The Executive Office of Health and Human Services (EOHHS) oversees essential health, social, disability, and juvenile justice programs for residents of the Commonwealth. EOHHS and its fifteen agencies provide these services through state-operated programs, contracts with private organizations, and direct benefit payments.

Objectives

In Fiscal Year 1997, EOHHS is streamlining operations through the common client identifier system, which enables every EOHHS agency to identify clients with a standard identification number and provides an unduplicated count of the number of people receiving EOHHS services. EOHHS is gaining further administrative efficiencies by establishing congruent regional boundaries, which will improve inter-agency communication by eliminating overlapping agency regions.

In Fiscal Year 1998, EOHHS will provide oversight and policy support to:

• implement the federal welfare reform law;
• implement the state Health Care Access Improvement Act; and
• establish a central secretariat business office through interdepartmental service agreements with EOHHS agencies.

The Personal Responsibility and Work Opportunity Reconciliation Act, the federal welfare reform legislation enacted in August, 1996, made significant changes to the Aid to Families with Dependent Children (AFDC) program, Medicaid, child care, and the Social Services Block Grant. In Fiscal Year 1998, EOHHS will work with the Department of Transitional Assistance, the Division of Medical Assistance, and the Department of Social Services to coordinate the implementation of the law and ensure that a safety net is in place to compensate for new federal restrictions regarding legal non-citizens. The Department of Transitional Assistance will provide services through the Emergency Aid to the Elderly, Disabled, and Children (EAEDC) program to approximately 11,700 non-citizens who will become ineligible for federal Supplemental Security Income benefits under federal welfare reform. In addition, the Division of Medical Assistance will provide basic, acute, and primary health care coverage for approximately 16,500 legal non-citizens who are no longer eligible for Medicaid.

Under the Health Care Access Improvement Act, the Division of Medical Assistance will expand Medicaid coverage during Fiscal Year 1998 to approximately 55,000 children and adults currently ineligible for the program. Also, the creation of the New State Benefit Plan will provide more than 30,000 long-term unemployed individuals with access to health care services. This plan will offer a more complete benefit package to approximately 18,000 individuals who previously received health benefits through the Department of Transitional Assistance's EAEDC program. The Division, along with the Executive Office of Elder Affairs, will implement the Senior Pharmacy program to provide drug prescription benefits to more than 50,000 elders. In addition, the Department of Public Health will offer the Children's Medical Security Plan to an additional 13,000 currently uninsured children and adolescents.

In an effort to consolidate certain administrative functions in Fiscal Year 1998, EOHHS will establish one central business office for all fifteen EOHHS agencies. This office will coordinate the management of industrial accident claims, training and recruitment, information technology, legal research, purchase of service contracting, and office space leasing.

Division of Child Care

As a new sub-unit of EOHHS, the Division of Child Care will have direct administrative responsibility for providing quality subsidized child care to eligible recipients of Transitional Aid to Families with Dependent Children (TAFDC) and other low-income working families. In addition, the Division will manage Trial Court and Family Preservation child care services.

In Fiscal Year 1998, the Division of Child Care will:

• administer all child care programs funded at EOHHS;
• collaborate with the Department of Education to study and promote a comprehensive statewide approach to subsidized child care for three and four year olds; and
• explore the costs and benefits of implementing a centralized intake and eligibility system for all state subsidized child care.

Budget Recommendations

The Fiscal Year 1998 recommendation for the administration of EOHHS is $2.24 million. This amount includes an increase of $200,000 to evaluate the effectiveness of various EOHHS programs, with an emphasis on reviewing services for children.

This budget recommendation includes a $15 million reserve in the Executive Office for Administration and Finance (1599-6896), to improve salaries for the lowest-paid human services provider staff delivering direct care services in residential settings to the Commonwealth's citizens.

The recommendation for the Division of Child Care is $242.44 million, a $25 million increase over Fiscal Year 1997 spending. This increase includes $10 million to provide approximately 2,500 additional child care slots to low-income working families, and $1.79 million for regional child care resource and referral services.

In Fiscal Year 1998, the Commonwealth will establish a new state minor fund, called the Child Care Fund, to consolidate all federal funds for human services-related child care. The total fund will be $178.36 million, comprised of $76.12 million from the federal Child Care Development Fund and $102.24 million from the Temporary Assistance to Needy Families block grant. To better reflect these funding changes and other provisions of the federal welfare reform law, the account structure for the Division of Child Care in Fiscal Year 1998 will be as follows:

Fiscal Year 1998 Spending in Fiscal Year 1997 Account Structure

FY98 Account Structure			FY97 Account Structure
4000-0190	Division of Child Care Administration	1,221,686	4000-0190	389,428
			4000-0702	632,258
			4407-9070	200,000
4000-0216	Regional Child Care Administration	10,030,665	4000-0190	6,556,373
			4000-0702	3,074,292
			4407-9070	400,000
4000-0217	Child Care for Education and Training	41,137,387	4000-0195	26,024,184
			4000-0220	4,044,366
			4000-0225	8,232,040
			4000-0702	1,632,797
			4407-9070	1,204,000
4000-0218	Child Care for Low-Income Working Families	134,209,306	4000-0195	48,991,992
			4000-0220	4,943,114
			4000-0225	69,781,711
			4000-0228	500,000
			4000-0702	5,596,489
			4407-9070	4,396,000
4000-0219	Child Care for Teen Parents	13,167,328	4000-0195	1,430,773
			4000-0215	6,324,978
			4000-0225	5,411,577
4000-0221	Trial Court Child Care	1,077,446	4000-0225	1,077,446
4000-0230	Family Preservation Child Care	41,600,298	4000-0230	38,341,078
			4000-0702	3,259,220