OFFICE OF HEALTH AND HUMAN RESOURCES
OFFICE OF HEALTH AND HUMAN RESOURCESTHE HONORABLE MARILYN B. TAVENNER., SECRETARY OF HEALTH AND HUMAN RESOURCESAgencies in the Health and Human Resources secretariat areresponsible for service delivery and management of responsesto the most critical human resource issues that Virginia faces.Priorities for agencies in the secretariat are to promote selfsufficiency and independence, assure access to affordablequality health care, strengthen families, improve care andtreatment for individuals who are mentally or physicallyimpaired, increase awareness and accessibility of long termcare, and improve the quality of life for older Virginians. Inaddition, the Health and Human Resources agencies ensuresafety for citizens through inspection programs for food safety,environmental health, hospitals and nursing homes, as well asoversight of certain health care professionals such as doctors,nurses, and counselors.HEALTH AND HUMAN RESOURCESAGENCIES INCLUDE:o Department for the Agingo Department for the Deaf and Hard-ofHearingo Department of Healtho Department of Health Professionso Department of Medical AssistanceServiceso Department of Mental Health, MentalRetardation and Substance AbuseServiceso Department of Medical Assistance Serviceso Department of Mental Health, MentalooooooRetardation and Substance Abuse ServicesDepartment of Rehabilitative ServicesWoodrow Wilson Rehabilitation CenterDepartment of Social ServicesVA Board for People with DisabilitiesDepartment for the Blind and VisuallyImpairedVA Rehabilitation Center for the Blind andVision ImpairedAccomplishments:Health Reform Commission: Governor Kaine has set agoal of making Virginia one of the 10 healthiest states inAmerica. Currently, Virginia is ranked the 22ndhealthiest state in the nation. To reach the top 10, theCommonwealth must reduce the number of uninsuredcitizens, reduce infant mortality, improve health carequality, meet increasing demands for physicians, nurses,and other health professionals, reduce tobacco use, andencourage all citizens to live an active and healthylifestyle. Last year the Governor convened a HealthReform Commission to recommend pathways to makeVirginia one of the healthiest states. In September 2007,the Commission presented over 40 recommendations tothe Governor, which is expected to serve as a roadmapfor future efforts to improve Virginia’s health.Health and Human ResourcesB-102
NATURAL RESOURCESTE HONORABLE L. PRESTON BRYANT, JR., SECRETARY OF NATURAL RESOURCESFinancing of Health and HumanResources Agencies*(Based on 2008 – 2010 Proposed Operating Budget)Federal41%DedicatedSpecial5%Special Funds12%General Fund42%* Funds with totals less than 1% have not been included.Access to Care: More than a million Virginiansreported they did not have health insurance in 2005.Adequate access to health care is critical to ensuringVirginia’s families stay strong and healthy so thatindividuals can continue to contribute to theCommonwealth’s dynamic economy. Over the last yearVirginia has expanded prenatal coverage to lowincome pregnant women and provided targetedpayment increases in the Medicaid program forphysicians and rural hospitals. These changes havebeen critical to reaching vulnerable populations andareas where health care services are most needed.Mental Health: The tragic events at Virginia Tech onApril 16th highlighted some of the gaps in our mentalhealth delivery system. To meet the immediate needsof mental health providers in the Blacksburg area,Virginia was successful in obtaining a grant from thefederal government in August of this year. Many of theother gaps identified following the incident will bedeliberated upon during the 2008 General Assemblysession. The secretariat is fully committed to workingwith the General Assembly and localities to improveour mental health system going forward.capacity by increasing the number of nursing faculty.Last year, additional nursing scholarships were madeavailable to nurses seeking advanced degrees to enablethem to teach in our nursing schools. In addition,existing nurse faculty received a salary increase tomake their salaries competitive with private providers.Lastly, a nursing workforce summit was held inAugust to identify additional pathways to increaseschool capacity and reduce current nurse shortages.Prevention:A critical component to advancingVirginia’s health rankings is encouraging citizens tomake healthier lifestyle choices. Over the last year, theDepartment of Health has developed a strongpartnership with the Department of Education tocombat childhood obesity. This partnership helped theCommonwealth receive a National Governor’sAssociation Grant to bolster existing efforts to combatobesity in schools and resulted in a successful HealthyStudents Summit with over 400 participants from localschool districts. The Commonwealth also implementeda high risk maternity program for Medicaid enrollees,established an Office of Minority Health, and expandedMedicaid disease management programs.Office of Health and Human ResourcesOperating Budget 005200620072008GF20092010Healthcare Workforce: The availability of nurses isone of the most critical workforce issues facingVirginia. To close the gap between growing demandand the limited number of nurse graduates, theCommonwealth sought to increase nursing schoolHealth and Human ResourcesB-103
