Health Equity

Updates

Department of Health / DC Health

• The Department's gross operating budget would increase by 3.2%
• The Health Emergency Preparedness and Response Administration budget would be reduced by $2.5m from the approved FY20 budget.
• The Health Regulation and Licensing Administration budget would increase by $9.2m from the approved FY20 budget.
• The Community Health Administration budget would increase by $5.4m from the approved FY20 budget although it does include a $266,000 decrease in Perinatal and Infant Health funding.
• The budget includes a one-time $5,275,000 adjustment to "support primary care and specialty providers, prenatal care to labor and delivery in Wards 7 and 8, the implementation of acute care hospitals, the treatment of substance abuse, and clinical licensing"
• The Howard Center of Excellence would receive a $4.2m increase in funding

Department of Health Care Finance (DHCF)

• In response to the public health emergency, an additional $35m is budgeted to Medicaid 
• DHCF's budget includes a $1,350,000 increase for physician supplemental payments to support large physician group at UMC campus and to support fee-for-service beneficiaries.
• The overall provider payment budget increased by $6.2m and there is no reduction in the provider rate
• However, there is a 47% decrease in physician care services payment for fee-for-service; this is offset according to the budget by an increase in MCO payments as the department shifts more people to managed care from fee-for-service.
  
• DHCF's budget also includes $485,000 to support the exchange of electronic advance directive forms

Funding for Priorities for Mayor's Commission on Health Systems Transformation

• A total of $4.8m is proposed to implement various recommendations, including:
• Retaining primary care and specialty care providers in high-need areas
• Enhancements for SHPDA's processes
• Implementation of electronic advanced directives
• Incentives to address social determinants of health
• Resources to link prenatal care services to labor & delivery services
• Resources for implicit bias training
• And more

Original story

Today DC Mayor Muriel Bowser unveiled her revised budget for fiscal year 2021, as well as announced updates to the fiscal year 2020 budget. In light of the impact of the public health emergency on the District, the budget was highly anticipated to see what and how many cuts would be need in District government operations, and if increased spending could be supported in places.

Today's announcement did not contain some of the drastic cuts other localities are expecting in their budgets. In her press conference, the Mayor attributed much of that to the District's surplus in recent years as well as conservative spending guidelines. The majority of anticipated deficits for FY20 and FY21 - estimated to be about $722m and $774m respectively - would be filled by:

• Surplus funds from FY19
• Use of reserve funds
• Planning to pay off Nationals ballpark debts on time instead of early
• Elimination of cost-of-living adjustments and raises for District government employees

The budget does invest in a few key areas of interest to the healthcare community:

• As promised, investing $365m in building the new hospital on the St. Elizabeth's campus. 
• Allocating an additional $25m+ to help Howard in its hospital and healthcare upgrades
• To cover an anticipated increase in Medicaid enrollees, adding $35m in increased enrollment costs
• Budgeting $4.8m in implementing the recommendations of the Mayor's Commission on Health Systems Transformation

The final point is important to MSDC, which as part of the Commission urged the District to support a network of independent physicians practices especially in underserved areas. It will be critical in the coming years to help residents receive treatment from local physicians to keep them out of the hospital.

Information will be added to this post as more budget information becomes available,