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JAC 06
BUDGET HEARINGS 01/17/2006
2006 Budget
Hearings, January 17, 2006, #0048 Department of Health
0 ~ 1/17/2006 7:56:20 AM ~ Start
Recording
5 ~ 1/17/2006 7:56:25 AM ~ Pause
5 ~ 1/17/2006 7:59:21 AM ~ Resume
5 ~ 1/17/2006 7:59:21 AM ~
12 ~ 1/17/2006 7:59:28 AM ~ Philp -
Welcome to The First Lady - pg. 352 - underage drinking laws
1:21 ~ 1/17/2006 8:00:37 AM ~ Mrs. Freudenthal
- The funding request would move monies to the gov. office from the Dept of
Health. Gov. has the authority to
enforce these underage drinking laws.
We're hoping to initiate the youth program. Adult messages are negative.
We need to have the youth taking care of their group. In Cody they have a very good program
going. I would be happy to answer
questions.
4:46 ~ 1/17/2006 8:04:03 AM ~ Hines - Your
comments reminded me of something a long time ago - I think it was Allied
Youth- main purpose was to make youth aware of drinking problems. Are you aware of any national gp?? Provided lots of information.
6:05 ~ 1/17/2006 8:05:21 AM ~ Freudenthal -
There are national gps, but I haven't heard of that name. Want to take gp of kids from WY to national
conference that would expose them to all the diff. models for safety
nationally. They go through so many new
names.
7:28 ~ 1/17/2006 8:06:45 AM ~ Philp - Sen.
Case and I had a meeting of gp in Fremont county and they were very
enthusiastic.
7:56 ~ 1/17/2006 8:07:13 AM ~ Freudenthal -
They do a good job and lots of mentoring.
Last year the entire Cody football team were members of CAM.
8:53 ~ 1/17/2006 8:08:10 AM ~ Anderson - In
my committee I think that you should be assured in my community that the adults
and youth are behind you.
9:22 ~ 1/17/2006 8:08:39 AM ~ Sherrard -
Because the First Lady endorses them we get so much more out of these
programs. Director of Dept. of Health
and State Health Officer - Opening remarks - Have been in decision making
capacity in this post since June. Spent
18 yrs practicing in Wheatland. 14-15%
of people in WY are uninsured. Dept. of
Health we can be a leader. We need to
look at proper ways to handle all of these programs. Don't make changes for sake of change. In two yrs. we lost about 65 yrs. in our department. Management is imp. to me and development of
workers. Medicaid is about 2/3 of our
budget. Iris Oleski resigned to spend
time w/ grandchildren. We want to give
you accurate and reliable info. If we
can't give it to you today, we will get it for you. We are trying to centralize our financials. Bob Peck is working with me to get this to
happen. IT needs to be worked on. We have numerous data bases in our
department and we need to get all these data bases to talk to each other. We have hired an IT person to help us with
this. In my 6 mos. tenure we have
carefully analyzed the budget. Trying
to establish trust and credibility is paramount to me. There is an inc. in our budget and we do
have an exception budget, but I think that you will see that many of the fed.
funds have been cut and the state has to pick up many of them. In our budget we are trying to understand
and explain the formula underwhich we have to operate. The controlable cost are things that we can
control and have been looked at very closely.
Have talked to the gov. and are trying to cut costs wherever we
can. Our nurses are making calls and
the emergency room visits are down because of this. We'll probably be back for supplemental budget, but we will try
to keep our cost down. We want people
to try to take care of themselves.
Public Health has huge role in state gov. We have new staff with WY health Care Commission - Dixie Roberts
- Am looking forward to working with her.
Have lot of needs in mental and substance abuse- need to learn more to
know how to treat. Are involved in
pandemic flu planning - dramatic impact.
Obesity crisis is costing state lots of money and lots of lives. Hard to get this going because can't see
immediate results. Need for
collaboration. Work for state and
people of WY. Want to accept and listen
so that we in health dept. can make decisions.
Physicians' Advisory Gp. is very important and meet w/ them every
month. I'm also a taxpayer in this
state & I try to be frugal. Yes, we
do have some places where can cut.
25:37 ~ 1/17/2006 8:24:54 AM ~ Simpson -
Looked at leg. final review report - to what degree does that document affect
you budget requests?
26:17 ~ 1/17/2006 8:25:34 AM ~ Sherrard - It
has lots to do with. We want to
reestablish that trust.
27:06 ~ 1/17/2006 8:26:22 AM ~ Simpson - We
suggest Medicaid redesign- where are you going w/ that?
27:27 ~ 1/17/2006 8:26:43 AM ~ Sherrard - We
are looking at DD and primary care waivers.
Various other cost containment measeures like the drug program. We are in line w/ other states.
28:49 ~ 1/17/2006 8:28:05 AM ~ Peck - Few
comments - met wi/ interim committee#1-realignment w/ reporting , 2 - realign.
w/ type of expenditures, 3 - dev. budget that would still expand our cost
containment, 4 - tried to provide some
type of metric - tried to create document that was shorter then our budget
document. Still trouble understanding
every page of budget. Would frame in global
sense - 1.1 billion is spent for care of people in WY.
33:19 ~ 1/17/2006 8:32:36 AM ~ Philp - I
appreciate what you are trying to do with budget, but be patient with us
because it makes it harder to track.
34:05 ~ 1/17/2006 8:33:21 AM ~ Peck - p. 16
- #1 - common client directory -
35:02 ~ 1/17/2006 8:34:18 AM ~ Sherrard - Is
part of trying to tie in IT in dept.
35:19 ~ 1/17/2006 8:34:36 AM ~ Peck - We
could still pay for person that is living in Utah, but was in Evanston. Workmen's comp.
36:21 ~ 1/17/2006 8:35:37 AM ~ Hines - is
this contracted?-or in dept?
36:33 ~ 1/17/2006 8:35:50 AM ~ Peck - now it
is contracted, but may bring into house.
36:50 ~ 1/17/2006 8:36:07 AM ~ Job - Is this
for the whole dept?
37:01 ~ 1/17/2006 8:36:17 AM ~ Peck - If is
not completed now it will be completed shortly.
37:25 ~ 1/17/2006 8:36:41 AM ~ Job - If
person needs
37:55 ~ 1/17/2006 8:37:12 AM ~ Claybox -
Deputy Administrator - We will try to integrate this with other programs in our
dept. Clients in our dept. have been
several programs.
39:04 ~ 1/17/2006 8:38:21 AM ~ Job Is this
amount going to inc. some of the costs in bill that is going to be coming
through.
39:37 ~ 1/17/2006 8:38:53 AM ~ Claybox - CCD
- WCIS - can integrate, but not duplicate
40:03 ~ 1/17/2006 8:39:20 AM ~ Job - What
about duplication of costs. Worried
about that now dup of services.
40:23 ~ 1/17/2006 8:39:40 AM ~ Claybox -
Could be possible to happen if person gets help from other state agencies.
41:16 ~ 1/17/2006 8:40:33 AM ~ Job - The two
systems will not duplicate ???
41:48 ~ 1/17/2006 8:41:04 AM ~ Claybox-
42:16 ~ 1/17/2006 8:41:33 AM ~ Nicholas -
What about costs for this?
42:28 ~ 1/17/2006 8:41:45 AM ~ Peck - IT
costs in dept was about 12.5 mil .
42:44 ~ 1/17/2006 8:42:01 AM ~ Jorgensen -
We served on interim dept this summer.
It is hard to get data and info.
Need to pursue this anyway that we can.
43:57 ~ 1/17/2006 8:43:13 AM ~ Peck - When
look what dept. of Health - 882 mil we asked and we will spend 879 mil . We are assuming that trend will continue and
that is why we are asking for that amt.
We need to try to find out and are working on that.
45:51 ~ 1/17/2006 8:45:08 AM ~ Berger- What
about a global system? Can you do that?
46:09 ~ 1/17/2006 8:45:25 AM ~ Sherrard - I
think that it is possible, but people need to be receptive to change.
46:39 ~ 1/17/2006 8:45:56 AM ~ Claybox - The
WCIS is a data base and it doesn't talk to medicaid system. The CCD links them.
47:30 ~ 1/17/2006 8:46:47 AM ~ Warren - How
are you going to use this data?
49:04 ~ 1/17/2006 8:48:20 AM ~ Sherrard -
49:12 ~ 1/17/2006 8:48:29 AM ~ Claybox - Our
total management system helps us to know whether we are our clients to not have
to much medication -
50:43 ~ 1/17/2006 8:49:59 AM ~ Peck - next
req. is for IT project software. Sev.
contracts that spent money and were not on time. This will help us to do it ourselves - can track change
orders. Should save us much more that
what is costing us for this. p. 18 - #3
- standardize in dept. for word processing .
Need to get everyone in dept on same #4 - need to identify computers
that can run programs that we have in our dept.
54:06 ~ 1/17/2006 8:53:23 AM ~ Meuli - What
is schedule for replacing hardware?