Secretary of Health and Human ResourcesOperating Budget HistoryGeneralFundNongeneralFundPositions2005 Appropriation 186,694,989 55,956,8160.002006 Appropriation 202,129,445 61,411,6780.002007 Appropriation 216,357,852 53,017,4980.002008 Appropriation 239,329,274 00http://www.hhr.virginia.gov/The Health and Human Resources Secretariat manages thedelivery of services and programs to ensure and provide for publichealth, provide services for persons with disabilities, establishhealth care coverage and social services for low-incomeVirginians, offer temporary assistance for Virginians working theirway toward self-sufficiency, increase access to health and socialservices information, work with families to overcome natural andmanmade disasters, and establish accountability in service delivery.New Operating Budget SummaryOperating Budget HistoryGeneralFundNongeneralFund2009 Base Budget 239,329,274 52,607,746Positions2009 Addenda 64,225,103 965,5790.002009 TOTAL 303,554,377 53,573,3250.002005 Appropriation 588,454 4,7906.002006 Appropriation 1,689,724 4,7906.002010 Base Budget 239,329,274 52,607,7460.002010 Addenda 84,922,836 00.002010 TOTAL 324,252,110 52,607,7460.002007 Appropriation 1,732,144 06.002008 Appropriation 1,732,144 06.00Recommended Operating Budget AddendaNew Operating Budget Summary2009 Base Budget Increase state pool funds for at-risk youth and familiesGeneralFundNongeneralFundPositions6.00 1,732,144 02009 Addenda 72,578 00.002009 TOTAL 1,804,722 06.002010 Base Budget 1,732,144 06.002010 Addenda 72,578 00.002010 TOTAL 1,804,722 06.00Recommended Operating Budget Addenda Distribute Central Appropriations amounts to agencybudgetsAdjusts the agency budget to reflect amounts moved fromCentral Appropriations to cover the cost of items such as thecontinuation of 2007 and 2008 salary and health insurancepremium increases, as well as changes in retirement anddisability contribution rates and other centrally funded items.For each year, 72,578 (GF).Comprehensive Services For At-Risk YouthAnd Familieshttp://www.csa.state.va.us/The mission of the Comprehensive Services Act for At-RiskYouth and Families (CSA) is to create a collaborative system ofservices and funding that is child-centered, family-focused andcommunity-based when addressing the strengths and needs oftroubled and at-risk youths and their families in theCommonwealth.Key Objectives and Performance Measures³ Maximize the number of CSA funded youth served incommunity and family based settingsWe will increase the proportion of children served at home, inschool and in the community.Provides additional funds to continue mandated specialeducation, foster care and foster care prevention services for atrisk youth. Projected expenditures include anticipated increasesdue to policy clarification during the previous fiscal year. Inline with projected program growth, these funds will cover anannual program growth of approximately 10 percent. For 2009, 65.4 million (GF). For 2010, 93.2 million (GF). Increase funding for basic foster care rateRaises maintenance payments made to foster family homes onbehalf of foster children by 15 percent in the first year and byan additional 10 percent in the second year. This increase willfacilitate stability in foster home placements, enhance localdepartments' ability to recruit families and avoid placement inmore costly residential facilities. For 2009, 1.1 million (GF).For 2010, 2.6 million (GF). Provide incentives to localities serving children incommunity-based settingsProvides incentives to localities to provide community-basedservices by changing the match rate for residential andcommunity based services. Localities will receive a highermatch rate from the state for services provided in communitysettings, and a lower match rate for services provided inresidential settings. For 2009, a decrease of 1.5 million (GF).For 2010, a decrease of 11.0 million (GF). Substitute Temporary Assistance for Needy Families(TANF) dollars for general fund support of eligible activitiesReplaces general fund dollars in certain activities with TANFappropriation. Recent data indicates that the TANF caseloadhas declined and with it the mandated expenditures for cashassistance and child care services. This reduction strategy willgenerate savings by supplanting general fund with TANF forcertain eligible activities in FY 2009 without reducing theoverall amount of support provided. For 2009, a decrease of 965,579 (GF) and an increase of 965,579 (NGF). Collect outcome data on children served by theComprehensive Services ActProvides funding for the purchase and maintenance of a datatool that will allow the agency to better coordinate informationOffice of Health and Human ResourcesB-104
