Roughly 12,000 Jobs to be Added Statewide with Expansion of Medicaid

A proposal to expand Medicaid to cover 160,000 more Coloradans will add roughly 12,000 jobs statewide, according to a rough estimate by economic development leader Tom Clark.  Legislators will be debating whether to accept the federal offer this session, which as part of the Affordable Care Act, offers states the option to expand Medicaid to persons living below 133% of the federal poverty level. Gov. Hickenlooper recently gave the expansion his support and estimated it would bring $12.28 billion in federal funds back to Colorado taxpayers over 10 years. Read more here.

Rural Fiscal Cliff Averted

The rural fiscal cliff was averted this week when Congress came to an agreement at the 11th hour. David Lee of the National Rural Health Association released the following comments in regards to the legislation.

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Hundreds of millions of dollars in rural health cuts were prevented by Congress as part of the last-minute “fiscal cliff” legislation passed late in the night on New Year’s Day. While many were watching an underwhelming Orange Bowl, the President signed-into law legislation that reinstates critical Medicare reimbursement payments to over 850 rural hospitals, as well as prevented cuts to rural primary care physicians and rural ambulance providers.

The fiscal cliff bill, which included large tax provisions and an extension of unemployment compensation, also reinstated the Medicare Dependent Hospital program and the Low-Volume Hospital adjustment, which both expired October 1. Had Congress not restored these payments, many rural fiscally fragile facilities likely would be forced to close their doors.

This is a big win for rural providers and NRHA wishes to thank all of grassroots advocates who made their plea to Congress to prevent these harsh cuts. Stay tuned, we aren’t completely out of the woods. The 2% across-the-board sequestration cuts were delayed for two months, but the battle will begin again soon. Additionally, all rural payments were extended for only a one-year period and additional calls for cuts are surely just around the corner. This means, this year’s Policy Institute, where rural advocates appeal to their Members of Congress, significant than ever.

Below is a list of the rural Medicare provisions included in the fiscal cliff legislation:

Medicare Physician Payment Update. This provision guarantees seniors have continued access to their doctors by fixing the Sustainable Growth Rate (SGR) through the end of 2013. Medicare physician payment rates are scheduled to be reduced by 26.5 percent on December 31, 2012. This provision would avoid that reduction and extend current Medicare payment rates through December 31, 2013. 

Work Geographic Adjustment. Under current law, the Medicare fee schedule is adjusted geographically for three factors to reflect differences in the cost of resources needed to produce physician services: physician work, practice expense, and medical malpractice insurance. This provision extends the existing 1.0 floor on the “physician work” index through December 31, 2013. 

Payment for Outpatient Therapy Services. Current law places annual per beneficiary payment limits of $1,880 for all outpatient therapy services provided by non-hospital providers, but includes an exceptions process for cases in which the provision of additional therapy services is determined to be medically necessary. This provision extends the exception process through December 31, 2013. The provision also extends the cap to services received in hospital outpatient departments only through December 31, 2013. 

Ambulance Add-On Payments. Under current law, ground ambulance transports receive add-on to their base rate payments of 2% for urban providers, 3% for rural providers, and 22.6% for super-rural providers. The air ambulance temporary payment policy maintains rural designation for application of rural air ambulance add-on for areas reclassified as urban by OMB in 2006. This provision extends the add-on payment for ground including in super rural areas, through December 31, 2013, and the air ambulance add-on until June 30, 2013.

Extension of Medicare inpatient hospital payment adjustment for low-volume hospitals. Qualifying low-volume hospitals receive add-on payments based on the number of Medicare discharges. To qualify, the hospital must have less than 1,600 Medicare discharges and be 15 miles or greater from the nearest like hospital. This provision extends the payment adjustment until December 31, 2013.

Extension of the Medicare-Dependent hospital (MDH) program. The Medicare Dependent Hospital (MDH) program provides enhanced reimbursement to support rural health infrastructure and to support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges. This greater dependence on Medicare may make these hospitals more financially vulnerable to prospective payment, and the MDH designation is designed to reduce this risk. This provision extends the MDH program until October 1, 2013.

For a full copy of the legislation, click here.