54:27 ~ 1/17/2006 8:53:44 AM ~ Claybox- Dept
has not had a schedule until now. Our
new IT person will be doing this.
55:03 ~ 1/17/2006 8:54:19 AM ~ Peck - p. 19
- # 5 -Need to realign positions because we moved to dir. office. Since they are not eligible for fed funds
- The positions that we have moved will
be beneficial to gen. funds - 1.7 mil $$
57:22 ~ 1/17/2006 8:56:39 AM ~ Meuli - In
doing this will you have problems with supplanting w/ fed funds??
57:48 ~ 1/17/2006 8:57:05 AM ~ Peck - We
have reviewed all of these.
58:14 ~ 1/17/2006 8:57:31 AM ~ Nicholas -
that is no longer covered.
58:34 ~ 1/17/2006 8:57:50 AM ~ Peck - When
moved to dir. office no longer eligible to get fed match.
59:05 ~ 1/17/2006 8:58:22 AM ~ Claybox - The
person moved was working dept. wide and that is why we moved so that it would
be a problem w/ feds.
59:55 ~ 1/17/2006 8:59:12 AM ~ Peck - #6 -
Moved position to dir. office.
1:00:17 ~
1/17/2006 8:59:34 AM ~ Nicholas - want to go back to computer part - in our
office upgrades never work. Just wait
until can get new systems.
1:01:55 ~
1/17/2006 9:01:12 AM ~ Claybox - That is what we are planning to do.
1:02:06 ~
1/17/2006 9:01:23 AM ~ Peck - p. 23 - #1 - Equipment fund request - want dir.
office to control any equipment costs over their budget. gov. denied - will figure other way to fund
this req. p. 25-26 - #1 - Financial
assistance - tax rebate has not been
req. in last few yrs. by those eligible and so are planning to reduce
amount p. 33 - This position does
qualify for fed monies so can reduce gen fund for this.
1:07:50 ~
1/17/2006 9:07:07 AM ~ Meuli - State licensing - are these individuals as
diligent in nursing homes?
1:08:59 ~
1/17/2006 9:08:15 AM ~ Sherrard - I believe they are.
1:09:31 ~
1/17/2006 9:08:47 AM ~ Job - Do any funds flow through Rural Health?
1:09:52 ~
1/17/2006 9:09:08 AM ~ Sherrard - Yes
1:10:00 ~
1/17/2006 9:09:16 AM ~ Peck - p. 40 - # 1 - Tech assistance to communities that
have been affected by the energy boom.
To provide some professional services to this area.
1:11:04 ~
1/17/2006 9:10:20 AM ~ Weidel - Manager of Rural Health - Need to support those
communities that are impacted by the energy boom.
1:11:43 ~
1/17/2006 9:10:59 AM ~ Anderson - How specific are you going to be because we
have considerable amount of impact in many rural communities because of
growth. Are we going to extend this
definition wo inc. other communities?
1:12:51 ~
1/17/2006 9:12:08 AM ~ Weidel-
1:13:38 ~
1/17/2006 9:12:55 AM ~ Sherrard - I agree w/ you. Our state is very rural. This office should be more active.
1:14:22 ~
1/17/2006 9:13:38 AM ~ Nicholas - I don't really get the idea of rual health.
1:14:47 ~
1/17/2006 9:14:03 AM ~ Sherrard - These communities that have an influx of
energy need lots of help. I don't think
it needs to be just in energy areas. We
would use in all growth areas.
1:16:31 ~
1/17/2006 9:15:48 AM ~ Meuli - We asked last time to hear what physicians in
rural areas are doing. We didn't give
you money to do that.
1:17:31 ~
1/17/2006 9:16:48 AM ~ Sherrard - WE are doing that by state of Nebraska
because they have done that already - contracted to them.
1:18:17 ~
1/17/2006 9:17:33 AM ~ Weidel - the money that you did give last time went to
network. Date will come to us.
1:19:02 ~
1/17/2006 9:18:18 AM ~ Meuli - Is Nebraska going to get info that you need?
1:19:42 ~
1/17/2006 9:18:58 AM ~ Weidel - That will take time, but in meantime we will be
doing what we can. It is being
monitored very closely.
1:20:38 ~
1/17/2006 9:19:54 AM ~ Hines - Rural health - you gave exception budget of 1.2,
look to pg. 38 - it is 2.8
1:21:12 ~
1/17/2006 9:20:29 AM ~ Peck - Look on p. 38 that is the entire budget - there
are two areas Now want to get on-going grants in place where they were. There were several B-ll process. Thought we'd add to standard budget all
budgets that we had B-ll 'd.
1:23:26 ~
1/17/2006 9:22:43 AM ~ Job - How much money do we put into Rural Health
Research budget?
1:23:54 ~
1/17/2006 9:23:11 AM ~ Weidel - Would like to give more to network. Is a resource issue- the WY network are
working primarily are recruiting nurse practioners, etc.
1:25:38 ~
1/17/2006 9:24:55 AM ~ Sherrard - They have not been able to recruit psyche
doctors.
1:26:22 ~
1/17/2006 9:25:39 AM ~ Anderson - What is the supply and demand for
psychiatrics??
1:27:46 ~
1/17/2006 9:27:03 AM ~ Weidel - Lots.
1:27:58 ~
1/17/2006 9:27:14 AM ~ Simpson - It depends on whether you want to be on call
all the time. Need to make more attractive
for them.
1:28:42 ~
1/17/2006 9:27:59 AM ~ Weidel - These are problems that we are addressing. Come is competitor improvement loans for 3
yrs.
1:29:42 ~
1/17/2006 9:28:58 AM ~ Peck - Community Services Block Grant - does not req. a
match. Medical Malpractice Loans - One time funding - Understanding there is a
bill to propose a continuation of this.
1:32:01 ~
1/17/2006 9:31:18 AM ~ Nicholas -
1:32:17 ~
1/17/2006 9:31:34 AM ~ Weidel - Have made 9 loans - 1.9 mil $$ - Have completed
first yr. and have had no defaults
1:33:00 ~
1/17/2006 9:32:16 AM ~ Peck - p. 52 - Community and family health - req. for
$30K for rabies vaccine - can give to communities that need it. Put into gen fund.
1:34:43 ~
1/17/2006 9:33:59 AM ~ Petersen - lot of discussion in House - How much money
was expended on this last yr.
1:35:09 ~
1/17/2006 9:34:25 AM ~ Sherrard - Don't have # - 1500 $ for treatment
1:36:06 ~
1/17/2006 9:35:23 AM ~ Anderson - Lost young lady in my district to menigitis
1:37:17 ~
1/17/2006 9:36:33 AM ~ Sherrard - That is sporadically. It is very difficult because symptoms are
like common cold and they can be dead in couple of days.
1:38:30 ~
1/17/2006 9:37:46 AM ~ Peck - p. 56 #1 - Crippling Maloocclusion program -
1:39:12 ~
1/17/2006 9:38:28 AM ~ Meuli - Is there another bill out there for this?
1:39:51 ~
1/17/2006 9:39:07 AM ~
1:40:23 ~
1/17/2006 9:39:39 AM ~ Case - When can we talk about dental discussion?
1:41:16 ~
1/17/2006 9:40:32 AM ~ Peck - We do have dental in Medicaid. We could do it then.
1:42:09 ~
1/17/2006 9:41:26 AM ~ Peck - p. 60 #1 - to eliminate the waiting list for
Renal dialysis
1:42:57 ~
1/17/2006 9:42:14 AM ~ Meuli - You have most for care of human transplants??
1:43:18 ~
1/17/2006 9:42:35 AM ~ Sherrard - Medicaid does pick up most the cost for
transplant
1:43:42 ~
1/17/2006 9:42:59 AM ~ Meuli - Are you seeing a lot more patients?
1:44:08 ~
1/17/2006 9:43:24 AM ~ Sherrard - Has inc. because of diabetes.
1:44:23 ~
1/17/2006 9:43:40 AM ~ Peck - Immunization - p. 64 - Try to register all
children - Have put on website.
1:45:57 ~
1/17/2006 9:45:14 AM ~ Simpson - On immunizations - one of concerns - bill that
is bringing bill from feds. Would like
to understand where reduction is so can understand.
1:47:51 ~
1/17/2006 9:47:08 AM ~ Sherrard - There are 45% of children that are not
covered. Economically we get more bang
for our buck for this.
1:49:19 ~
1/17/2006 9:48:35 AM ~ Simpson - Would req. that we have a budget footnote so
that we can universal vaccine. Need
accurate figure.
1:49:59 ~
1/17/2006 9:49:16 AM ~ Hines - Have talked to our county health and I assumed
that we would see this in the exception budget.
1:50:58 ~
1/17/2006 9:50:14 AM ~ Meuli - Everything was paid for, but not the fed.
government limited it.
1:51:43 ~
1/17/2006 9:51:00 AM ~ Job - No longer immunizing adults??? Is that a chg in policy?
1:52:05 ~
1/17/2006 9:51:21 AM ~ Sherrard - There was a shortage of tetanus vaccine a
while back. Provide me that name.
