Financing

Illinois' integrated maternal and child health program for the reduction of infant mortality is supported by a combination of state and federal resources. The SFY'06 and SFY'07 budgets by program component are presented in Table 6.

Table 6 Budget for Integrated Infant Mortality Reduction Strategy by Program Component and State Fiscal Year: 2006 and 2007 ($000s)

The WIC budget includes funds for both program operations at the state and local level (referred to as Nutrition Services and Administration, or NSA) and funds for the purchase of food. The food funds include both an award from the USDA and rebates on the purchase of infant formula from Ross Laboratories. Rebates add an average of $65 million to the program's food budget each year. Grant awards to local agencies are based on estimated caseload.

Local agencies receive $130.00 per participant per year in NSA funds for program administration and each participant receives approximately $700.00 in food benefits per year. Due in part to the effectiveness of the Department's integrated approach to service delivery, Illinois' WIC caseload continues to grow in contrast to other states in federal Region V. This trend results in annual increases to Illinois' WIC award from the USDA.

The FCM program was supported by one General Revenue Fund appropriation in SFY'07. The Department also used federal Title V (Maternal and Child Health Services Block Grant) and Title XX (Social Services Block Grant) funds to support the program. Local health departments also add their own funds for the operation of the program. At the end of FY07, FCM and TIPCM providers were paid a 1.5% COLA to provide additional reimbursement for FCM services provided during that fiscal year.

The Department has worked closely with the IDHFS since 1990 to obtain federal matching funds through the Medicaid program for FCM expenditures. The IDHFS and the federal Center for Medicare and Medicaid Services have agreed that FCM expenditures can be considered administrative costs of the Medicaid program.

Prior to SFY'05, the Department only used funds appropriated through the "IMRI Medicaid" line item to obtain federal matching funds, even though claimable expenditures exceeded this amount. In order to increase federal revenue through the Medicaid program, the Department began claiming the maximum amount possible through the FCM program.

The Department has helped local health departments negotiate agreements with the IDHFS that allow them, as units of local government, to receive federal match for the local funds they expend in support of the FCM program. This increased the total amount of funds available for the FCM program by about $4 million per year without an increase in the Department's appropriation for the FCM program.

The Department budgets and reconciles FCM expenditures using per-family-per-month "rates" that were set on the basis of program expenditures and caseload in 1990. The rates were increased for the first time in Fiscal Year 2007, and are now $27.04 per month (or $324.48 per year) for a family with a pregnant woman or an infant and $12.88 (or $154.56 per year) for a family with a child over one year of age. (In Cook and St. Clair counties, the rate for families with an older child is $17.24 per month, or $207 per year.)

Targeted Intensive Prenatal Case Management began in Fiscal Year 2001 with an appropriation of $2.5 million. The Department also claims federal matching funds through the Medicaid program for these expenditures. The CHSI and Closing the Gap in Infant Mortality are supported by federal discretionary grants. Unfortunately, federal funding for Closing the Gap was discontinued as of June 30, 2007. The Department has been working with the Illinois Maternal and Child Health Coalition to identify alternative sources of funding.