Lance Montour

The session featured an overview of the Maryland Department of Health (MDH) budget for Fiscal Year 2025, noting a total allowance decrease of $261 million or 1.3% from the working appropriation, largely driven by lower projected Medicaid enrollment due to the unwinding process following the COVID-19 public health emergency. Proposed deficiencies for Fiscal 2024 totaling $635 million, mainly due to anticipated Medicaid shortfalls, were also discussed. COVID-19 federal stimulus funds usage and phase-out were covered. Discussions included contractual conversions to Merit positions and issues concerning Medicaid Home and Community Based Service (HCBS) waiver programs, noting significant growth in waitlist registries for Community Options and Autism waivers despite unfilled authorized slots, attributed to provider capacity limitations and administrative delays from staff vacancies. Provider rates and rate-setting studies were reviewed, including ongoing transition for DDA and the planned two-phase rate study for community-based Behavioral Health Services. Finally, findings from the Office of Legislative Audits regarding MDH's federal fund accounting procedures were highlighted, detailing $3.5 billion lacking proper documentation, with $2.1 billion reported recovered as of November 2023.

The committee session addressed challenges related to call volumes and customer service, particularly concerning the ability of individuals to get through to the controller's office. Discussions included strategies for improving the call answer rate, modernizing systems, and allocating resources to address the high volume of calls. The committee also discussed initiatives to aid federal workers affected by the shutdown, including loan payments and suspension of payment plan requirements.

The meeting of the Joint Audit and Evaluation Committee began with introductions of the co-chairs and members, including a welcome to the new co-chair from the Senate. The Legislative Auditor provided an overview, highlighting the audit report concerning the Department of General Services, Office of the Secretary, and other units. Key discussion points included the relocation of state agencies to Baltimore's central business district, lease transactions, and capital funds. Specific findings addressed the lack of documented cost-benefit analysis for leasing versus purchasing property, the structure of lease solicitations, and the evaluation of lease proposals.

The Budget and Taxation Committee held a briefing with auditors to review certain emergency procurements related to the State of Maryland's COVID-19 response. The legislative auditor, Greg Hook, and his team presented findings on emergency procurements conducted by state agencies between March 2020 and May 2021, totaling approximately $1.7 billion. The review noted a lack of compliance with state regulations for emergency procurements and ineffective monitoring of related payments. Specific procurements discussed included those for N95 masks and ventilators from Blue Flame Medical, and consulting services from Ernst & Young (EY).