Department of State Health ServicesLegislative Appropriations Request

Public HearingJuly 20, 2004

DSHS Organizational Chart

CommissionerDepartment of State Health Services

Eduardo J. Sanchez, MD, MPH

DSHS Council

Internal AuditThomas Martinec

Chief Operating OfficerRandy Fritz

Chief Financial OfficerMachelle Pharr

Deputy Commissioner forBehavioral and Community

Health ServicesDavid Wanser, PhD

Assistant CommissionerFamily & Community

Health ServicesEvelyn Delgado

Assistant CommissionerMental Health & Substance

Abuse ServicesJoe Vesowate

Assistant CommissionerPrevention &

Preparedness ServicesAlecia Hathaway, M.D.

AssistantCommissioner

Regulatory ServicesRichard Bays

Center forProgram

CoordinationDebra Stabeno

Center for DSHSPolicy &

InnovationRick Danko, PhD

CommunityHealth Services

SpecializedHealth Services

NutritionServices

CommunityMental Health &

SubstanceAbuse Services

Hospitals

CommunityPreparedness

DiseasePrevention &Intervention

LaboratoryServices

Health CareQuality

Environmentaland Consumer

Safety

AccountingWilson Day

BudgetKathleen Barnett

Executive &Staff Operations

LegalCathy Campbell

HealthInformation &Vital Statistics

Center forConsumer &

External AffairsJayne Nussbaum

July 2004

InformationTechnology

Tom Thornton

Regional &Local Services

ContractMonitoring &

Oversight

Deputy Commissioner forPublic Health Services

Nick Curry, MD, MPH

Strategic Budget Structure&

FY 2006-07 LAR

DSHSStrategic Budget Structure

• DSHS was created by H.B. 2292, 78th Texas Legislature, Regular Session.

• Includes the functions of the:– Texas Commission on Alcohol and Drug Abuse,– Texas Department of Health,– Texas Health Care Information Council, and – Mental health (MH) services of the Texas Department of Mental

Health and Mental Retardation (TDMHMR)

• Begins operations on September 1, 2004.

• In order to address the physical and behavioral health service priorities of a growing Texas population, DSHS staff worked with legacy agency staff, HHSC leadership, the Legislative Budget Board, and the Governor’s Office to develop the strategic budget structure for the new agency [See ATTACHMENT A].

Goal 1: Preparedness and Prevention

Services DSHS will protect and promote the public’s health by decreasing health threats and sources of disease. Example of programs in this goal include, but are not limited to:

– Coordinate Public Health Services

– Public Health Preparedness

– Immunizations

– HIV/STD and Hepatitis C Prevention

– Kidney Health

– Children with Special Health Care Needs

– Laboratory Services

Goal 2: Community Health Services

DSHS will improve the health of children, women, families and individuals, and enhance the capacity of communities to deliver health care services. Examples of programs within this goal include but are not limited to:

– WIC and Farmer’s Market Nutrition Services

– Women and Children’s Health Services

– Primary Care and County Indigent Services

– Mental Health Services for Adults and Children

– Substance Abuse Prevention, Intervention and Treatment

– EMS & Trauma Care Systems

Goal 3: Hospital Facilities Management and Services

DSHS will promote the recovery and abilities of persons with infectious disease and mental illness who require specialized treatment. The programs included in this goal are:

– Texas Center for Infectious Diseases

– South Texas Health Care System

– Mental Health State Hospitals

– Mental Health Community Hospitals

Goal 4: Consumer Protection Services

DSHS will achieve a maximum level of compliance by the regulated community to protect public health and safety. The strategies under this goal include:

– Food (Meat) and Drug Safety

– Environmental Health

– Radiation Control

– Health Care Professionals

– Health Care Facilities

Goal 5: Indirect Administration Goal 6: Capital Items

Indirect Administration includes:– Central Administration– IT Program Support– Other Support Services– Regional Administration

Capital Items include:– Laboratory Bond Debt– Construction of Health Care Facilities– Capital Repair and Renovation – Mental Health Facilities– Capital Item

2004-2005 Baseline Spending Level

The baseline spending level is the starting point for the DSHS Legislative Appropriations Request for 2006-2007. It is based on :

- fiscal year 2004 estimated expenditures, and

- fiscal year 2005 budgeted

Towards this end, the new agency has developed its 2005 Operating Budget and has also restated the estimated expenditures of the three legacy agencies into the new DSHS strategic goals.

