Committee on Health
FY14 DOH Budget Questions
Department of Health
1.
Please provide the following budget information for FY13 and FY14 for the Department of Health
(DOH). For FY13, please include the amount approved and expenditures to date. a.
At the agency level, please provide the information broken out by source of funds and by
Comptroller Source Group and Comptroller Object b.
At the program level, please provide the information broken out by source of funds and by
Comptroller Source Group and Comptroller Object; and c.
At the activity level, please provide the information broken out by source of funds and by
Comptroller Source Group.
Please see AMP submission.

Committee on Health
FY14 DOH Budget Questions
2.
Please list any Memoranda of Understanding (MOU) DOH has either entered into, or is planning to enter into, during FY13 and FY14. In addition, please list what agency the MOU is with, how much the MOU is for, what programs or services the MOU will support, and if the funds for FY13 MOUs have been transmitted.
Please see AMP submission.
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Committee on Health
FY14 DOH Budget Questions
3.
For each program within DOH, please provide the following: a.
Please explain any FTE increases/decreases contained within the proposed FY14 budget. In addition, please provide copies of any workforce planning strategies that have been developed to address critical vacancies within DOH.
The FY14 budget contains a proposed reduction of 5.7 FTE’s in HAHSTA. HAHSTA attributes this reduction as a result of the realignment action which took place in January 2013. No additional reductions are planned for FY14.
b.
A list of all federal grants awarded or anticipated for FY14. Include the grant amount, grant purpose, grant period, grant liquidation period, and whether or not FY14 funds represent carryover from previous years.
Please see attachment. c.
A list of any contracts that will be entered into for FY14, including any multiyear contracts that will continue in FY14. Please make sure the response for the program level includes the vendor, a detailed description of the services to be provided, contract amount, contract period, funding source, and whether or not it was competitively bid.
Please see attachment. d.
A list of any sub-grants that will be awarded in FY14, including any FY13 sub-grants that will continue in FY14. Include the sub-grantee, a detailed description of the services to be provided, sub-grant amount, sub-grant period, funding source, and whether or not it was competitively bid.
Please see AMP submission. e.
A list of any human care agreements that will be executed in FY14, including any FY13 human care agreements that will continue in FY14. Include the sub-grantee, a detailed description of the services to be provided, human care agreement amount, human care agreement period, funding source, and whether or not it was competitively bid.
HAHSTA does not have any human care agreements that will be executed in FY14. f.
A list of any projected surpluses or deficits for FY13.
HAHSTA does not anticipate any projected surpluses or deficits for FY13.
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Committee on Health
FY14 DOH Budget Questions
4.
Please provide the following: a.
An accounting of all anticipated special purpose revenue funds for FY14 and FY13 including the source of the funds and the intended purpose. The Department’s response should address the following funds: i.
General Counsel – FOIA; ii.
Methadone Fees; iii.
EMS Fees; iv.
Pharmacy Protection; v.
Radiation Protection; vi.
Board of Medicine; vii.
ICF/MR Fees and Fines; viii.
SHPDA Fees; ix.
SHPDA Admission Fee; and x.
Any additional special purpose revenue funds within the agency.
HAHSTA does not have special purpose revenue funds for FY14.
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Committee on Health
FY14 DOH Budget Questions
5.
Please list all program enhancements within the proposed FY14 DOH budget, broken out by program. For each program enhancement, please indicate if it is a new initiative, an expansion of existing services, or a restoration of prior services.
HAHSTA does not have any program enhancements proposed in the FY14 budget.
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Committee on Health
FY14 DOH Budget Questions
6.
Please list all technical adjustments within the proposed FY14 DOH budget, broken out by program.
For each technical adjustment, please provide a description and rationale along with the associated dollar amounts and FTEs (if applicable).
There are no technical adjustments within the proposed FY14 DOH/HAHSTA budget.
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Committee on Health
FY14 DOH Budget Questions
7.
Please list all reductions within the proposed FY14 DOH budget, broken out by program. For each reduction, please provide a description and rationale along with the associated dollar amounts and
FTEs (if applicable).
HAHSTA has a reduction $310,726 and 2.5 FTEs in Private Grant funds as the Fred Hutchinson Cancer
Grant, associated with the Testing Linkage to Care (TLC) Plus Study, ends in FY 2013. HAHSTA does not expect any impact on service delivery or individuals.
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Committee on Health
FY14 DOH Budget Questions
8.
Please provide a breakdown of fixed costs within the FY14 budget, broken out by program. This includes: utilities (CSG 30); telecommunications (CSG 31); rent (CSG 32); janitorial services (CSG
33); security services (CSG 34); and occupancy (CSG 35).
Please see AMP submission.
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Committee on Health
FY14 DOH Budget Questions
9.