1:52:44 ~
1/17/2006 9:52:00 AM ~ Peck - p. 73 - T & A Metabolic Screening - Money we
have collected for us to routinely pay for newborns tests.
1:54:47 ~
1/17/2006 9:54:03 AM ~ Hines - Previously didn't understand fees were
collected??
1:55:16 ~
1/17/2006 9:54:33 AM ~ Sherrard - State used to pay for this, but couldn't any
longer. Charge to families is a new way
to handle this.
1:56:40 ~
1/17/2006 9:55:56 AM ~ Peck - this is not a gen fund request - it is just a
vehicle to show this from hospitals.
1:57:17 ~
1/17/2006 9:56:34 AM ~ Warren - If you had a medicaid mom, would mom be
billed? what about low income??
1:57:43 ~
1/17/2006 9:57:00 AM ~ Peck - Have to have a vehicle to deposit these funds
that we collect and pay lab for services they provide.
1:58:24 ~
1/17/2006 9:57:41 AM ~ Nicholas - Regardless of source of revenue???
1:59:14 ~
1/17/2006 9:58:31 AM ~ Peck - p. 78, # WIC - Mountains Plains Consortium WIC
system - for our share to pay
2:00:50 ~
1/17/2006 10:00:06 AM ~ Peck - #2 - totally paid for by fed. funds #3 - inc. in
revenue- want to have budget accurately reflect this
2:01:56 ~
1/17/2006 10:01:11 AM ~ Pause
2:01:56 ~
1/17/2006 10:16:17 AM ~ Resume
2:02:24 ~
1/17/2006 10:16:45 AM ~ Sherard, p. 84 #1 correct funding for admin. nursing
staff, county pays 35%, incorrectly applied to admin. staff also. GF.
2:04:11 ~
1/17/2006 10:18:32 AM ~ Meuli - Campbell Co. inluded?
2:04:25 ~
1/17/2006 10:18:47 AM ~ Peck - they opted out.
Only county.
2:04:44 ~
1/17/2006 10:19:06 AM ~ Job - Dec. 1, 2005 Report to JAC. This committee has done a lot to try to get
nursing salaries up. Recommendation was
to keep market surveys curfrent.
Salaries? Keep them up?
2:08:04 ~
1/17/2006 10:22:26 AM ~ Jorgensen What can state do?
2:08:40 ~
1/17/2006 10:23:02 AM ~ Sherard - Public Health nurses are integral part. We are in pretty good shape for what is
going on out there.
2:10:08 ~
1/17/2006 10:24:30 AM ~ Peck #2 We can live with Governor's rec. #3 county
vehicles, we use state vehicles and counties reimburse.
2:11:41 ~
1/17/2006 10:26:02 AM ~ Peck p.
introduce Terry Green, Medicaid office
2:13:41 ~
1/17/2006 10:28:03 AM ~ Meuli What is ACS? Peck ACS is the claims processing
vendor for Medicaidwith an office in Cheyenne.
2:14:24 ~
1/17/2006 10:28:45 AM ~ Terry Green
2:14:45 ~
1/17/2006 10:29:06 AM ~ Peck #2 continuation of revaluation of Medicaid
positions, match should be in Medicaid office, net effect is an increase.
2:16:05 ~
1/17/2006 10:30:26 AM ~ Peck #1 p. 104 to correct FMAP increase fed match and relief to GF. #2 Gov.
denied, we can manage. p. 110 #1 FMAP rate expected to decrease, net effect to
our budget will increase $900,000.
2:18:37 ~
1/17/2006 10:32:58 AM ~ Meuli for each decrease, how much does it cost in
GF. Does this go thru ACS fiscal agent?
2:19:24 ~
1/17/2006 10:33:46 AM ~ Peck, about $400,000 for SCHIP,
2:19:54 ~
1/17/2006 10:34:16 AM ~ Patty Goosmon, admin. for SCHIP, currently have nothing
to do with ACS.
2:20:41 ~
1/17/2006 10:35:02 AM ~ Simpson - 2 yr. rate?
2:20:51 ~
1/17/2006 10:35:13 AM ~ Goosmon - new rate July of 2005, based upon an
estimated rate increase for this next biennium
2:21:31 ~
1/17/2006 10:35:53 AM ~ Simpson - rate decreased?
2:21:40 ~
1/17/2006 10:36:01 AM ~ Goosmon - based upon estimates with Medicaid rates by
Blue Cross.
2:22:24 ~
1/17/2006 10:36:45 AM ~ Job - cap on program or on individuals?
2:23:18 ~
1/17/2006 10:37:39 AM ~ Roxanne Homar, State Pharmasist, cap was on any new
enrollments, per statute. We hope to
open up by July. Medicare Part D is
confusing if we open up both programs at the same time.
2:24:24 ~
1/17/2006 10:38:46 AM ~ Job - know how many unserved?
2:24:35 ~
1/17/2006 10:38:57 AM ~ Homar - insufficient data, people are not applying
because of cap.
2:25:05 ~
1/17/2006 10:39:27 AM ~ Peck - Medicaid Clawback is very confusing. May have better data in May when period
ends. Automatic enrollment in Clawback
2:26:09 ~
1/17/2006 10:40:31 AM ~ Homar - Medicare D required to pay back state
costs. Complicated calculation, 13
steps. Supposed to pay 90% back, phases
down by 2016. Will be more
expensive. We continue to pay for
medications for dual eligible persons that Medicare D. People who go on Medicare D must also be
part of Medicare B, then eligible for Medicare. Don't know how many will be coming in.
2:28:50 ~
1/17/2006 10:43:11 AM ~ Meuli - amt. set aside?
2:28:59 ~
1/17/2006 10:43:20 AM ~ Peck, exception requests in order?
2:29:19 ~
1/17/2006 10:43:41 AM ~ Philp yes
2:29:25 ~
1/17/2006 10:43:46 AM ~ Peck - GF required for FMAP chang
2:29:44 ~
1/17/2006 10:44:06 AM ~ Philp - is it a firm number?
2:29:58 ~
1/17/2006 10:44:19 AM ~ Peck - our best guess is 72, won't get 2008 est. till
Nov. next yr.
2:30:30 ~
1/17/2006 10:44:51 AM ~ Peck #2 #3
2:32:03 ~
1/17/2006 10:46:25 AM ~ Simpson - dual eligible, why Clawback if only pd. once
regardless of which program.
2:32:31 ~
1/17/2006 10:46:53 AM ~ Homar - specific to Prescription Drugs taken each mo.
Feds estimated how much was pd. Recurring cost and feds want state to pay its
part.
2:33:29 ~
1/17/2006 10:47:50 AM ~ Simpson - do you agree?
2:33:37 ~
1/17/2006 10:47:59 AM ~ Homar unusual to have state pay for a fed. program, and
we have no management of it.
2:34:11 ~
1/17/2006 10:48:33 AM ~ Warren - how determine what portion of Medicare D do we
have to pay back?
2:34:36 ~
1/17/2006 10:48:58 AM ~ Homar - increasing budget demands at fed. level. State already shouldering part of the
program, they still want states to support as in the past. We have been able to manage plan, and now we
are stuck with a payment with no ability to affect program.
2:35:50 ~
1/17/2006 10:50:11 AM ~ Peck - state was to have picked up 90%, about $15m
expected to be. Actual will be nearly
50% more than first promised. Some
states are fighting implementation of this program. Roxanne's group will monitor.
2:37:19 ~
1/17/2006 10:51:41 AM ~ Simpson - concept to pay back fed. funds due to dual
eligibility, where does it show in budget?
2:37:55 ~
1/17/2006 10:52:16 AM ~ Peck - p. 118 for clawback
2:38:15 ~
1/17/2006 10:52:36 AM ~ Homar, p. 120 fed. funds reverting back
2:38:34 ~
1/17/2006 10:52:55 AM ~ Simpson - same figure net to zero. Can you tell within WY Medicaid program is
correct, justified?
2:39:05 ~
1/17/2006 10:53:27 AM ~ Homar, best 5,400 people already in system. Don't know how many more will come into
system. +20% a guesstimate.
2:39:55 ~
1/17/2006 10:54:16 AM ~ Peck- old prescription plan referenced.
2:40:23 ~
1/17/2006 10:54:45 AM ~ Peck, p. 122, Medicare D does not pay for excluded
drugs. We will continue to pay for them.
2:41:36 ~
1/17/2006 10:55:58 AM ~ Job - We know how many dual eligibles, wouldn't these
also be effected here, why remain level?
2:42:32 ~
1/17/2006 10:56:54 AM ~ Peck, unsure how much.
Roxanne will continue to include in cost containment effors. Governor willing to establish a contingency
fund. Costs have continued to rise, may
not be adequate.
2:44:29 ~
1/17/2006 10:58:50 AM ~ Job - Roxanne has given excellent data, not sure $20m
in a contingency fund is adequate.
