During the 2018 session, the Governor proposed and the General Assembly passed Medicaid expansion. As part of this process, the Executive Branch conducted and completed a financial analysis, identifying several program resources that would benefit from additional revenue generation through Medicaid expansion and where general fund support could be offset in anticipation of this new Medicaid revenue. One of the program areas identified was Community Service Board (CSB) programs supported through general fund grants to localities. The analysis made the assumption that the CSBs would realize new revenue for the individuals that are currently receiving services who would now be eligible for Medicaid, to include those currently served through Governor’s Access Program (GAP). Based on this analysis, the finalized bill Chapter 2, 2018 Acts of Assembly Special Session I, reduced the general fund appropriation of the CSBs by $11.1 million in FY 2019 and $25.0 million in FY 2020.

Based on a subsequent analysis conducted by the Department of Behavioral Health and Developmental Services (DBHDS) and confirmed through discussion with CSB leadership, it was determined that Community Service Boards may not immediately generate the anticipated revenue as a result Medicaid Expansion. Based on this feedback, the Executive Branch included in the proposed budget and the General Assembly later modified this language to address the concern. The current Appropriation Act (2019 Acts of Assembly, Chapter 854) includes language requiring the Department of Behavioral Health and Developmental Services to provide a report to the Governor and General Assembly on May 15, 2019, and quarterly thereafter on status of CSB general fund reductions resulting from anticipated new revenue generated from Medicaid Expansion.

The following sections provide details, including the methodology and status of the required General Fund Reduction information in the attached Appendix A.