Rural Hospitals Get Relief In Fiscal Cliff Deal

The New Year’s Day “fiscal cliff” deal means at least an extra $450,000 this year to tiny Jones Memorial Hospital in rural upstate New York. Click here to read the full article from Kaiser Health News.

Recommendations from TBD Released

Leaders of a large-scale effort to ask Coloradans how to address the state's long-term problems released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases but is light on specifics.
The recommendations from the eight-member board of directors of TBD Colorado, or "To Be Determined," came after months of community engagement with more than 1,200 Coloradans during 70 public meetings across the state. The recommendations were presented to Gov. John Hickenlooper, a Democrat who initiated the TBD effort, at the Denver Botanic Gardens.


Read more: TBD Colorado: Consider tax increases, constitutional reforms - The Denver Post http://www.denverpost.com/breakingnews/ci_21993932/tbd-colorado-consider-tax-increases-constitutional-reforms?source=rss#ixzz2COSDJAQe
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Leaders of a large-scale effort to ask Coloradans how to address the state's long-term problems released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases but is light on specifics.
The recommendations from the eight-member board of directors of TBD Colorado, or "To Be Determined," came after months of community engagement with more than 1,200 Coloradans during 70 public meetings across the state. The recommendations were presented to Gov. John Hickenlooper, a Democrat who initiated the TBD effort, at the Denver Botanic Gardens.


Read more: TBD Colorado: Consider tax increases, constitutional reforms - The Denver Post http://www.denverpost.com/breakingnews/ci_21993932/tbd-colorado-consider-tax-increases-constitutional-reforms?source=rss#ixzz2COSDJAQe
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Leaders of a large-scale effort to ask Coloradans how to address the state's long-term problems released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases but is light on specifics.
The recommendations from the eight-member board of directors of TBD Colorado, or "To Be Determined," came after months of community engagement with more than 1,200 Coloradans during 70 public meetings across the state. The recommendations were presented to Gov. John Hickenlooper, a Democrat who initiated the TBD effort, at the Denver Botanic Gardens.
The TBD effort, paid for with about $1.2 million in donated funds, focused on five issues: education, health, transportation, the state budget

The Spot Blog

• Read the inside scoop on Colorado politics and policies at blogs.denverpost.com/thespot/.
• Full political news coverage at denverpost.com/politics.

and the state workforce. Critics have savaged the effort as the inevitable precursor to a tax-increase initiative, although Hickenlooper and TBD organizers have denied there was any predetermined agenda.

Read more: TBD Colorado: Consider tax increases, constitutional reforms - The Denver Post http://www.denverpost.com/breakingnews/ci_21993932/tbd-colorado-consider-tax-increases-constitutional-reforms?source=rss#ixzz2COSTbIMw
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Leaders of a large-scale effort to ask Coloradans how to address the state's long-term problems released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases but is light on specifics.
The recommendations from the eight-member board of directors of TBD Colorado, or "To Be Determined," came after months of community engagement with more than 1,200 Coloradans during 70 public meetings across the state. The recommendations were presented to Gov. John Hickenlooper, a Democrat who initiated the TBD effort, at the Denver Botanic Gardens.
The TBD effort, paid for with about $1.2 million in donated funds, focused on five issues: education, health, transportation, the state budget

The Spot Blog

• Read the inside scoop on Colorado politics and policies at blogs.denverpost.com/thespot/.
• Full political news coverage at denverpost.com/politics.

and the state workforce. Critics have savaged the effort as the inevitable precursor to a tax-increase initiative, although Hickenlooper and TBD organizers have denied there was any predetermined agenda.

Read more: TBD Colorado: Consider tax increases, constitutional reforms - The Denver Post http://www.denverpost.com/breakingnews/ci_21993932/tbd-colorado-consider-tax-increases-constitutional-reforms?source=rss#ixzz2COSTbIMw
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Leaders of a large-scale effort to ask Coloradans how to address the state's long-term problems released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases but is light on specifics.
The recommendations from the eight-member board of directors of TBD Colorado, or "To Be Determined," came after months of community engagement with more than 1,200 Coloradans during 70 public meetings across the state. The recommendations were presented to Gov. John Hickenlooper, a Democrat who initiated the TBD effort, at the Denver Botanic Gardens.