2:45:02 ~
1/17/2006 10:59:24 AM ~ Peck - cost containment effort has been successful,
don't know true impact.
2:45:49 ~
1/17/2006 11:00:10 AM ~ Philp in Nov. gave us a chart of new agencies - ask for copies for committee.
2:46:18 ~
1/17/2006 11:00:40 AM ~ Peck will bring back after lunch.
2:46:28 ~
1/17/2006 11:00:49 AM ~ Peck p. 126, State Foster Care moved to its own EORG
2:47:13 ~
1/17/2006 11:01:34 AM ~ Peck, p. 127 Medicare Buy-In could be increases, $20m
is a GF contribution matched by Feds.
2:48:02 ~
1/17/2006 11:02:23 AM ~ Philp - p. 128 projected expenditure is $17.2m,
Standard budget reflects only $14m+
2:48:37 ~
1/17/2006 11:02:58 AM ~ Peck projections assumed rate increase. If there were increases, $4.5m total could
be budget.
2:49:42 ~
1/17/2006 11:04:03 AM ~ Philp - $17m reflects?
2:49:54 ~
1/17/2006 11:04:15 AM ~ Peck projections for 05-06 about $16m
2:50:27 ~
1/17/2006 11:04:49 AM ~ Philp inflation increase?
2:50:36 ~
1/17/2006 11:04:58 AM ~ Peck no, this is premium based, feds set premium rate.
2:51:01 ~
1/17/2006 11:05:22 AM ~ Philp - same client load?
2:51:10 ~
1/17/2006 11:05:31 AM ~ Peck yes
2:51:19 ~
1/17/2006 11:05:40 AM ~ Philp - but it has increased over the years.
2:51:34 ~
1/17/2006 11:05:56 AM ~ Peck yes. I'll
get information to help you analyze.
2:51:59 ~
1/17/2006 11:06:20 AM ~ Nicholas - inconsistencies in budget narrative and
tables and why appear to be inconsistent?
2:52:30 ~
1/17/2006 11:06:51 AM ~ Peck -This budget process was a challenge, my first
budget to prepare. Found some errors in
rush to prepare. Narrative and tables
were done by different people, review tie in and normally LSO staff helped,
too. Want document to be perfect, but
it is not.
2:54:56 ~
1/17/2006 11:09:18 AM ~ Nicholas - for 4 years we have put a lot more money
into DOH. Tough job, what confidence do
you have to do it and still provide services?
2:55:38 ~
1/17/2006 11:09:59 AM ~ Peck - in private practice, I had to live within a
budget with no opportunity to come back mid way and ask for more. Inefficiencies do give some leeway. Let's be conservative, we will do a better
job of projecting actual need. Dr.
Sherard supportive. Seeing costs go
down in two most expensive programs, e.g. admittance to hospitals, gives some
flexibility.
2:58:36 ~
1/17/2006 11:12:57 AM ~ Sherard, some frustrations controllable vs.
uncontrollable costs, clawback is a nightmare, foster care, FMAP all have
little or no control. Administrator
wants some control over budget. Hate to
project and predict on faulty information.
We are trying to be good stewards of state funds.
3:00:15 ~
1/17/2006 11:14:36 AM ~ Hines - what bothers me is where you are asking for
a flat budget, increasing
continually. What will happen in the
next 2 years? How do you project a flat
budget when you have no control
of. Conservative appreciates you cost
containment. I'd like to understand
this better. Can you get info on some
of your cost containment measures this week?
3:02:59 ~
1/17/2006 11:17:20 AM ~ Sherard - in DOH review we spelled out many of these. Press release $6m savings, can provide list
of all. Preferred drug list, setting up
formulary due to Medicare setting up Formulary.
3:04:02 ~
1/17/2006 11:18:24 AM ~ Hines - have that review? Was it mailed to us?
3:04:22 ~
1/17/2006 11:18:44 AM ~ Philp was mailed to you.
3:04:31 ~
1/17/2006 11:18:52 AM ~ Meuli - in narrative on Medicare Buy-in states
160/month Part A, are you confident with these numbers?
3:05:29 ~
1/17/2006 11:19:50 AM ~ Peck - accurate, can easily track this premium based
program.
3:05:56 ~
1/17/2006 11:20:18 AM ~ Philp - accurate table on p. 128?
3:06:18 ~
1/17/2006 11:20:39 AM ~ Peck - historical data is accurate, projections are
not, just estimates. Specific rate
today - I can find it out.
3:06:57 ~
1/17/2006 11:21:19 AM ~ Philp requested population information.
3:07:22 ~
1/17/2006 11:21:44 AM ~ Nicholas - different categories with flat increases, no
ability to control rates, population, budget to recruit people into
program. If you have a mechanism to
affect expenditure, set a budget which is lower to see how reimburse
positions. Is this one of the areas
that will be what it is, and is just an exercise to project.
3:09:35 ~
1/17/2006 11:23:57 AM ~ Sherard - no control about hospital reimbursement by
Medicare.
3:10:09 ~ 1/17/2006
11:24:30 AM ~ Nicholas - any hidden areas that we can control?
3:10:26 ~
1/17/2006 11:24:48 AM ~ Sherard - makes sense for dual eligibles to also
participate in Medicare.
3:10:53 ~
1/17/2006 11:25:14 AM ~ Job - amt. spent this year to date?
3:11:08 ~
1/17/2006 11:25:29 AM ~ Peck - 12 then 18 months?
3:11:27 ~
1/17/2006 11:25:48 AM ~ Job yes.
3:11:34 ~
1/17/2006 11:25:55 AM ~ Simpson - p. 25 of summary, how do you read the
columns.
3:12:11 ~
1/17/2006 11:26:32 AM ~ Peck, sorry top was cut off, meant to correct.
3:12:35 ~
1/17/2006 11:26:57 AM ~ Peck - WHIPP p. 130 no additional request.
3:13:16 ~
1/17/2006 11:27:37 AM ~ Peck p. 132 Equality Care Mandatory Services
-Adult project overall shortage GF,
$18.5m to handle immediate needs. Will be some $ available in other programs.
3:16:52 ~
1/17/2006 11:31:14 AM ~ Meuli - mandatory services, number of recipients went
up in all areas except in family planning.
90% ff reimbursement, nice to see those numbers go up.
3:17:46 ~
1/17/2006 11:32:08 AM ~ Terri - may be seeking services in other facilities and
not going thru Medicare.
3:18:12 ~
1/17/2006 11:32:33 AM ~ Berger - Select Committee suggested that the footnote
to not revert unused funds to GF.
3:19:22 ~
1/17/2006 11:33:43 AM ~ Peck - per capita income increase, we continue to see
people eligible for services are increasing.
Average number of people receiving services each month in high 5,000's.
3:20:29 ~
1/17/2006 11:34:50 AM ~ Philp - don't see increase.
3:20:49 ~
1/17/2006 11:35:10 AM ~ Peck, if going up considerably we may be under
budgeted. We do have some flexibility
to provide services.
3:21:23 ~
1/17/2006 11:35:45 AM ~ Philp - inflation increase not reflected.
3:21:39 ~
1/17/2006 11:36:01 AM ~ Peck - correct
3:21:45 ~
1/17/2006 11:36:07 AM ~ Warren - numbers of pregnant moms decrease, increase?
3:22:26 ~
1/17/2006 11:36:48 AM ~ Peck - an error, remaining same.
3:22:45 ~
1/17/2006 11:37:06 AM ~ Job - asking for additional funds to make end of
biennium whole? Where is it in this budget
to get next bienniums?
3:23:29 ~
1/17/2006 11:37:50 AM ~ Peck - save 7% on current will positively affect next
year. We should save $
3:25:02 ~
1/17/2006 11:39:23 AM ~ Job - keep flat
3:25:15 ~
1/17/2006 11:39:36 AM ~ Peck our goal is to work within our budget, with Gov.
suggested with better cost containment
3:26:18 ~
1/17/2006 11:40:40 AM ~ Job when DD folks call complaining of cuts, I want to
refer them to you.
3:26:43 ~
1/17/2006 11:41:05 AM ~ Peck - more money put into DD/
3:26:58 ~
1/17/2006 11:41:20 AM ~ Sherard - last few years have been demoralizing, trying
to do good job, manage our funds, we will be back in supplemental budget for
more money, hope it won't be a lot of money.
Trying to be good stewards. We
will deal with it if it is a problem.
3:28:42 ~
1/17/2006 11:43:03 AM ~ Job - all share concerns, DOH up 15% each year. Hard to believe you are that good, getting
hard questions.
3:29:31 ~
1/17/2006 11:43:53 AM ~ Nicholas - 23% increase in budget, may be 27 -
30%. we cannot sustain this type
increase in this budget each year.
Concern that if you have to make up 7% to sustain budget, assumes no
increases in Standard Budget. Likely
need to make 14% in cost containment.
Applaud efforts to get hold of this.
Your heart is in the right place.
Only 7% at no growth, know rate increases will come, so this is not all.