GR-Dedicated

12%

GR 35%

Federal 48%

Other 5%

FY 2004-05 Baseline Spending Levels All Goals

Fund Type FY04 FY05

GR $800,960,885 $792,717,988

GR-Ded $259,154,760 $298,286,917

Federal $1,064,017,106 $1,086,428,158

Other $87,764,523 $149,767,289

Total $2,211,897,274 $2,327,200,352

FY 2004-05 Baseline Spending LevelsGoal 1: Preparation and Prevention

Services

Fund Type FY04 FY05

GR $152,454,653 $150,310,352

GR-Ded $13,412,086 $12,583,303

Federal $243,650,729 $251,848,745

Other $21,888,629 $20,502,896

Total $431,406,097 $435,245,296

FY 2004-05 Baseline Spending Levels Goal 2: Community Health Services

Fund Type FY04 FY05

GR $350,987,561 $345,718,798

GR-Ded $231,195,850 $271,662,822

Federal $764,549,673 $790,436,467

Other $18,869,866 $52,484,841

Total $1,365,602,950 $1,460,302,928

FY 2004-05 Baseline Spending Levels Goal 3: Hospital Facilities Management

and Services

Fund Type FY04 FY05

GR $251,957,470 $254,792,187

GR-Ded $500,181 $500,181

Federal $18,545,101 $17,475,156

Other $39,264,592 $32,553,236

Total $310,267,344 $305,320,760

FY 2004-05 Baseline Spending Levels Goal 4: Consumer Protection Services

Fund Type FY04 FY05

GR $24,794,906 $24,395,060

GR-Ded $9,590,358 $9,170,553

Federal $8,694,790 $8,804,772

Other $297,720 $262,000

Total $43,377,774 $42,632,385

FY 2004-05 Baseline Spending Levels Goal 5: Indirect Administration

Fund Type FY04 FY05

GR $20,691,295 $17,501,591

GR-Ded $1,315,605 $1,229,378

Federal $14,746,881 $13,446,984

Other $3,602,014 $3,651,701

Total $40,355,795 $35,829,653

FY 2004-05 Baseline Spending Levels Goal 6: Capital Items

Fund Type FY04 FY05

GR $75,000 $0

GR-Ded $3,140,680 $3,140,680

Federal $13,829,932 $4,416,035

Other $3,841,702 $40,312,615

Total $20,887,314 $47,869,330

Reductions to Baseline Request

The Governor's Office of Budget, Planning & Policy and the Legislative Budget Board instructed each state agency to limit its 2006-2007 baseline request for general revenue-related funds to 95 percent of the sum of amounts expended in fiscal year 2004 and budgeted in fiscal year 2005.

Under these instructions, the baseline request for fiscal year 2006 and 2007 for the Department of State Health Services must be $107.5 million less than its 2004-2005 spending levels.

Reductions to Baseline Request – Guiding Principles

The following options are being considered to achieve the reductions to the baseline request:

• Maximize the potential savings of DSHS consolidation

• Maximize the use of federal funds

• Minimize impact to services

Options for Consideration for Exceptional Items – LAR 2006-07

2006-2007 funding requests for amounts that exceed 95 percent of the baseline spending level may be submitted as Exceptional Items.

DSHS program staff have developed options for consideration for Exceptional Items [See ATTACHMENT B] in the following categories:

– Restoration

– Prevention

– Infrastructure

– Expansion

High-level information regarding the LAR will be posted at the new website of the Department of State Health Services. Comments will be accepted via the web or e-mail at:

www.dshs.state.tx.us/LAR

LAR@dshs.state.tx.us

We encourage you to submit comments by Friday, July 30, 2004 in order to be considered in the LAR preparation.

DSHS Contact: Kyle Baxter, Texas Department of Health, 512-458-7640 or kyle.baxter@tdh.state.tx.us