Louisiana Department of Health: Fiscal Year 2018 State Budget

Gov. John Bel Edwards’ executive budget for fiscal year 2017-18 allocates $2.58 billion in state general funds for the Louisiana Department of Health – the second largest commitment of state funds after the Department of Education. The vast majority of that ($2.22 billion – or 86 percent) will go to support the Medicaid program, where it will be used to draw down federal matching funds. The remaining $357 million is divided up between the Office of the Secretary, the department’s five programmatic offices, and the state’s 10 human services districts.

Nearly all offices within the health agency were subject to mid-year reductions after the special fiscal session in February 2017, and those cuts were carried forward in the governor’s FY 2018 budget. As a result, with the exception of the Office of Public Health and the Office of the Secretary, all LDH offices are set to receive fewer state general fund dollars in the upcoming fiscal year than in the current year.

Human Services Districts
After Medicaid, the human services districts together receive the largest amount of state general funds in the LDH budget. Each district serves a different geographic region of the state by providing a variety of community-based services to people with developmental disabilities and behavioral health needs. Altogether, the 10 districts receive $120 million in state general funds in the FY 2018 budget, down from the $123.8 million in the current fiscal year. The Metropolitan (New Orleans) and Capital Area (Baton Rouge) Human Services Districts get the largest amounts of state funds in the FY 2018 budget, at $17.5 million and $15.7 million respectively.

Behavioral Health

The Office of Behavioral Health (OBH) facilitates comprehensive care for Louisianans with addiction and mental health disorders. The office oversees the provision of behavioral health services through the Healthy Louisiana Medicaid managed care organizations and the human services districts. OBH also provides care directly to patients at the state’s two free-standing psychiatric inpatient facilities:  the Central Louisiana State Hospital in Pineville and Eastern Louisiana Mental Health System in Jackson.

The executive budget recommends a $5.2 million reduction in state general funds to OBH in FY 2018, including the elimination of the Access to Recovery program that provides clients with access to alcohol and drug abuse recovery services. Total FY 2018 funding for OBH from all sources is $226.2 million including $45.7 million in federal funding. The office currently has 1,422 full-time employees (FTEs) and the governor’s FY 2018 budget includes funding for just 1,410 FTEs.

Public Health

The Office of Public Health (OPH) manages programs and staff in 63 parish health centers providing family planning services, maternal and child health visits, health education and patient referrals. OPH also employs engineers, doctors, chemists, biologists, nurses, sanitarians, clinicians, emergency preparedness experts that are charged with everything from monitoring food and water safety to inspecting tattoo shops and tanning salons for compliance with health standards. OPH also provides preventive services including vaccinations and disaster preparedness trainings.

The FY 2018 executive budget provides  $47.2 million in state general funds for OPH, a $3.5 million increase from FY 2017. Part of that proposed funding increase is $2 million for the continuation of Zika response and prevention activities that were previously funded a federal grant that is set to expire this fiscal year. The bulk of the office’s funding comes from the federal government. In FY 2018, federal funding for OPH is projected to be $276 million, or 71 percent of the office’s total budget.  The office currently has 1,204 full-time employees, eight of which would be eliminated in the governor’s FY 2018 budget.  

While annual reductions and mid-year cuts in state funding have hit the Medicaid program and its providers the hardest, the cuts also have fallen on our state’s first line of defense of against chronic disease, epidemics, and addiction. Louisiana’s growing opioid crisis and the continued threat of a Zika outbreak underscore the importance of stronger investments in behavioral and public health. Stable funding for LDH is critical to ensuring the department can maintain the services and programs that keep Louisiana’s communities safe, healthy, and prosperous.