Comprehensive Services For At-Risk Youth And Families (Continued)related to a uniform assessment instrument. The ability to trackoutcome data for children served through the ComprehensiveServices Act will aid localities in providing effective services inthe most appropriate setting. For 2009, 225,000 (GF). For2010, 52,000 (GF). Adjust utilization management languageChanges language to reflect existing practice for utilizationmanagement services. Current language requires theDepartment of Medical Services to contract for utilizationmanagement services for certain localities receiving paymentfrom the Office of Comprehensive Services. This languageadjustment will streamline the utilization management process.This amendment is embedded in budget language.funding as been stagnant for several years and these positionsare now supported from the general fund. Continue 2008 budget reductionsContinues the budget reductions included in the Governor's2008 reduction plan into the 2008-10 biennium. For each year,a reduction of 709,441 (GF).Department for the Deaf and Hard-of-Hearinghttp://www.vddhh.org/Department for the AgingThe Virginia Department for the Deaf and Hard of Hearing(VDDHH) works to reduce the communication barriers betweenpersons who are deaf or hard of hearing and those who arehearing, including family members, service providers, and thegeneral public.http://www.vda.virginia.gov/Key Objectives and Performance MeasuresThe Virginia Department for the Aging (VDA) promotes thedignity, independence, and security of older Virginians bypromoting partnerships with families and communities.³ We will increase the pool of qualified interpreters availableKey Objectives and Performance Measures³ We will implement the No Wrong Door initiative in moreArea Agencies on Aging (AAAs) and within each expandthe number of business processes that are incorporated inthe information technology solution.The number of Area Agencies on Aging business processesincorporated in the No Wrong Door initiative.Operating Budget HistoryGeneralFundNongeneralFundPositions2005 Appropriation 15,102,765 29,859,08627.002006 Appropriation 15,432,765 29,859,08627.002007 Appropriation 17,719,307 31,689,69827.002008 Appropriation 19,349,077 31,593,18927.00New Operating Budget SummaryGeneralFundNongeneralFundPositions2009 Base Budget 19,349,077 31,593,18927.002009 Addenda( 645,085) 133,4430.002009 TOTAL 18,703,992 31,726,63227.002010 Base Budget 19,349,077 31,593,18927.002010 Addenda( 645,085) 133,4430.002010 TOTAL 18,703,992 31,726,63227.00Recommended Operating Budget Addenda Distribute Central Appropriations amounts to agencybudgetsAdjusts the agency budget to reflect amounts moved fromCentral Appropriations to cover the cost of items such as thecontinuation of 2007 and 2008 salary and health insurancepremium increases, as well as changes in retirement anddisability contribution rates and other centrally funded items.For each year, 64,356 (GF) and 133,443 (NGF).to fill assignments coordinated by VDDHH.We will fill interpreter requests from Virginia Courts, stateagencies and 12-step programs.Operating Budget HistoryGeneralFundNongeneralFundPositions2005 Appropriation 1,203,631 177,94214.002006 Appropriation 1,328,631 177,94214.002007 Appropriation 1,378,340 182,33314.002008 Appropriation 1,378,549 4.00New Operating Budget Summary2009 Base Budget 1,378,549 14,382,2292009 Addenda( 3,948) 6,8490.002009 TOTAL 1,374,601 14,389,07814.002010 Base Budget 1,378,549 14,382,22914.002010 Addenda( 3,948) 6,8490.002010 TOTAL 1,374,601 14,389,07814.00Recommended Operating Budget Addenda Distribute Central Appropriations amounts to agencybudgetsAdjusts the agency budget to reflect amounts moved fromCentral Appropriations to cover the cost of items such as thecontinuation of 2007 and 2008 salary and health insurancepremium increases, as well as changes in retirement anddisability contribution rates and other centrally funded items.For each year, 64,980 (GF) and 6,849 (NGF). Continue 2008 budget reductionsContinues the budget reductions included in the Governor's2008 reduction plan into the 2008-10 biennium. For each year,a reduction of 68,928 (GF). Realign positions to reflect proper funding sourceConverts three positions from general fund to nongeneral fundto more accurately reflect the fund split. The agency's federalOffice of Health and Human ResourcesB-105