Read more: TBD Colorado: Consider tax increases, constitutional reforms - The Denver Post http://www.denverpost.com/breakingnews/ci_21993932/tbd-colorado-consider-tax-increases-constitutional-reforms?source=rss#ixzz2COSTbIMw
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Leaders of a large-scale effort to ask Coloradans how to address the state's long-term problems released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases but is light on specifics.
The recommendations from the eight-member board of directors of TBD Colorado, or "To Be Determined," came after months of community engagement with more than 1,200 Coloradans during 70 public meetings across the state. The recommendations were presented to Gov. John Hickenlooper, a Democrat who initiated the TBD effort, at the Denver Botanic Gardens.


Read more: TBD Colorado: Consider tax increases, constitutional reforms - The Denver Post http://www.denverpost.com/breakingnews/ci_21993932/tbd-colorado-consider-tax-increases-constitutional-reforms?source=rss#ixzz2COSTbIMw
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Leaders of a large-scale effort to ask Coloradans how to address the state's long-term problems released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases but is light on specifics.

Read more: TBD Colorado: Consider tax increases, constitutional reforms - The Denver Post http://www.denverpost.com/breakingnews/ci_21993932/tbd-colorado-consider-tax-increases-constitutional-reforms?source=rss#ixzz2COShIqb4
Read The Denver Post's Terms of Use of its content: http://www.denverpost.com/termsofuse

Leaders of TBD, a large-scale effort to ask Coloradans how to address the state's long-term problems, released on Wednesday a set of recommendations that calls for constitutional reforms and hints at tax increases.

The recommendations from the eight-member board of directors of TBD Colorado, or "To Be Determined," came after months of community engagement with more than 1,200 Coloradans during 70 public meetings across the state. The recommendations were presented to Gov. John Hickenlooper, who initiated the TBD effort.

The TBD effort focused on five issues: education, health, transportation, the state budget and the state workforce. The full report is due to be released December 3rd. Read more here.

Provider Groups Lobby Against Fiscal Cliff

As lawmakers and President Barack Obama discuss possible changes to federal entitlement programs as part of a larger deal to avoid the fiscal cliff, provider groups are making their case loud and clear - cuts are not welcome. The fiscal cliff is the mix of expiring tax breaks and automatic spending reductions set to begin in January.

In a document provided to lawmakers, the American Hospital Association said, "providers already face billions of dollars in Medicare and Medicaid payment cuts, and additional reductions could jeopardize beneficiaries’ access to care. True entitlement reform and approaches to change the health care delivery system are needed – not provider cuts.” Read the full article here.

State Budet Update

The Governor released his budget request on November 1st. This is the beginning of a long process to set the budget for Fiscal Year 2013-14. Beginning this week, the Joint Budget Committee (JBC) began hearing briefings from the various state departments. Some health related highlights from Governor Hickenlooper's budget request are listed below.

 

• Purchase a Medicaid Management Information System (MMIS or claims payment).
• Add a dental benefit for adults, including pregnant women, covered by Medicaid. This is to be capped at $1,000 per patient.
• Change the current Medicaid dental program for kids to an Administrative Services Organization, similar to that of CHP+.
• Expand the current Substance Use Disorder Medicaid benefit and include substance use disorder treatment under the Behavioral Health Organization (BHO) contract.
• Increase provider rate by 1.5%. The increase would not apply to RHCs, FQHCs, nursing homes or pharmaceutical reimbursements.
• Create a behavioral health crisis system (mental health triage).
• Increase funds for Local Public Health Agencies to support legislatively required core public health services in some communities. 
• Increase the average cost per K-12 student from $6,474 to $6,659.

 

We're still waiting to hear the Governor's plans for the Medicaid expansion (states can expand their eligibility for Medicaid up to 133% FPL as part of the Affordable Care Act).The federal guidance is expected to be released in the next week, so we can expect to hear something publicly soon after that.

Should You Celebrate Safety Net Clinic Week? The Answer is Probably Yes!

Is My Clinic A Safety Net Clinic? The answer may not be obvious. If you have ever wondered if your clinic is a safety net clinic, the following survey may help you answer that question.