3:32:14 ~
1/17/2006 11:46:36 AM ~ Peck - heard message of last year that JAC was
concerned about increases. Gov. also
concerned. There is not a $200m hit to
help budget. If you want to hedge your
bets, understand. We must be careful
how to spend our money. We hope to have
better information at Supplemental Budget.
3:34:23 ~
1/17/2006 11:48:44 AM ~ Sherard, set goals, during bust cycle we have to cut
back. Would like to build in accurate
COLA to know what is amount. Complex,
but provide more ability to give accurate information.
3:35:49 ~
1/17/2006 11:50:11 AM ~ Jorgensen - applaud efforts, all share desire to
provide health care if needed, put choke collar on agency, we cannot live with
increases, now setting aside an amount just in case. We have an administrative team in place. Want to level playing
field, state has $, but enough folks want to be fair. Let someone administer.
3:38:18 ~
1/17/2006 11:52:39 AM ~ Nicholas - don't make bet to have to hedge. If this is your approach, fine. There is a bet out there,
3:39:04 ~
1/17/2006 11:53:25 AM ~ Simpson #1, p. 135, why list under Adult Services
Foster Care, etc?
3:39:47 ~
1/17/2006 11:54:08 AM ~ Peck - cover in one place to avoid piecemealing thru
entire budget.
3:40:12 ~
1/17/2006 11:54:33 AM ~ Simpson - immediate need?
3:40:20 ~
1/17/2006 11:54:42 AM ~ Peck - yes, on top of request or built in?
3:40:45 ~
1/17/2006 11:55:06 AM ~ Peck - additional $ to 2007-2008 budget.
3:41:05 ~
1/17/2006 11:55:27 AM ~ Meuli - increasing Medicaid opitons added. Health Dept. asked for this increase? Appeal came from Advocacy groups. Legislature must also keep priorities.
3:42:21 ~
1/17/2006 11:56:42 AM ~ Sherard - KidCare doubled, legislature makes this
call. Leveraging ff with waivers, may
be costing more in the long run.
3:42:58 ~
1/17/2006 11:57:20 AM ~ Meuli - waiting lists?
Surrounding states have long lists, we continue to serve all.
3:43:31 ~
1/17/2006 11:57:52 AM ~ Sherard - don't know
3:43:46 ~
1/17/2006 11:58:06 AM ~ Pause
3:43:46 ~
1/17/2006 1:00:05 PM ~ Resume
3:43:46 ~
1/17/2006 1:00:05 PM ~ Philp - take lunch break, convene at 1:00
3:43:53 ~
1/17/2006 1:00:12 PM ~ Hines - Maybe we could move through - we've been asking
for more info- could speed process if you could come back on Friday or Monday.
If we had something that we operate "on same page". Maybe so we won't in on such a long
discussion.
3:46:46 ~
1/17/2006 1:03:05 PM ~ Peck - p. 140 - #1 - funding for DD child waiver
participants. The excess funds we used
for their medical costs.
3:48:56 ~
1/17/2006 1:05:15 PM ~ Meuli - When we did ed. budget they said that some of
their money was going for this program.
3:49:42 ~
1/17/2006 1:06:01 PM ~ Mikesell- There some 6B monies that education receives
we will get some. They are not included
in this budget.
3:51:07 ~
1/17/2006 1:07:26 PM ~ Simpson - children that are taken into custody are they
included??? What about relinguishment of custody??
3:51:54 ~
1/17/2006 1:08:13 PM ~ Peck - You set up a sep. EORG for foster children
3:53:09 ~
1/17/2006 1:09:28 PM ~ Chuck Hayes - I believe that they have to be medicaid
eligible to receive the services.
3:53:42 ~
1/17/2006 1:10:01 PM ~ Peck - for children that are not in DFS custody they are
in this custody.
3:54:21 ~
1/17/2006 1:10:40 PM ~ Nicholas - I assumed that all the med. services were
given to the these children.
3:55:12 ~
1/17/2006 1:11:31 PM ~ Peck - had a waiting list for the child waiver. Once they come on the waiver they are
eligible for services. Moving to mext
EORG - med. costs for foster care children Look at realignment documents p. 153 - #1 - Medicaid coverage of smoking
cessation drugs -
4:00:20 ~
1/17/2006 1:16:39 PM ~ Case - Dental Coverage - What is covered?
4:01:04 ~
1/17/2006 1:17:23 PM ~ Sherrard - In adult medicaid program we provide for 2
visits a year. If person comes in for
absess that is one visit for the year.
4:02:16 ~
1/17/2006 1:18:35 PM ~ Case - children get twice as much money than adults.
4:03:19 ~
1/17/2006 1:19:38 PM ~ Sherrard - Dr. Christianson put info together for me. A
bare bones for adults would be $750/year.
4:05:13 ~
1/17/2006 1:21:32 PM ~ Case - The people sometimes have tooth problem and have
to have it pulled then employers won't hire them.
4:06:39 ~
1/17/2006 1:22:58 PM ~ Peck - Indian Health - they bill very sporadically-
couldn't get handle on it. p. 159 - #1
- attempt to realign
4:08:33 ~
1/17/2006 1:24:52 PM ~ Job -
4:09:44 ~
1/17/2006 1:26:03 PM ~ Case - Base on # of medicaid eligible
4:10:12 ~
1/17/2006 1:26:31 PM ~ Peck - p. 162 - #1 - Chg. in medicaid fed. match rate at
state hospital
4:11:37 ~
1/17/2006 1:27:56 PM ~ Warren-
4:11:55 ~
1/17/2006 1:28:14 PM ~ Hernandez - Ages of 21 -65 are not eligible for
medicaid. We have about 12 over the age
of 65. Seldom that we have any under
21.
4:12:56 ~
1/17/2006 1:29:15 PM ~ Peck - #1 - DD adult wiver services
4:15:59 ~
1/17/2006 1:32:18 PM ~ Case - You made the projection based on # that was on
the list on July 1st, but we came up less??
4:17:32 ~
1/17/2006 1:33:51 PM ~ Peck - Let Mikesell answer
4:18:46 ~
1/17/2006 1:35:05 PM ~ Mikesell- Took all off list last spring. Some had less needs than most.
4:19:19 ~
1/17/2006 1:35:38 PM ~ Case - How do we decide when we are going to assist
these families or not??
4:20:05 ~
1/17/2006 1:36:24 PM ~ Mikesell- I believe that committee wants to have 50
out-of-home placement. Want to have a group home, etc. Will cost over $500K.
4:21:11 ~
1/17/2006 1:37:30 PM ~ Case - Is the Training School an option ?
4:21:52 ~
1/17/2006 1:38:11 PM ~ Mikesell- Have been offering the Training School as a
option for some in least restrictive environment.
4:22:32 ~
1/17/2006 1:38:51 PM ~ Case - Do they receive dental service? If you are at the Training School you get
free dental service.
4:23:45 ~
1/17/2006 1:40:04 PM ~ Sherrard - I think that we need to let the families make
some of those decisions if they are presented w/ the options.
4:24:51 ~
1/17/2006 1:41:10 PM ~ Berger - Don't see the projections for the ones for the
future. Those that are participating in
this program.
4:26:01 ~
1/17/2006 1:42:20 PM ~ Peck - Need to look at all the providers for the state.
4:26:37 ~
1/17/2006 1:42:56 PM ~ Sherrard -
4:29:23 ~
1/17/2006 1:45:42 PM ~ Job - do we have rules and regs for all these programs??
4:29:59 ~
1/17/2006 1:46:18 PM ~ Mikesell- Yes, there are some rules and regs.
4:30:20 ~
1/17/2006 1:46:39 PM ~ Job - We have excess funds now.
4:31:14 ~
1/17/2006 1:47:33 PM ~ Mikesell-In August projections
4:32:18 ~
1/17/2006 1:48:37 PM ~ Hines - Adult DD waivers - same type of - info -
4:33:42 ~
1/17/2006 1:50:01 PM ~ Peck - It applies to all 3 waivers. I'll redo & bring the figures to you.
4:35:16 ~
1/17/2006 1:51:35 PM ~ Case - we had a footnote on a project to get pay up for
community base programs.
4:36:49 ~
1/17/2006 1:53:08 PM ~ Mikesell- Legis granted 3% inc. for director's
salariesl, etc.
4:38:11 ~
1/17/2006 1:54:30 PM ~ Philp - DD Children's Waiver Services
4:38:50 ~
1/17/2006 1:55:09 PM ~ Peck - p. 169, #1 Additional funding for current
caseload
4:39:45 ~
1/17/2006 1:56:04 PM ~ Meuli- Is this where you give some to children?
4:40:13 ~
1/17/2006 1:56:32 PM ~ Mikesell- That is in the DD Preschool budget.
4:40:30 ~
1/17/2006 1:56:49 PM ~ Peck - Acquired Brain Injury Waiver Services -We've
recommended 10 mil
4:41:24 ~
1/17/2006 1:57:43 PM ~ Case - Some services are provided at the training
School. Is there a need for more ABI
services??