Department of Health (Continued)Department of HealthRecommended Operating Budget Addendahttp://www.vdh.state.va.us/ Distribute Central Appropriations amounts to agencyThe Virginia Department of Health is dedicated to promoting andprotecting the health of Virginians.Key Objectives and Performance Measures³ Increase the influenza and pneumococcal vaccinationcoverage rates in adults 65 years of age and older.The percentage of adults 65 years of age and older in Virginiawho are appropriately immunized against influenzaThe percentage of adults 65 years of age and older in Virginiawho are appropriately immunized against pneumonia³ Improve the quality of life and the quality of health careprovided to long-term care residents diagnosed withpressure ulcers, or at risk for acquiring pressure ulcers. ()The percentage of residents of long term care facilities inVirginia who have pressure ulcers³ Increase Virginia's citizens access to safe and affordabledrinking waterThe number of additional Virginia citizens who will gainaccess to safe and affordable drinking water³ We will Increase immunization rates of children at twoyears of age90% of two-year old children in Virginia will be appropriatelyimmunized³ We will reduce the prevalence of obesity in VirginiaThe percentage of adults in Virginia who are obese³ We will reduce the prevalence of smoking among Virginians Transfer appropriation to Department of EnvironmentalQualityTransfers funding and two positions as authorized in Chapter847, Item 295, Paragraph B, 2007 Appropriation Act. Thistransfer supports the Department of Environmental Quality'sbiosolids program pursuant to House Bill 2802, which waspassed during the 2007 General Assembly Session. For eachyear, a reduction of 183,026 (GF). Remove appropriation for Comprehensive HealthInvestment Project of RoanokeRemoves unsupported federal appropriation. For each year, areduction of 249,358 (NGF). Increase appropriation in the Financial Assistance for NonProfit Emergency Medical Services Organizations andLocalitiesProjects a revenue increase of four percent in the "Four forLife" Fund based on historical revenue collections and vehicleregistrations. These funds are used to support the provision oftraining and education of Emergency Medical Servicespersonnel, the purchase of equipment and supplies, and tosupport local government operations. For each year, 4.2million (NGF). Increase appropriation in Trauma Center FundThe percentage of adults who smokeThe percentage of youth who smoke³ We will reduce teenage pregnancy rates in VirgniaThe teenage pregnancy rate among females ages 10-19 inVirginia³ We will reduce infant mortalityIncreases support due to increased revenue collections from therestoration of revoked motor vehicle licenses and multipleoffenders convicted of driving under the influence. Revenue isused for defraying the costs of providing emergency medicalcare to victims of automobile accidents attributable to alcoholor drug use. For each year, 4.2 million (NGF). Increase appropriation in Special Supplemental NutritionThe infant mortality rateOperating Budget 005 Appropriation 138,787,326 338,103,9912006 Appropriation 142,773,275 345,158,5903,598.002007 Appropriation 161,715,879 368,461,7503,768.002008 Appropriation 169,123,134 ons 169,123,134 366,304,2993,771.00New Operating Budget Summary2009 Base BudgetbudgetsAdjusts the agency budget to reflect amounts moved fromCentral Appropriations to cover the cost of items such as thecontinuation of 2007 and 2008 salary and health insurancepremium increases, as well as changes in retirement anddisability contribution rates and other centrally funded items.For each year, 11.6 million (GF) and 14.5 million (NGF).Program for Women, Infants, and ChildrenIncreases support due to the United States Department ofAgriculture increasing its federal grant award from 57 millionto 80 million. The grant covers food costs as well as ananticipated increase in program enrollment. For each year, 23.1 million (NGF). Reduce appropriation for Drinking Water State RevolvingFundReduces support to reflect declining federal waterworksconstruction funding. For each year, a reduction of 4.5million (NGF). Increase special fund appropriation for private grants anddonationsIncreases support in Local and Maternal Child Health Servicesand Chronic Disease and Prevention Control service areas inorder to meet revenue and expenditure needs. For each year, 900,000 (NGF).2009 Addenda 10,144,932 49,015,23429.002009 TOTAL 179,268,066 415,319,5333,800.002010 Base Budget 169,123,134 366,304,2993,771.002010 Addenda 13,167,921 45,984,24329.00 Remove appropriation in Injury and Violence Prevention2010 TOTAL 182,291,055 412,288,5423,800.00Removes appropriation in order to be in compliance withOffice of Health and Human ResourcesB-106
Department of Health (Continued)Section 32.1-34.1 of the Code of Virginia, which allowsdonations to local health departments to be used only inconjunction with the Community Health Services program. Foreach year, a reduction of 10,000 (NGF). Remove appropriation and transfer two positions to theDepartment of Environmental QualityRemoves funding related to the transfer of two positions asauthorized in Item 295,
Health and Human Resources B-102 OFFICE OF HEALTH AND HUMAN RESOURCES THE HONORABLE MARILYN B. TAVENNER., SECRETARY OF HEALTH AND HUMAN RESOURCES . o Department for the Aging o Department for the Deaf and Hard-of-Hearing . encourage all citizens to live an active and healthy lifestyle. Last year the Governor convened a Health
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