 

First, does your clinic provide preventive and primary health care services or chronic disease management?

Yes / No

 

If you answered yes to the question above, please read each statement below and determine if the statement is true.  

• My clinic is a federally certified Rural Health Clinic (RHC).
• My clinic is located in a health professional shortage or medically underserved area.
• My clinic offers free or discounted services on a sliding fee scale or as a flat fee.
• My clinic sees uninsured patients regardless of their ability to pay.
• My clinic accepts Medicaid, Child Health Plan (CHP), and/or Tri-Care.
• My clinic participates in the Colorado Indigent Care Program (CICP).
• My clinic does not accept reimbursements from third-party payers.
• My clinic utilizes volunteer clinicians.
• My clinic is eligible for FTCA medical malpractice liability protection.
• My clinic receives Primary Care Fund dollars.
• My clinic receives grants, contributions and/or donations.
• My clinic is part of a Family or Internal Medicine Residency Program.
• My clinic provides translation services for non-English speaking patients.
• My clinic receives Section 330 funding (under the Public Health Services Act).
• My clinic provides Indian Health Services.
• My clinic receives funding under Title X.

If your clinic provides health care services and the answer to one or more of the options above is yes, then congratulations, your clinic is a safety net clinic! Therefore, the Colorado Rural Health Center and ClinicNET encourage you to consider celebrating Safety Net Clinic Week August 20th through 24th, 2012. SNCW is a week dedicated to raising awareness of all the various types of clinics with a commitment to serving patients who might otherwise have difficulty getting medical care.

 

Why is it important to celebrate Safety Net Clinic Week? Because while safety net clinics have some similarities, they also look very different from one another and it is important to know where, why and how health care is currently being delivered. When it comes time for the federal, state, or even local government to make decisions regarding provider reimbursements, tobacco tax funds, Medicare or Medicaid payments, public coverage program eligibility, electronic health records (EHR) incentives, or other important policy choices, the people making those decisions need to understand how they affect safety net clinics like yours.

Improvement in Colorado's Revenue Forecast Impact FY12-13 Budget

On March 19^th the Legislative Council (nonpartisan research staff of the CO General Assembly) released the latest economic and revenue forecast for Colorado.  Staff reported that the economy continues to gain strength.  The Fiscal Year 2011-12 General Fund budget is in balance, and an estimated $256 million left in the General Fund at the end of the year above the required reserve.  This is $108 million higher than the amount expected in December.  Click here to read the report. 

The budget-balancing package is expected to be introduced in the House next week.  Part of the proposed budget for FY 12-13 is the Senior Homestead Exemption, which exempts 50 percent of the first $200,000 of a home’s assessed value.  Voters approved the tax break in 2000, but the amendment allows the legislature to zero out the tax break if necessary.  Lawmakers have elected to zero out the tax break in all but four years since it was passed.   However, in light of the latest revenue forecast, the Joint Budget Committee said the state revenues are sufficient to restore the Exemption.  To get the benefit, a senior must be at least 65 years old and have lived in their home for the last 10 years. 

Budget Works 2012—January 13

The Colorado Fiscal Policy Institute is presenting its annual Budget Works conference on January 13, 2012 at the History Colorado Center in Denver. The day-long workshop will focus on federal funding and how it affects the state budget and Colorado residents. Click here to read more and to register. 

Governor Hickenlooper Releases FY 2012-2013 Budget

Today Governor Hickenlooper delivered his proposed FY 2012-2013 budget to the Joint Budget Committee (JBC). The budget request totals $20.09 billion. His proposal contains few cuts to healthcare programs. No Medicaid provider rate cuts were proposed and Amendment 35 funding will not be transferred to the General Fund but will be granted out through CDPHE to local organizations for prevention and health promotion activities. Cost-sharing for higher income beneficiaries of Medicaid and CHP+ is proposed. New revenue-generating measures are not in the plan; however, it calls for education budget cuts of $90 million for K-12 and $60 million for higher education.

We will share more information about the Governor’s budget as it becomes available. The budget represents the first step in the FY 2012-2013 budget process, continuing with JBC hearings and briefings beginning this month. The JBC will draft the Long Bill that requires the full legislature’s approval and the Governor’s signature.

