.1

Administration

2001-2003 major revenue sources

FEDERAL FUNDS Title XIX (Medicaid) Title IV-E (Foster Care) Title XX (Social Services Block Grant) Title IV-A (Emergency Assistance) Title IV-B (Child Welfare Services) OTHER FUNDS SSI and Child Support Unitary Tax-Child Abuse Assessment Federal Funds

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Health Division

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Enhancement of tobacco prevention and education with $5 million from the tobacco Master Settlement Agreement of 1998.

• Elimination of General Funds for the State Technical Assistance Team, which provided support for the statewide Child Fatality Review (CFR) and 35 county CFR teams.

• · Elimination of General Funds for the Perinatal Project Contract with Oregon Health Sciences University.

• Allocation of $500,000 to the Office of Multicultural Health, to develop and implement a minority health issues database. The database will provide information to identify public-health issues that are relevant to minority communities and strategies to address them.

• SB 769 directs the Department to develop a juvenile diabetes database that will serve as a repository for data collected through school surveys and from reporting physicians, and make it available for scientific research. New funding of $100,000 will support development of the database.

• The Environmental Health Drinking Water Program and the Maternal and Child Health Program will work with stakeholders to fund grants to fluoridate community water systems with $500,000 General Fund support.

• $200,000 in new General Fund support for the development of standards for Emergency Medical Services for Children.

2001-2003 legislatively adopted budget

Client benefits/purchased services

* WIC includes $104 million of food and infant formula rebate dollars, which are not limited.
** Funding for Tobacco Tax Revenues (Ballot Measure 44) and tobacco Master Settlement Agreement.

Services provided by DHS

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
Compliance, data analysis, technical assistance, laboratory testing, licensing and certification, vital records	468	$9.2	$68.2

Administration

2001-2003 major revenue sources

FEDERAL FUNDS Women, Infant and Children Grant AIDS/HIV/Sexually Transmitted Diseases Maternal and Child Health Block Grant Environmental Protection Agency Drinking Water Program Medicaid, Family Planning Waiver OTHER FUNDS Fees Tobacco Tax (Ballot Measure 44) and tobacco settlement funds Grants, Other Charges

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Mental Health and Developmental Disability Services Division

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Reconfiguration of the intensive treatment services for children with disabling mental health conditions, so that children receive services in the most integrated community settings possible.

• Addition of staff at the Oregon State Hospital and Eastern Oregon Psychiatric Center to address new federal rules regarding mental health seclusion and restraint policies.

• Implementation of the Universal Access Plan for people with developmental disabilities, to greatly increase access to community services by expanding residential beds, respite care, in-home supports and crisis services in the first phase of a multi-year settlement agreement in the Staley v. Kitzhaber lawsuit.

• Additional funding to improve infection control at the Oregon State Hospital and to provide treatment for clients with hepatitis C.

• Two new wards to be opened at the Oregon State Hospital will accommodate growth in forensics caseload.

2001-2003 legislatively adopted budget

Client benefits/purchased services

	Clients served (biennium)	General Fund ($ millions)	Total Funds ($ millions)
Community Mental Health Services	111,623	$270.6	$558.8
Community Developmental Disability Services	15,782	304.8	663.0
TOTAL		$575.4	$1,221.8

DHS institutional services

	Average daily population	General Fund ($ millions)	Total Funds ($ millions)
Oregon State Hospital (incl. Portland)	672	$95.2	$169.1
Eastern Oregon Psychiatric Center	60	11.5	15.0
Fairview Training Center	0	0.8	0.8
Eastern Oregon Training Center	65	8.9	24.1
State Operated Group Homes	151	30.9	74.5
TOTAL		$147.3	$283.5
Total Staff (FTE) = 2,225

Other services provided by DHS

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
Licensing, quality assurance, service development, Crisis/Diversion, and Extended Care Management	145	$11.7	$21.1

Administration

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
	122	$10.3	$38.9

2001-2003 major revenue sources

FEDERAL FUNDS Title XIX (Medicaid) Other Federal Funds and Grants OTHER FUNDS Grants, Other Charges Client Medicare Resources Medicaid Upper Payment Limits Transfer

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Senior and Disabled Services Division

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Increases in nursing facility and community-based care rates.
  

• Caseload growth in long-term care programs of 4,960 cases.
  

• Additional field staff to work with increasing numbers of community-based care clients.
  

• Implementation of the new Client Assessment and Planning System (CA/PS) on the Oregon Access automated system.

• Implementation of Independent Choices pilot project in three counties.

• Implementation of a new Older Americans Act program for family caregivers.

• Development of a new rate structure for Adult Foster Care and Residential Care Facilities.

• Participation in the development of a 2001-03 budget for the newly approved Home Care Commission.

• Development of a pilot project in Washington and Multnomah counties to test a county veterans services program.

2001-2003 legislatively adopted budget

Client benefits/purchased services

	Clients served (monthly)	General Fund ($ millions)	Total Funds ($ millions)
Community-based care*	28,511	$221.5	$552.5
Nursing facilities	5,737	178.2	496.1
Oregon Project Independence	3,738	13.7	13.7
Older Americans Act	125,000	0.0	26.8
Old Age Assistance	7,519	0.0	3.7
Aid to Blind and Disabled	37,110	0.3	4.9
General Assistance	2,833	0.0	21.5
Employment initiative		0.2	0.2
TOTAL		$413.9	$1,119.4

* Includes Personal Care and Program for All-inclusive Care for the Elderly (PACE).