4:42:01 ~
1/17/2006 1:58:20 PM ~ Mikesell- Don't have any on waiting list. Some would want to use the facilities there.
4:43:22 ~
1/17/2006 1:59:41 PM ~ Case - Superintendent Hudson -
4:43:58 ~
1/17/2006 2:00:17 PM ~ Hudson - ABI program has been small - have been looking
at the prog. - Could provide additional
services there w/ staff that we have.
In order to accommodate many more we would need some extra staff. Not tried to identify the # that could. We
haven't tried to solicit. There
probably are a number that could be provided for here.
4:46:40 ~
1/17/2006 2:02:59 PM ~ Meuli - Limiting the number either in actual #'s or in
monies. Need to evaluate the people
that are in this program. Have
reevaluate these people that are in the program?? There was a footnote.
4:48:42 ~
1/17/2006 2:05:01 PM ~ Mikesell- There was a footnote that put cap of 85 on
participants. That was struck last
year. We did consider some others. Am continuning to accept applicants.
4:49:39 ~
1/17/2006 2:05:58 PM ~ Job - # of ABI because of Iraq because of headgear, etc.
- let them know that there services
4:50:54 ~
1/17/2006 2:07:13 PM ~ Anderson - In regard to having been through this. There is much hope with this type of injury.
4:53:53 ~
1/17/2006 2:10:12 PM ~ Case - Need to go out and be more aggressive. Best treatment is in 1st year.
4:54:38 ~
1/17/2006 2:10:57 PM ~ Sherrard - My policy is to keep treatment in WY if we
can.
4:55:45 ~
1/17/2006 2:12:04 PM ~ Warren - Integrated data program. Is there a disconnect between funding and
people?
4:56:32 ~
1/17/2006 2:12:51 PM ~ Peck - There is a 6 mil surplus, but we have no one on
the waiting list p. 176 - #1 - 1.2 mil-
these people haven't had fee increase for 20 years.
4:58:33 ~
1/17/2006 2:14:52 PM ~ Berger - Curious for a projection for '07-'08.
4:58:58 ~
1/17/2006 2:15:17 PM ~ Philp -
4:59:50 ~
1/17/2006 2:16:09 PM ~ Nicholas - When you predict your increases are you
getting rid of waiting list. If you maintain the list
5:01:51 ~
1/17/2006 2:18:10 PM ~ Case - On assisted living waiver - is it a good deal for
us rather than a nursing home.
5:03:03 ~
1/17/2006 2:19:22 PM ~ Morrow - Administrator of Aging - It is about half than
for a nursing home. Provide services in
a more humane place.
5:05:50 ~
1/17/2006 2:22:09 PM ~ Case - why don't we get rid of nursing home- just keep
assisted living facilities???
5:06:47 ~
1/17/2006 2:23:06 PM ~ Morrow- didn't think that we should come in every year
and ask for more.
5:07:43 ~
1/17/2006 2:24:02 PM ~ Case - Is it cost effective???
5:08:56 ~
1/17/2006 2:25:15 PM ~ Meuli - Long term care in nursing home has more
personnel - Are you telling me that
there are less and less people ending up in assisted living??
5:09:57 ~
1/17/2006 2:26:16 PM ~ Morrow - Yes, # in nursing homes has declined because we
have so many in home programs - effective.
5:10:43 ~
1/17/2006 2:27:02 PM ~ Philp - p. 182
5:11:10 ~
1/17/2006 2:27:29 PM ~ Peck - Bill at fed. level to cut back on match in some
states. WY was one of states most
affected. If bill passes, we may have further reduction.
5:12:57 ~
1/17/2006 2:29:16 PM ~ Nicholas, budgeted fed. match is first, expect second
reduction.
5:13:28 ~
1/17/2006 2:29:47 PM ~ Peck - we estimated what 07 and 08 rates would be. We
received final 07 rate after budget was submitted. We projected 08 again, and
think it is accurate.
5:14:48 ~
1/17/2006 2:31:07 PM ~ Hines final rate?
5:14:56 ~
1/17/2006 2:31:15 PM ~ Peck combined rate for months within each year.
5:15:30 ~
1/17/2006 2:31:49 PM ~ Simpson - why rate on p. 183 same?
5:16:20 ~
1/17/2006 2:32:39 PM ~ Peck - accidentally calculated
5:16:50 ~
1/17/2006 2:33:09 PM ~ Hines - feds give, state lose.
5:17:08 ~
1/17/2006 2:33:27 PM ~ Peck - tougher budgets, prescription drugs, new AORG
State Health Officer, p. 200 Public Health Preparedness p. 202 ol Bioterrorism
5:19:01 ~
1/17/2006 2:35:20 PM ~ Sherard - 16 + 1 positions to be put into standard
budget, all fed. funds
5:19:51 ~
1/17/2006 2:36:10 PM ~ Peck - ORACLE software, 100% ff, p. 204 Computer
equipment all ff.
5:20:51 ~
1/17/2006 2:37:10 PM ~ Meuli - all approved by CIO
5:21:01 ~
1/17/2006 2:37:20 PM ~ Sherard, yes and Gov.
5:21:07 ~
1/17/2006 2:37:26 PM ~ Sherard, Bioterrorism, move position
5:21:43 ~
1/17/2006 2:38:02 PM ~ Peck, support services all ff
5:21:53 ~
1/17/2006 2:38:12 PM ~ Peck - p. 215 Poision Center Telehealth p. 218 funds cut
from fed. budget, likely won't receive these funds.
5:23:04 ~
1/17/2006 2:39:23 PM ~ Sherard - WY has been trying to get this going. Trying to set up collaborative effort with
Albany Co. nurses, veterans come into office and teleconference to VA Center in
Cheyenne. Successful program, in limbo.
5:24:17 ~
1/17/2006 2:40:36 PM ~ Simpson, p. 218
list.
5:24:57 ~
1/17/2006 2:41:16 PM ~ Sherard that grant went away.
5:25:17 ~
1/17/2006 2:41:36 PM ~ Simpson - any funds available?
5:25:34 ~
1/17/2006 2:41:53 PM ~ Sherard - none available, working with Sen. Schiffer to
see if it can be combined with mental health?
5:26:10 ~
1/17/2006 2:42:29 PM ~ Sherard - will get info. Rep. Berger requested
5:26:32 ~
1/17/2006 2:42:51 PM ~ Warren - will the bill coming out be where funding will
go?
5:26:53 ~
1/17/2006 2:43:12 PM ~ Sherard - haven't made recommendations as we don't know
form of bill.
5:27:15 ~
1/17/2006 2:43:34 PM ~ Peck - #2 request changes funding for 2 positions, now
changed.
5:28:05 ~
1/17/2006 2:44:24 PM ~ Peck p. 222 Health and Safety - if fed. funding is not
available, can positions be left.
5:29:10 ~
1/17/2006 2:45:29 PM ~ Sherard - telehealth widely used in AK, other rural
states, has strengths, some weaknesses.
Immeasurably important. Need to
make it stick in WY.
5:30:30 ~
1/17/2006 2:46:49 PM ~ Anderson - State Pen connection and State Hosp.?
5:30:50 ~
1/17/2006 2:47:09 PM ~ Sherard, is a connection to State Pen, underutilized.
Introduced Linda Chasson
5:31:33 ~
1/17/2006 2:47:52 PM ~ Peck - hospitals
5:31:52 ~
1/17/2006 2:48:11 PM ~ Peck - Vital Records, p. 227 software needed
5:32:57 ~
1/17/2006 2:49:16 PM ~ Peck - p. 228 to collect fees to adjust fed. funding
which was B-11'd. request to make part of standard budget. Cancer surveillance
#1 #2 eligible for ff.
5:35:13 ~
1/17/2006 2:51:32 PM ~ Meuli - what part is spent on treatment? Chasson -
programs explained.
5:36:11 ~
1/17/2006 2:52:30 PM ~ Peck - $1.4m for treatment breast and cervical cancer.
5:36:35 ~
1/17/2006 2:52:54 PM ~ Peck - public health laboratory, many requests, p. 242
thru 245 for 7 requests.
5:37:29 ~
1/17/2006 2:53:48 PM ~ Philp questions on any?
5:38:42 ~
1/17/2006 2:55:01 PM ~ Meuli charges to other depts.?
5:38:59 ~
1/17/2006 2:55:18 PM ~ Sherard, looking into this, but not done yet.
5:39:13 ~
1/17/2006 2:55:32 PM ~ Meuli - fed. approved
5:39:22 ~
1/17/2006 2:55:41 PM ~ Sherard 99% sure it is.
5:39:30 ~
1/17/2006 2:55:48 PM ~ Pause
5:39:30 ~
1/17/2006 3:12:39 PM ~ Resume
5:39:30 ~
1/17/2006 3:12:39 PM ~ Philp - take 10 min. break
5:39:44 ~
1/17/2006 3:12:53 PM ~ Peck p. 253 HIV Prevention
5:40:53 ~
1/17/2006 3:14:02 PM ~ Chasson - Hepetitis vaccine had been provided by a
grant, discontinued, asking funding to be from GF.