Please provide a list of all facilities maintained by DOH, including square footage, facility name, location, description, leased/owned designation, ward, lease number, rent, and other fixed costs that are included in the cost of rent (utilities, security, etc.). Please provide a narrative description of any proposed facility changes for FY14.
Please see AMP submission.
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Committee on Health
FY14 DOH Budget Questions
10.
Please provide DOH’s proposed capital budget authority and spending plan for FY14. Please distinguish between any new funds for FY14 and any previously allocated funds. In addition, please provide a description of all planned capital projects for FY13 (including the DOH employee responsible for the project), any associated effect the capital projects will have on DOH’s operating budget, and a project timeline.
Please see AMP submission.
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Committee on Health
FY14 DOH Budget Questions
11.
What are DOH’s performance measures for FY14? How were these measures developed? How does the FY14 budget reflect these performance measures? For each DOH performance measure, please provide the FY14 outputs and outcomes, including the key result indicators intended to measure these outcomes.
Please see AMP submission.
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Committee on Health
FY14 DOH Budget Questions
12.
Please describe any other programmatic expansions, mayoral initiatives or anticipated reductions for
FY14. Please provide a breakdown by program and provide a detailed description, including FY14 spending plans, the target population to be served, and the name and title of the DOH employee responsible for the initiative.
HAHSTA does not have any program enhancements, initiatives or significant reductions proposed in the
FY14 budget.
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Committee on Health
FY14 DOH Budget Questions
13.
Please describe what, if any, impact federal health care reform will have on the budget for the
Department of Health in FY14. Please include any federal grants that may be applied for and the timeline for applying to and/or receiving that funding.
Health Care Reform through the Affordable Care Act provides a tremendous opportunity to expand HIV medical care and treatment and preventive health for persons living with HIV and at risk of HIV. Health
Care Reform is already underway in the District of Columbia with DC’s early implementation of Medicaid expansion. As many as 2,000 persons living with HIV in the District have been extended Medicaid health care coverage since July 1, 2010. More than half of the beneficiaries of the HAHSTA AIDS Drug
Assistance Program (ADAP) have enrolled in Medicaid and continue to receive services.
With the soon-to-be established Health Benefit Exchange, those persons living with HIV without health insurance and with incomes exceeding the expanded Medicaid limit will be able to purchase affordable health insurance. The Department of Health and the DC HIV community have been working with the Health
Benefit Exchange Board to ensure that HIV medical care and treatment will be an essential benefit. The
Health Benefit Exchange will also be funding organizations to support persons with HIV to navigate the health insurance options and inform them of the financial assistance available under the Affordable Care
Act.
Health Care Reform also advances an effective model for ensuring healthy outcomes through medical homes. The Affordable Care Act gives jurisdictions options to establish a range of medical home models, including for HIV. The Department of Health sees the opportunity to build on the foundations of current
HIV medical providers in the District with medical home features, such as coordinated care among clinical and non-clinical providers to ensure retention in medical care, health information technology to maximize real-time status of patient conditions, integration with hospitals and other medical providers, among other resources.
The Affordable Care Act promotes cost efficiencies. The Department of Health has led the implementation of a newly established DOH managed the HIV/AIDS Pharmacy Network; a group of local pharmacies organized to provide HIV anti-retroviral and related therapies to eligible clients. With close collaboration between the DOH Pharmacy Warehouse (within the Community Health Administration) and the
Department of Health Care Financing, the network has expanded to provide services to ADAP, Medicaid fee-for-service and Medicaid managed care organization clients. HAHSTA estimates $37 million dollars will be saved in the first year due to increased efficiencies.
Health care reform enables HIV medical providers to improve their billing of Medicaid and other third-party payer sources. The revenue generated from Medicaid and other payers will enhance the fiscal status of
CARE Act funded agencies to ensure their organizational stability, administrative infrastructure and compensation for the systematically high costs of providing care to people with HIV.
As Health Care Reform expands medical care and treatment, it effectively increases prevention strategies to reduce new HIV infections. Science has demonstrated that regular treatment can suppress the quantity of
HIV to nearly undetectable levels. This state of viral load suppression is now proven to substantially decrease the chance a person can transmit HIV to another person. This approach is known as “treatment as prevention”. Along with this approach, the Affordable Care Act does promote and fund preventive health and routine screenings, such as HIV to diagnose the condition early. Early diagnosis, immediate connection to care and prompt initiation of treatment all contribute to a standard life span and healthy outcomes for persons living with HIV.
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Committee on Health
FY14 DOH Budget Questions
14.
For FY13, please provide a worksheet detailing budgeted Medicaid revenue, the amount received, and the services that were provided. At the program level please provide the amount of Medicaid
Revenue DOH anticipates receiving in FY14.
Please see AMP submission.
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