What Do Federal Deficit Proposals Mean for Rural?

Decisions are being made in Washington DC that will impact rural health care. If you would you like to learn more about the ongoing negotiations to reduce our nation’s deficit and understand how various proposals could impact rural providers and communities, please attend a Federal Advocacy webinar on Tuesday, October 4, from 2:00-3:00pm. The Colorado Rural Health Center, in partnership with the Area Health Education Centers, will be hosting the webinar to provide information on this important topic and share resources for communicating with your elected officials. Click here to register for the webinar. If you are unable to attend tomorrow, a recording of the webinar will be available on CRHC's webpage and The Rural Voice.

Federal Budget Update and Upcoming Webinar

Although much attention is being directed to the deficit reduction proposals and work of the President and Super Committee, the federal fiscal year 2011 ends on September 30 and none of the FY 2012 appropriation bills have been enacted by Congress. To avoid a government shutdown on October 1, Congress has been working on a Continuing Resolution that would keep programs funded. After some concerns that the two chambers would not reach a compromise, an agreement was reached yesterday evening that should keep the government operating. This Continuing Resolution does include spending reductions from FY 2011 levels that were agreed upon during deficit reduction negotiations earlier this summer.

The Senate did complete its markup of the FY 2012 Labor-HHS Appropriations bill last week, recommending level funding for many rural health programs including SHIP and Flex. The House has not completed its work on the Labor-HHS bill and it’s not clear whether Congress will pass the spending bills or wait for the Super Committee’s recommendations that are due on November 23.

Want to learn more about the current federal budget negotiations? CRHC, in partnership with the Area Health Education Centers, will be hosting a webinar on October 4 from 2:00-3:00 pm to discuss the issues, how they might impact rural providers and communities, and provide information and resources for communicating with your elected officials. Click here to register for the webinar. 

Cutting Healthcare Providers Also Impacts Patients

An article in today’s New York Times highlights the impacts that cuts to healthcare providers can have on patients. 

September Revenue Forecast

Colorado’s economic growth has slowed over the summer, according to today’s revenue forecasts released by the Office of State Planning and Budgeting and the Colorado Legislative Council. The state economy faces many national and global threats; however, agriculture and oil prices are strong. The state’s current FY 11-12 budget is in balance, with a $64 million projected surplus. For FY 12-13, forecasters projected a surplus of approximately $370 million, assuming that the current year’s surplus is rolled over and the economic outlook remains steady. Given this minimal projection for the next year and annual increases in demand for services including Medicaid, spending reductions are expected for the coming year. Read more. 

The Budget Control Act of 2011: Implications for Medicare

A new brief by the Kaiser Family Foundation, The Budget Control Act of 2011: Implications for Medicare, provides an overview of the new law that came out of this summer’s negotiations on raising the debt ceiling and deficit reduction, including a timeline and process for raising the debt ceiling and lowering the federal deficit. The brief also describes the role of the new Joint Select Committee on Deficit Reduction, aka the “Super Committee”, examines how Medicare spending could be affected by changes proposed by the Committee, or if that process fails, by sequestration. Click here to read the brief. 

Update on Congressional Deficit “Supercommittee”

The deal reached by Congress and the White House that raised the debt ceiling also called for the creation of a bipartisan Congressional “supercommittee” called the Joint Select Committee on Deficit Reduction. This committee is charged with finding at least $1.2 trillion in savings. These recommendations are due by Thanksgiving, with the entire Congress to vote on them by Christmas to avoid automatic cuts in military and healthcare programs, specifically payments to Medicare providers. Nearly all of the members of this committee have been named. Click here to read about this committee and its members to date.  

Update on Federal Deficit Reduction Negotiations

The bipartisan “Gang of Six” in the U.S. Senate has put forward a plan for deficit reduction. Reports have stated that the deal, totaling $3.7 trillion over 10 years, would include 26 percent revenue increase and 74 percent spending cuts. Early information shows a possible $200 billion in cuts to health care. The released information, however, does not include the specifics of where these cuts would be made. Earlier proposals have included reducing or eliminating the Medicaid Hospital Provider Fee, $14 billion in Medicare cuts to rural providers, and reducing the federal matching rate for Medicaid to the states.