Services provided by DHS

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
Includes case management, area agencies on aging funds and quality assurance staff	935	$90.4	$232.6

Administration

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
	111	$13.0	$28.0

2001-2003 major revenue sources

FEDERAL FUNDS Title XIX (Medicaid) Food Stamps Title III (Older American's Act) Medicare Titles IV & V (Senior Employment & Training) OTHER FUNDS Supplemental Security Income Recoveries Estate Recoveries Client Pay-in Local Match Fees

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Vocational Rehabilitation

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Rehabilitation Services continues to receive incremental increases in federal funding (approximately 2 percent to 3 percent annually).

• Reducing the backlog of Disability Determination Services continuing disability reviews has caused an increase in the number of cases adjudicated, thereby increasing the federal funding allocation.

• Funding for centers for independent living was increased by $1.3 million (General Fund).
  

Major new initiatives

2001-2003 legislatively adopted budget

Client benefits/purchased services

Services provided by DHS

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
Employment services for people with disabilities and disability determination services	404	$6.8	$62.5

Administration

2001-2003 major revenue sources

FEDERAL FUNDS Section 110, Basic 110 Grant (Vocational Rehabilitation) Title II/XVI (Social Security Act Disability Determination) Section 633 Title VI C (Supported Employment) Section 711 (Independent Living) Section 302 (Training Grant) Rehabilitation Services Administration Employment Initiative Department of Labor Work Incentive Grant OTHER FUNDS Worker Compensation Funds Youth Transition Program

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Office of Alcohol and Drug Abuse Programs

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Rate increases for managed-care and alcohol-and-drug-program providers.

• Rate increases for providers of residential care.

• Funding of treatment enhancements begun in 2000 for the full 2001-03 biennium.

2001-2003 legislatively adopted budget

Total Fund expenditures - $112.9 million

Client benefits/purchased services

Services provided by DHS

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
Licensing, data analysis, policy development, public education, prevention, evaluation, training and technical assistance	32	$1.3	$7.6

Administration

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
	22	$1.6	$4.0

2001-2003 major revenue sources

FEDERAL FUNDS Substance Abuse Block Grant Title XIX (Medicaid) Center for Substance Abuse Treatment Categorical Safe and Drug Free Schools and Communities Other grants and income OTHER FUNDS Beer and Wine Tax Intoxicated Driver Program Fund/Marijuana Fines Miscellaneous Revenue Interagency Charges/Income Lottery Funds

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Office of Medical Assistance Programs

Budget history ($ millions)

Program changes and additions in the 2001 legislatively adopted budget

• Numerous actions will be taken to reduce prescription drug expenditures which include the following
  • Lowering pharmacy dispensing fees and ingredient payments
  • Implementing a case management program for antidepressants
    
  • Implementing co-pays for prescription drugs
    
  • Developing incentives to use mail order pharmacies
  • Implementing a pharmacy "lock-in" to address clients who use multiple physicians and pharmacies
  • Limiting initial dispensing of long-term drugs to a 15-day supply
  • Implementing a program that purchases generic drugs with an Oregon Maximum Allowable Cost (MAC)
  • Implementing a disease state management program for clients with asthma, diabetes and congestive heart failure, and evaluating cost savings
  • Implementing a case management program for the 700 most costly clients

• A new Senior Prescription Drug Assistance Program will serve individuals who are 65 and over at incomes up to 185 percent of the Federal Poverty Level and without prescription drug coverage for the past six months.

• An approach to prescription drugs will ensure that individuals in the fee-for-service Oregon Health Plan receive the most effective prescription drug available at the best possible price.

• "Oregon Health Plan 2" expands coverage to Oregon's low-income, uninsured children and families with incomes up to 185 percent of the Federal Poverty Level. This change will require a waiver of the federal Medicaid program. Expanded coverage is funded by federal match for the Family Health Insurance Assistance Program expenditures and by establishing two levels of benefit packages for the Medicaid portion of the Oregon Health Plan (OHP).

• House Bill 3214 provides coverage for women diagnosed with breast or cervical cancer through the Oregon Breast and Cervical Cancer Program, a screening program funded by the Centers for Disease Control and Prevention. These screenings are available to women 64 or under who do not have health insurance.

2001-2003 legislatively adopted budget

Client benefits/purchased services

* OHP also includes funds for clients served in managed-care settings for alcohol and drug programs.
** Includes $321.1 million of tobacco tax revenues.

Administration

2001-2003 major revenue sources

GENERAL FUND FEDERAL FUNDS Title XIX (Medicaid) Title XXI (CHIP) OTHER FUNDS Tobacco Tax and tobacco settlement funds Other Revenue

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Department-wide support services

Budget history ($ millions)

Program changes in the 2001 legislatively adopted budget

• Phase out of the Year 2000 remediation effort costs for the department's mainframe computer systems, to ensure they function correctly after the turn of the century.

• Continuation of the replacement of the current Medicaid Management Information System (MMIS).

• Replacement of the contracting and payment systems used to administer community mental health, developmental disability, and alcohol and drug services in Oregon.

2001-2003 legislatively adopted budget

Services provided by DHS

	Staff (FTE)	General Fund ($ millions)	Total Funds ($ millions)
Volunteer Program Field Staff	32	$0.0	$6.1
Community Development Projects		0.0	5.2
Lifespan Respite Care Program		1.1	1.1
Foster Grandparent Program		0.0	.5
TOTAL		$1.1	$12.9

Administration

2001-03 major revenue sources

FEDERAL FUNDS Social Services Block Grant Title XIX (Medicaid) OTHER FUNDS Other Grants and Income Charges to Department divisions for services

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