5:41:27 ~
1/17/2006 3:14:36 PM ~ Peck 100% ff
5:41:49 ~
1/17/2006 3:14:58 PM ~ Meuli - do you have enough funding to provide services
fro HIV Aids
5:42:18 ~
1/17/2006 3:15:27 PM ~ Chasson - 10 new cases of HIV and 5 new Aids, expect
further cases
5:42:48 ~
1/17/2006 3:15:56 PM ~ Meuli waiting lis?
5:42:54 ~
1/17/2006 3:16:02 PM ~ Chasson, no.
5:43:00 ~
1/17/2006 3:16:09 PM ~ Peck
5:43:30 ~
1/17/2006 3:16:39 PM ~ Peck - Radon project reduction in funding
5:44:01 ~
1/17/2006 3:17:10 PM ~ Philp - TB controls, no
exception request
5:44:35 ~
1/17/2006 3:17:44 PM ~ Meuli how many new TB cases?
5:44:45 ~
1/17/2006 3:17:53 PM ~ Sherard - 4-5, not many
5:45:06 ~
1/17/2006 3:18:15 PM ~ Peck p. 279 some
tobacco impact money included as it has an effect on cardiovascualar disease.
5:45:59 ~
1/17/2006 3:19:08 PM ~ Meuli - how much money is in Tobacco Trust Fund? Principle or interest only?
5:46:28 ~
1/17/2006 3:19:37 PM ~ Peck - cannot dip into principle. Interest is available for use by
programs. Some goes into permanent
trust. Meet each fall to make
recommendations.
5:47:35 ~
1/17/2006 3:20:44 PM ~ Meuli - balance?
5:47:43 ~
1/17/2006 3:20:52 PM ~ Peck - not sure of
5:47:57 ~
1/17/2006 3:21:06 PM ~ Warren - can we get updated report on what remains in
fund.
5:48:23 ~
1/17/2006 3:21:32 PM ~ Peck actually managed by Gov. office, I;ll try to get
info.
5:48:45 ~
1/17/2006 3:21:54 PM ~ Peck - genetics progam moved to Family Health
5:49:14 ~
1/17/2006 3:22:23 PM ~ Sherard - some still contracted out.
5:49:37 ~
1/17/2006 3:22:46 PM ~ Peck - Diabetes Control p. 290 Lead Poisioning moved to
Radon project. Bioterrorism - moved
Infectious disease Epidemiology p. 300
5:51:20 ~
1/17/2006 3:24:28 PM ~ Philp - why in DOH?
5:51:37 ~
1/17/2006 3:24:45 PM ~ Sherard Public health function
5:51:49 ~
1/17/2006 3:24:58 PM ~ Peck - funds not eligible for management positions
5:52:34 ~
1/17/2006 3:25:43 PM ~ Peck #3 corrects ff, added by B-11 in past
5:52:57 ~ 1/17/2006
3:26:06 PM ~ Meuli - any MD's in Epidemiology?
5:53:21 ~
1/17/2006 3:26:30 PM ~ Sherard - 3 Physicians in dept. + at State Hosp. have 8-9 psychiatrists + @ State Training
School.
5:54:05 ~
1/17/2006 3:27:14 PM ~ Peck - Breast Cervical Cancer combined Mental Health, p.
317 - WINDS Program, move patients from State Hosp. to homes. #2
5:55:58 ~
1/17/2006 3:29:07 PM ~ Simpson - what database is being built?
5:56:16 ~
1/17/2006 3:29:25 PM ~ Chuck Hayes, WY Client
5:56:39 ~
1/17/2006 3:29:48 PM ~ Meuli - how many served by Mental Health grant?
6:00:00 ~
1/17/2006 3:33:08 PM ~ Hayes - Fremont
Co, Peak Wellness, and Casper are places that receive $ from this. Suicide
Prevention - standard budget Peck State
Hospital p. 329 #1-5 are increases in costs at state hospital. Never adjusted increase of these costs over
the years. Hospital managed these
increases by using float. Want accurate budgets.
6:03:49 ~
1/17/2006 3:36:58 PM ~ Peck - go individually?
6:04:13 ~
1/17/2006 3:37:21 PM ~ Warren p. 321 Gov. directed State Hospital to
6:04:38 ~
1/17/2006 3:37:47 PM ~ Dr. Hernandez - great collaboration for cheaper costs.
Will continue to spend this.
6:05:15 ~
1/17/2006 3:38:24 PM ~ Simpson #2 part of $2m payment for services under Title
25, contract with other facilities if cannot take at State Hosp?
6:06:00 ~
1/17/2006 3:39:09 PM ~ Hernandez - If non-residents of WY are put thru testing
under Title 25, they become cost of hospital if waiting for bed.
6:07:07 ~
1/17/2006 3:40:15 PM ~ Philp - about 1/2 of equipment was denied by Gov. Move to electronic records rated mid-grade
by CIO.
6:08:17 ~
1/17/2006 3:41:26 PM ~ Peck - canteen, p. 340
6:09:30 ~
1/17/2006 3:42:38 PM ~ Peck introduced Steven Gilmore, new Substance Abuse
coordinator
6:10:38 ~
1/17/2006 3:43:46 PM ~ Philp - 100% fed funds?
Need a correction.
6:11:47 ~
1/17/2006 3:44:56 PM ~ Peck Explained substance abuse priorities
6:12:55 ~
1/17/2006 3:46:04 PM ~ Gilmore - DASIS
p. 350 #6 now eligible for fed. funds. #7 First Lady addressed this
morning
6:14:04 ~
1/17/2006 3:47:13 PM ~ Meuli - where does DASIS come from?
6:14:18 ~
1/17/2006 3:47:26 PM ~ Gilmore -ff, sub-recipient, B-11 also.
6:15:04 ~
1/17/2006 3:48:13 PM ~ Peck #8 reclassified position, from ff to gf.
6:15:37 ~
1/17/2006 3:48:45 PM ~ Simpson - p. 354
does this inlude fed. fees professional services?
6:16:26 ~
1/17/2006 3:49:35 PM ~ Peck it is where it should be, let me look at how we
adjusted that account. Under #2 added
ff, otehrs.
6:17:46 ~
1/17/2006 3:50:55 PM ~ Simpson - grants and aids payments. GF $ for Fed grants?
6:18:09 ~
1/17/2006 3:51:18 PM ~ Peck accumulation of all fed grants added to budget. p.
349 is applicable budgets to apply funds to. p. 350 #4, reductions
6:19:31 ~
1/17/2006 3:52:40 PM ~ Simpson - I get it.
6:19:41 ~
1/17/2006 3:52:50 PM ~ Peck #9 for ads to support First Lady's Underaged
Drinking Initiative.
6:20:21 ~
1/17/2006 3:53:29 PM ~ Philp - has it been transferred?
6:20:31 ~
1/17/2006 3:53:40 PM ~ Peck - no
6:20:37 ~
1/17/2006 3:53:46 PM ~ Nicholas - why not?
6:21:27 ~
1/17/2006 3:54:36 PM ~ Peck - needed a person, found one which was fjully ff,
needed to reclassify.
6:22:08 ~
1/17/2006 3:55:17 PM ~ Peck - need to find like funding positons if you
change. We had taken vacant positions.
6:23:51 ~
1/17/2006 3:57:00 PM ~ Sherrard - We have evaluated every position in dept.
6:25:20 ~
1/17/2006 3:58:28 PM ~ Peck - p. 364 -
p. 367 #1 - in Children & Families Initiative- courts - Funding for
problem solving courts
6:27:02 ~
1/17/2006 4:00:11 PM ~ Philp - Is that in a bill?
6:27:15 ~
1/17/2006 4:00:23 PM ~ Nicholas - Bill coming through that is an agregate????
6:27:43 ~
1/17/2006 4:00:52 PM ~ Peck - a 17 mil $ bill and this is only part of a bill
6:28:05 ~
1/17/2006 4:01:14 PM ~ Sherrard - there were 3 bills
6:28:16 ~
1/17/2006 4:01:25 PM ~ Peck - p. 370 - Substance abuse - just biennalizes this program
6:29:14 ~
1/17/2006 4:02:23 PM ~ Gilmore - program is quite a bit of initiative
throughtout the state w/ meth DEQ training comes from this - Dr. Barber
6:30:41 ~
1/17/2006 4:03:50 PM ~ Warren - ques. on p. 369 - tobacco Settlement income
acct in amt of $555,000 is used for service contracts for data collection
-could we get all the data collection together???
6:32:10 ~
1/17/2006 4:05:19 PM ~ Sherrard - this is very important and we are trying to
consolidate and these are some of tasks so we are not being redundant
6:32:49 ~
1/17/2006 4:05:58 PM ~ Warren - sounds like issue you are looking at, etc.