Because the details the health care cuts under consideration are still unknown, it is critical to continue communicating with our members of Congress, especially Senators Bennet and Udall. Please contact Senator Bennet, Senator Udall, and your Representative with this message: “Please protect Medicare and Medicaid as you consider changes and cuts in the federal budget. Rural communities rely on these programs and significant cuts will threaten access to care and economic growth in rural Colorado.” Feel free to personalize your message with how Medicare and Medicaid impact your community. Thanks to all who have already contacted your elected officials.

You can contact your legislators by phone and email: 

Senator Michael Bennet, 202.224.5852 

Senator Mark Udall, 877.768.3255 

Capitol Switchboard, 202.224.3121 (ask for your Representative's office and to speak with the staff who handles health issues)

Click here for a list of Colorado's members of Congress and email addresses for their healthcare staff. If you don't know who represents you in Congress, click here and enter your zip code.

Call to Action: Contact Your Member of Congress & U.S. Senators Today

As has been mentioned in previous posts, political leaders in Washington are discussing options for raising the nation’s debt ceiling limit by August 2^nd and cutting federal spending to address the deficit. Medicare and Medicaid are under consideration for substantial spending cuts, including reducing the federal Medicaid matching rate to the states, and limiting or eliminating the Medicaid hospital provider fee that supports expansion of coverage to the uninsured and the hospitals that care for the medically vulnerable.

As you know, Medicare and Medicaid are essential to rural healthcare providers and communities. The proposed cuts will severely compromise access to healthcare for rural residents and hamper local economies that depend on healthcare providers for jobs and economic development. Colorado’s Congressional delegation needs to hear from you about the importance of Medicare and Medicaid to rural Colorado. Please take five minutes today or no later than Wednesday July 13 to contact Senator Bennet, Senator Udall, and your Representative with this message: “Please protect Medicare and Medicaid as you consider changes and cuts in the federal budget. Rural communities rely on these programs and significant cuts will threaten access to care and economic growth in rural Colorado.” Feel free to personalize your message with how Medicare and Medicaid impact your community. 

You can contact your legislators by phone and email: 

Senator Michael Bennet, 202.224.5852

Senator Mark Udall, 877.768.3255

Capitol Switchboard, 202.224.3121 (ask for your Representative's office and to speak with the staff who handles health issues)

Click here for a list of Colorado's members of Congress and email addresses for their healthcare staff. If you don't know who represents you in Congress, click here and enter your zip code.

Thank you for your calls and emails. Please contact Sara if you have any questions and we will post updates on the budget negotiations as they are available.  

 

States Cutting Medicaid Rates, Healthcare Programs At Risk in Budget Negotiations

Several states, including Colorado, began their fiscal years on July 1 by reducing Medicaid payment rates to providers and hospitals. A Kaiser Health News report outlines various states’ changes in Medicaid, including payment and benefit reductions, that may further compromise access to care for Medicaid recipients.

In Washington, Medicaid and Medicare program cuts are under consideration as political leaders negotiate budget and debt issues. Negotiators are discussing serious reductions in Medicaid, including reducing the federal matching rate to the states and limiting or eliminating the Medicaid hospital provider fee that both supports Colorado’s coverage expansions to the uninsured and our hospitals that care for the un- and underinsured. Negotiations are expected to continue for the next several weeks as the national debt ceiling limit approaches on August 2^nd. Given the critical role that Medicare and Medicaid play in rural communities, CRHC has been communicating with Colorado's members of Congress about these issues and will be sharing opportunities for you to contact your member directly in the coming days. Please contact Sara if you have any questions.  

June Revenue Forecast

The Governor's Office of State Planning and Budget released its June revenue forecast for General Fund revenue, estimating an increase in revenues by $78.1 million compared with the March 2011 forecast. Although citing some positive economic developments, the forecast projects flat revenues for FY 11-12 and estimates a shortfall of $22.4 million in the coming year to maintain a four percent reserve requirement. Modest economic growth is not expected until FY 2012-2013. Read more.