FY24 Health & Human Services Virtual Budget Briefing Q & A

FY24 Health & Human Services Budget Briefing - IDHS Q & A

1. During the Covid-19 pandemic the recommendations were to "open a window", would not that still be the most feasible and cost effective route, rather than spend a fortune on filters that require much maintenance and up-keep??
   • At the Illinois School for the Deaf and the Illinois School for the Visually Impaired, staff were and are continued to be encouraged to bring outdoor air into the facility when appropriate. Using dedicated federal funding designed to address the impact of the pandemic, HEPA filtration systems were purchased for isolation COVID Units in each facility to prevent the spread of the disease.
2. Is there a line item for repair of grounds at state run i.e Elizabeth Ludeman Center in Park Forest Illinois.
   • The IDHS FY24 proposed budget includes funding for repair and maintenance service contracts as well permanent improvements at our state-owned facilities, including the Ludeman Center. Life safety improvements are priority. There is a water main project in process at the Ludeman Center overseen by the Capital Development Board. Once this is completed, the Capital Development Board will then begin a road and sidewalk project at the Ludeman Center.
3. On February 8, 2023, DHS-DDD announced that its rate change calculations for CILA will result in the elimination of nearly 3.8 million in direct support professional funded hours. This came as a complete surprise to the community. Does the DHS-DDD budget:
   1. through both an FY23 supplemental request and FY24 request, restore the elimination of nearly 3.8 million in DSP hours?
   2. If not a restoration, does the budget include any resources to address the elimination of hours in part?
      • The FY23 supplemental and FY24 budget request does not include the additional cost to restore the DSP hour reductions associated with the Guidehouse CILA rate calculator. IDHS does not need a FY23 supplemental to cover the cost of the "rate pause" regarding the DSP hours in the CILA Rate Calculator implementation. IDHS will work with the Governor's Office of Management & Budget regarding potential budget impact to FY24 depending on the continued efforts to ensure the appropriate DSP staff hours that meet individual needs.
4. Does the DHS-DDD budget include funding in FY24 to continue funding the Guidehouse rate study? If yes:
   1. what areas of the rate study are being funded (i.e. - DSP wage rate adjustments
   2. how much funding represents annualized costs from FY23?
   3. How much represents "new" guidehouse funding - costs that are not FY23 annualizations?
      • The FY24 budget request includes an $1.50/hr increase for DSP wages effective 1/1/24 and regionalization rate for the Community Day Services program effective 1/1/24, both subject to federal CMS approval. The Governor's FY24 proposed funding includes $56.7M in new GRF funds to support the annualization of the FY23 Guidehouse CILA rate calculator, regionalization factor for CILA, and the $1.00/hr DSP wage increase effective 1/1/23. The full cost of annualizing the FY23 Guidehouse recommendations is $98.2M.
5. A crisis remains in the overall lack of residential service and supports for children and youth with I/DD and requiring behavioral health supports. Does the proposed FY24 budget allocate resources towards building back lost capacity in this area?
   • The FY24 proposed budget supports placing 500 children with I/DD of the PUNS list into the home-based support program. This program provides services to children and young adults with developmental disabilities who live at home with their families. IDHS is also exploring the development of stabilization homes for children.
6. The FY23 budget made an historic investment into Medicaid behavioral health services and supports, however, there were several crises related services that weren't included. Does the proposed FY24 budget include additional resources towards Medicaid matched crisis behavioral health services and supports?
   • It should be noted even though IDHS/DMH has funding in the budget to fund Medicaid FFS the Medicaid rates are all held within Rule 140 and HFS is responsible for Medicaid rate setting. IDHS did make a historic investment in crisis services by funding the Crisis Care System program for $69.5M, 988 Call Center for $9.5M and Living Rooms (ER alternatives) for $8.4M (TOTAL = $87.4M). Medicaid rate increases for FY24 are not in the Governor's Introduced Budget.
7. What are the specific funded components of Home Illinois?
   • Home Illinois has $350M in key investments for services and supports to prevent and end homelessness in Illinois. Components include more than $155M to support unhoused populations, $26M for homelessness prevention services, $25M in Rapid Rehousing services, over $40M for development of new permanent supportive housing units, $12.5M for new scattered site permanent supportive housing units, $37M to create more non-congregate shelter units and more than $30M to provide street outreach, medical respite, re-entry services, access to counsel and other shelter diversion supports.
8. Does Home Illinois include increases to current funding sources such as the DHS Emergency and Transitional Housing grant funding?
   • The Home Illinois GRF appropriation of $200.3M includes over $40M to support expansion of emergency and transitional housing services.
9. Will funds from Home Illinois be available for domestic violence shelters?
   • The Home Illinois funds are targeted to prevent and end homelessness. Many victims of domestic violence find themselves facing homelessness and could be eligible for shelter services and supports provided under the Home Illinois program. Funding for the GRF Domestic Violence Services is included in the Governor's FY24 proposed budget at the same level of FY23 of $70.9M. The request maintains the $50M increase in FY23.
10. Does the Governor's IDHS budget, and in particular the Home Illinois Initiative, include funding for legal aid services for eviction? Eviction Help Illinois has been funded by IDHS since February of 2021 and is integral to eviction prevention. If yes, can you please share the budgeted amount?
    • The Home Illinois plan does include continuation of the Court Based Rental Assistance program operated by the Illinois Housing Development Authority. The proposed budget includes $30.0M of federal Emergency Rental Assistance funds for Court Based Rental Assistance. The IDHS proposed Home Illinois budget continues to fund $2.0M for Access to Counsel.
