FY 2021 Health agency budget “asks”

Governor Doug Ducey’s budget proposal won’t be submitted to the legislature until January, but the priorities and funding issues included in state agency budget requests offer a glimpse into what we might see when his executive budget is released.

The Governor’s Office of Strategic Planning & Budgeting (OSPB) collected the budget requests from state agencies at the beginning of September. The requests help inform the Governor and his staff as they develop the state’s executive budget plan, which is then delivered to the legislature. Here are some of the budget “asks” we will be looking out for from the Arizona Department of Health Services and the Arizona Health Care Cost Containment System.


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Arizona Department of Health Services (ADHS):

For FY 2021, the Arizona Department of Health Services’ budget request asks for $470 million in total funds, made up of $150.4 million in appropriated funds and $319.6 million in non-appropriated funds.

The requested appropriated funds represent a $2.9 million reduction compared to the department’s FY 2020 appropriation. Specifically, the budget requests $1.3 million less in general funds, and a $1.65 million reduction in other appropriated funds.



ADHS does, however, ask for an additional, ongoing general fund increase of $1.4 million from the Emergency Medical Services Fund to support local and state emergency medical services systems. The fund is used for programs that support EMS training in low populated areas, high-risk perinatal services, and a state loan repayment program for providers who agree to practice in medically underserved areas of the state.

The budget request includes $256,000 in additional appropriated funds from the Newborn Screening Program Fund. This includes a one-time $200,000 appropriation to replace aging equipment used for the newborn screenings, and an ongoing $56,000 increase for the increased costs of reagents and supplies for testing.

There is also a request for an ongoing $95,000 increase in funds from the Nursing Care Institution Resident Protection Revolving Fund for various projects that improve the quality of care for Arizonans at nursing facilities across the state.


Arizona Health Care Cost Containment System (AHCCCS):

The Arizona Health Care Cost Containment System’s 2021 budget request requests a $208 million increase in state general funds and a $14.8 million decrease in other appropriated funds, resulting in an overall appropriated fund increase of $193.2 million above FY 2020 amounts.

Combined with non-appropriated and federal funds, AHCCCS is requesting an additional $1.59 billion in total funds.

AHCCCS has 19 decision packages within its FY 2021 request.

“Six (6) of the decision packages are caseload, rate, or new mandate-driven Title XIX changes. Of the remaining decision packages, one (1) adjusts prescription drug rebate funding; five (5) adjust supplemental payments to hospitals and providers; two (2) are administrative adjustments; two (2) are base modifications; and [three] (3) involve changes to non-appropriated funds only.”

Those decision packages include an increase of $566,893,500 Total Fund for traditional Medicaid Services (which includes funding for the Traditional Capitation, Traditional Fee-for-Service, Traditional Reinsurance, Traditional Medicare Premiums, Breast and Cervical Cancer, Ticket to Work, and Acute Medicare Part D Clawback subprograms). The increase results in an overall FY 2021 request of $5.75 billion for these services.

The decision packages also request an increase of $499.3 million Total Funds for Proposition 204 Services appropriation, an increase of $63.8 million in Total Funds for the ACA Newly Eligible Adult population, and a $238.6 million Total Fund increase for Arizona Long Term Care System appropriation.

The full ADHS budget ask is available here, and the AHCCCS’s is available here.