6:33:16 ~
1/17/2006 4:06:24 PM ~ Sherrard - Large substance abuse bill, etc
6:33:51 ~
1/17/2006 4:06:59 PM ~ Anderson - report that came out of Dept of Health about
Meth that would provide wealth of info to answer some of your questions
6:34:42 ~
1/17/2006 4:07:51 PM ~ Meuli - We did
put a bill through that had lot of money for meth initiative.
6:35:13 ~
1/17/2006 4:08:22 PM ~ Peck- Might be referring to 3 mil $ that was given to
Dept of Health.
6:36:05 ~
1/17/2006 4:09:13 PM ~ Hazard - Fiscal manager - HB 308 was appropriated to us
- 1 mil went to prevention - monies went into communities.
6:37:38 ~
1/17/2006 4:10:47 PM ~ Nicholas- can you give how much has been funded and how
much really needs to be funded again.
6:38:27 ~
1/17/2006 4:11:35 PM ~ Sherrard - We have been in upheavel and Gilmore has been
here short time. Treatment for
substance abuse is very individualized- same treatment doesn't work for all
patients. We've learned a lot.
6:39:49 ~
1/17/2006 4:12:58 PM ~ Nicholas - HB 58 - substance abuse - do you and labor go
over every year what has been spent and how much do you need???
6:41:25 ~
1/17/2006 4:14:34 PM ~ Meuli - I would like to see where 3 mil $$ was spent.
6:41:56 ~
1/17/2006 4:15:05 PM ~ Sherrard - We do keep track of where money was
spent. Meth is incredibly difficult to
treat - much longer time than alcohol
6:43:17 ~
1/17/2006 4:16:26 PM ~ Simpson- p. 370 - #1 req. for drug courts - 3 new ones
and 1 more in fall - it is in anticipation of more coming on in bien.
6:44:49 ~
1/17/2006 4:17:58 PM ~ Peck - p. 377 -
6:46:06 ~
1/17/2006 4:19:15 PM ~ Mikesell - all individuals come under this program. Select committee on developmental programs -
Dr. Linda Gitsee- after the studies will be sponsoring either HB 12 - 12 mil $$
to fund developmental preschool. In
past conducted count of children - Utah State Univ. study is rec. approx.
72.06/child.
6:51:16 ~
1/17/2006 4:24:25 PM ~ Warren - We heard about some wants for child care
centers. We don't need to have
redundancy- Hope that all dept. are talking together with regards to all of
these programs.
6:52:49 ~
1/17/2006 4:25:57 PM ~ Simpson - Help me understand how you arrived the 2.8 mil
figure. What per child/per yr amount
did you use?
6:53:29 ~
1/17/2006 4:26:37 PM ~ Mikesell - $52.10 amount
6:53:40 ~
1/17/2006 4:26:49 PM ~ Berger - What formula did you use here????
6:54:16 ~
1/17/2006 4:27:25 PM ~ Mikesell- p. 377 - Look at table
6:55:05 ~
1/17/2006 4:28:14 PM ~ Meuli - Why do we see the increase in the young pop???
6:55:21 ~
1/17/2006 4:28:30 PM ~ Mikesell- In '07 and '08
6:57:01 ~
1/17/2006 4:30:10 PM ~ Meuli - Why are we seeing such an increase in #'s?
6:57:52 ~
1/17/2006 4:31:01 PM ~ Nicholas - follow up on Simpson's question Having hard
time seeing this. We look at this
during callbacks.
6:59:22 ~
1/17/2006 4:32:31 PM ~ Peck - Competitive advantage
6:59:56 ~
1/17/2006 4:33:05 PM ~ Philp - What # of students did you use to
calculate? Can bring this back with you
at callbacks. I will recalculate this
for you.
7:00:44 ~
1/17/2006 4:33:53 PM ~ Peck - p. 399 - State training school Want to see what
actual costs are here.
7:03:00 ~
1/17/2006 4:36:09 PM ~ Case - gen. questions to track this budget- what about
positons???
7:03:55 ~
1/17/2006 4:37:04 PM ~ Sherrard - 14 positions - some were reallocated before I
came on - Want to look at lots of
their programs, etc. and see what needs
to be kept and changed.
7:06:45 ~
1/17/2006 4:39:54 PM ~ Case - would you tell us about the condition of the
training center/
7:07:19 ~
1/17/2006 4:40:28 PM ~ Diana - Survey last fall - one of most highly rated
facility in nation. Usually a facility
has at least 100 deficiencies- training center in Lander really had only 34
deficiencies & so it probably is the best in the nation. want to evaluate
& decide where we need to improve.
We serve ventilator patients and others won't.
7:11:03 ~
1/17/2006 4:44:12 PM ~ Job - want to respond to something Dr. Sherrard
said. Have we added to that number of
specialists???
7:11:56 ~
1/17/2006 4:45:05 PM ~ Sherrard - We have been looking at that.
7:12:56 ~
1/17/2006 4:46:05 PM ~ Mikesell- little over 900 providers
7:15:11 ~
1/17/2006 4:48:20 PM ~ Job - was it a money issue??
7:15:29 ~
1/17/2006 4:48:38 PM ~ Sherrard - Haven't been on job long enough to feel
comfortable doing that
7:17:05 ~
1/17/2006 4:50:14 PM ~ Peck - if you look at equipment needs - Hudson came up
w/ list #3 information technology - chg
out some monitors
7:21:58 ~
1/17/2006 4:55:06 PM ~ Peck -p. 416- Division on Aging - p. 418 - T & A
account & conference Senior Care -
p. 427 - Fits in w/ long tern and assisted living
7:23:52 ~
1/17/2006 4:57:01 PM ~ Case- inc. funding - are we talking about inc. per
person cost, etc.
7:24:27 ~
1/17/2006 4:57:35 PM ~ Morrow -In-home
services are growing - not as many fees are collected. Not able to provide as much because the
poverty level = can't pay fees $800,000 is to help them
7:26:41 ~
1/17/2006 4:59:50 PM ~ Case - are we going to see cost for assisted living
also???
7:27:01 ~
1/17/2006 5:00:10 PM ~ Morrow - this is an incredible economic program- falls on local providers to provide the 25%
match. Family caregivers give most of care- this just helps them. Imp. and cost effective program Want to
keep people out of instutions 4
counties don't have this program because the providers don't want to give 25%
match.
7:32:30 ~
1/17/2006 5:05:38 PM ~ Peck - Nutritional services, p. 441 - inc. fed funding
7:33:28 ~
1/17/2006 5:06:36 PM ~ Meuli - do you anticipate an increase in costs?
7:34:26 ~
1/17/2006 5:07:35 PM ~ Morrow - trend over yrs the nutritional funding by feds
has been flat. Have been told that
there might have 1% increase, but with other adjustments it will probably be
flat
7:35:53 ~
1/17/2006 5:09:02 PM ~ Peck - #2 p. 441
7:37:49 ~
1/17/2006 5:10:57 PM ~ Meuli - if fraud is found would you get some funds?
7:38:19 ~
1/17/2006 5:11:28 PM ~ Morrow - no, it would go back to feds
7:38:36 ~
1/17/2006 5:11:45 PM ~ Peck - p. 459 - funding to give more money to senior
centers many of programs have been
moved to medicaid Pioneer Home -
7:41:25 ~
1/17/2006 5:14:33 PM ~ Jack Tarter - Pioneer Home - Inc. in utilities and food
7:42:38 ~
1/17/2006 5:15:47 PM ~ Peck - Veterans Home - get some help from VA
7:43:20 ~
1/17/2006 5:16:28 PM ~ Hines
7:43:23 ~
1/17/2006 5:16:32 PM ~ Tarter - get some funds to offset gen fund
7:43:59 ~
1/17/2006 5:17:07 PM ~ Peck - p. 487 -
p. 490 - retirement center - gov has asked us to do an analysis some changes in residents counts - think
that it won't be self-sufficient, think
that it will need some gen. funds gov
approved some #3 was denied p. 498 -
donations to Pioneer Home
7:50:29 ~
1/17/2006 5:23:37 PM ~ Meuli - talked about formula in nursing homes to be
rebased. Is there enough money to cover
that???
7:51:01 ~
1/17/2006 5:24:10 PM ~ Peck - we are working on that now, but we aren't far
enough ahead yet.
7:51:53 ~
1/17/2006 5:25:02 PM ~ Meuli- that is still in process and there may be req.
for additional funds??
7:52:43 ~
1/17/2006 5:25:52 PM ~ Peck - that is a possibility.
7:53:22 ~
1/17/2006 5:26:31 PM ~ Tarter - ABI - Sen Job - the milenium act req. that the
Veterans paid full
7:54:02 ~
1/17/2006 5:27:11 PM ~ p. 501 - SBC rec. denial of the const. for state
hospital inpatient care area p. 504 -
warehouse addition at Training School- approved by SBC & governor p. 506 - Day program remodel at Training
School - SBC recommended and gov recommended
7:57:33 ~
1/17/2006 5:30:41 PM ~ Pause
7:57:33 ~
1/17/2006 5:32:36 PM ~ Stop Recording