11. Kudos on including funding for IHDA's court-based rental assistance. Can you please share the amount? Is there any other rental assistance included in the IDHS budget?
    • The Home Illinois plan does include continuation of the Court Based Rental Assistance program operated by the Illinois Housing Development Authority. The proposed budget includes $30.0M of federal Emergency Rental Assistance 2 funds for Court Based Rental Assistance. The proposed budget includes appropriations to support expending any unexpended Emergency Rental Assistance 2 funds in FY24.
12. Will eligibility for Smart Start Workforce Compensation Contracts require any percentage of their licensed capacity enrolled in CCAP (Strengthen and Grow Grants required 10% CCAP enrollment)?
    • Yes, there will be a required percentage of Child Care Assistance Program participation to be eligible for Workforce Compensation Contracts. The Division of Early Childhood is working with the field to develop these requirements and will share additional details shortly.
13. Can you clarify when both the Smart Start Contracts would launch (workforce and quality support)? Timeline chart didn't align with the description.
    • The Division of Early Childhood is actively engaging the field in development of these timelines. Exact dates and details will be shared shortly. It is important to note, though, that the Division of Early Childhood will be making funding available without gap moving forward, from the current Strengthen and Grow Child Care Grants, through the transition into Smart Start Contracts in State Fiscal Year 2024, and beyond.
14. Are programs eligible for both or either Quality Support and Workforce Compensation contracts?
    • Assuming eligibility requirements are met, providers could be eligible for both Workforce Compensation Contracts and Quality Support Add-Ons. Quality Support Add-Ons are designed to give additional funding to Workforce Compensation Contract providers to help work towards increasing capacity, high quality, and readiness to implement PFA/E and E/HS. The Division of Early Childhood is actively engaging the field to determine how these contracts will best be delivered to eligible providers, including the possibility of one bundled contract for both Workforce Compensation and Quality Support.
15. If early childhood center-based programs have 2 year olds and are licensed through DCFS but the 3 's and 4's they serve are under ISBE purview as part of a day school, will only the 2 year old part of the program be eligible for these state Smart Start contracts? What about PreK that is housed in a day school. Will they be eligible?
    • IDHS will continue to fund the Child Care Assistance Program and ISBE will continue to fund Early Childhood Block Grant programs. IDHS and ISBE will be working together and with the early childhood to finalize eligibility requirements for Smart Start Contracts.
16. How will you assure salary parity for community-based providers that don't receive ECBG funding? What is the salary expectation for community center-based programs that receive ECBG funds? Is it the same as expected for programs that receive Smart Start workforce compensation contracts ($17-$19 per hour).
    • ISBE will continue to be responsible for administration of ECBG funding.
17. Will the Smart Start workforce contracts address the financial loss that will inevitably occur when more 3 and 4 year olds leave the center-based programs for public PreK through the ECBG investment?
    • IDHS is working closely with ISBE to align all Smart Start programs, including prioritizing community-based organizations in ECBG funding.
18. Does the DHS budget account for the ending of the SNAP emergency allotment with any additional GRF funding either for this program or other programs to meet food insecurity?
    • The Governor's FY24 proposed budget does not include GRF to replace the federal SNAP emergency allotments ending. The proposed budget does include $2.0M GRF for a new State Food Purchasing Program to link Illinois farmers with food banks to provide Illinois grown products to low-income families.
19. To better understand the Home Illinois Program, do you have a breakout of new versus level or reappropriated FY23 funds for homeless prevention? I am trying to determine how much of the DHS Home Illinois line item represents prior year funding levels under other line item names or agencies?
    • The Home Illinois funding proposed in the IDHS budget includes a $200.3M GRF appropriation. The $200.3M includes $85.3M in new GRF investments and $115.0M in FY23 base funding realigned.
20. What does the "Mental Health Grants - Home-Based Program" fund?
    • The $1.3M appropriation from the Health & Human Services Medicaid Trust fund provides supports to assists individuals with mental illness to remain in their homes.
21. What is covered/funded under "Mental Health Treatment"?
    • This $5.0M appropriation, from the Mental Health Reporting Fund, is used to support the Front Door Diversion Program. The Front Door Diversion Program provides services to eligible individuals to maintain individuals in the most integrated community-based setting.
22. What will the "ARPA - Mental Health, Behavioral Health, Substance Abuse and Other Services - Reappropriation" fund?
    • For FY24, estimating $7.4M will be re-appropriated. These funds will be used to support ongoing projects in FY24.
23. What will the "Mental Health Block Grant", "Mental Health Block Grant - ARPA", and "Mental Health Block Grant Children and Adolescents" fund?
    • The Mental Health Block Grant appropriation of $50M is used to expend federal funds for Mental Health Crisis Services, Residential Services, and the First Episode Psychosis Program. The Mental Health Block Grant - ARPA appropriation of $25M is used to expend federal ARPA funds for Mental Health Crisis Services and the First Episode Psychosis Program. The Mental Health Block Grant Children and Adolescent appropriation or $4.3M is used to expended federal funds for services to youth.
24. On page 339 of the Governor's operating budget, what will the "Community Mental Health Services Block Grant" fund?
    • The table on page 339 groups appropriations by fund. The $83.2M is the proposed appropriation total from the Community Mental Health Services Block Grant. The spending from this fund includes Mental Health Crisis Services, Residential and the First Episode Psychosis Program.