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Funding for Health and Welfare

Description: 

Most of the state’s public health and welfare programs are administered by three state agencies: the Arizona Health Care Cost Containment System (AHCCCS, the state’s alternative to Medicaid), the Department of Economic Security (DES), and the Department of Health Services (DHS). Most of the appropriations to AHCCCS and DHS come from the general fund, but DES receives close to half of its appropriations from other funds.

Appropriations are approved by the Arizona Legislature before the beginning of each fiscal year, but adjustments to appropriations can be made during the year. Actual expenditures are essentially the same as the latest approved appropriations. The data are reported for fiscal years; for example, fiscal year 2012 runs from July 1, 2011 through June 30, 2012. An annual time series of appropriations from all funds are available back to fiscal year 1989 and include appropriations through the current fiscal year.

In order to compare expenditures over time, the effects of inflation, population growth, and per capita economic growth must be considered. Reporting expenditures per $1,000 of personal income automatically adjusts for all three factors. The fiscal year average (the average of the four quarters of the fiscal year) of personal income is used to standardize the public finance data. Thus, total appropriations from all funds per $1,000 of personal income are used to compare the funding for the three state agencies over time.

Another way of looking at funding for public health and welfare is to examine total expenditures (including federal funds) by program. These expenditures were divided by the number of people enrolled in each program. Appropriations per recipient were divided by per capita personal income in order to adjust for inflation and per capita economic growth. Per capita personal income was calculated using the fiscal year average for personal income and the average of the population at the beginning and end of the fiscal year.

Data Source: 

Appropriations by agency are reported by the Arizona Joint Legislative Budget Committee (JLBC) http://www.azleg.state.az.us/jlbc.htm. The expenditure data for the general fund and for all funds are taken from the Appropriations Report; when released late in a fiscal year, the report includes revised appropriations for the current fiscal year and appropriations for the following fiscal year. The Appropriations Report is released several weeks after the budget has been passed by the Legislature and approved by the Governor.

Monthly AHCCCS enrollment is available at http://www.azahcccs.gov/reporting/enrollment/population.aspx. For the other programs, total expenditures and the number enrolled are reported monthly by the Arizona Department of Economic Security, Family Assistance Administration https://www.azdes.gov/appreports.aspx. Fiscal year annual average figures are calculated.

Personal income is estimated quarterly by state by the U. S. Department of Commerce, Bureau of Economic Analysis http://www.bea.gov/regional/index.htm. It is released about three months after the end of the quarter; revisions to estimates for prior quarters are made every quarter.

The calculation of per capita personal income for the fiscal year uses annual population estimates as of July 1. Through 1999, the source is the U. S. Department of Commerce, Census Bureau. Their time series of population estimates is most easily accessed from the BEA: http://www.bea.gov/regional/index.htm. Since 2000, the source is the Arizona Department of Administration, Office of Employment and Population Statistics: http://www.workforce.az.gov/population-estimates.aspx. Both sets of estimates are released in December.

Data Quality Comments: 

Because of differences by state in accounting systems, the JLBC data are not comparable to those of any other state.

Some of the inputs to the calculation of personal income by state are estimated. Personal income estimates are subject to revision. Figures for the current fiscal year are projected. Personal income is a comprehensive measure of the economy but has conceptual limitations when employed to adjust public revenues and expenditures.

iconTotal Appropriations for Social Service Agencies Per $1,000 of Personal Income, Arizona State Government

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Visualization Notes:

Total spending on health and public welfare programs is a function of the number of people receiving assistance and the average dollar amount of assistance provided per recipient. Relative to the size of the Arizona economy, total appropriations for each agency — AHCCCS (the Arizona Health Care Cost Containment System, the state’s version of Medicaid), the Department of Economic Security plus the Department of Child Safety, and the Department of Health Services — have fluctuated but have experienced little trend since the late 1980s.

iconNumber Enrolled in Health and Social Services Programs Per 1,000 Residents in Arizona

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Visualization Notes:

* 2013 starts the first year of a change in AHCCCS's total count methodology

Relative to the growth of the Arizona population, the numbers enrolled in the largest of the public health and welfare programs — AHCCCS, medical assistance, and the supplemental nutrition assistance program (food stamps) — have increased considerably over time. The number enrolled in each program varies countercyclically, with increases in enrollment during recessions and decreases during periods of strong economic growth. Very large increases occurred between fiscal years 2007 and 2011. With the gradual improvement in the Arizona economy, the per capita figure has dropped a little in each of the programs since fiscal year 2011.

In contrast, the per capita numbers enrolled in the cash assistance, unemployed parents, and temporary assistance to needy families programs have declined significantly due to program restrictions; the cash assistance and unemployed parents programs are no longer offered.

iconAverage Payment Per Recipient in Social Services Programs Per $1,000 of Per Capita Personal Income, Arizona

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Visualization Notes:

The average payment in fiscal year 2014 in the supplemental nutrition assistance program (food stamps) was near the historical norm after adjusting for per capita personal income. In contrast, the average per person payment has fallen considerably in the temporary assistance to needy families program. Large declines occurred in the cash assistance and unemployed parents programs prior to their terminations.

Data Source

Appropriations by agency are reported by the Arizona Joint Legislative Budget Committee (JLBC) http://www.azleg.state.az.us/jlbc.htm. The expenditure data for the general fund and for all funds are taken from the Appropriations Report; when released late in a fiscal year, the report includes revised appropriations for the current fiscal year and appropriations for the following fiscal year. The Appropriations Report is released several weeks after the budget has been passed by the Legislature and approved by the Governor.

Monthly AHCCCS enrollment is available at http://www.azahcccs.gov/reporting/enrollment/population.aspx. For the other programs, total expenditures and the number enrolled are reported monthly by the Arizona Department of Economic Security, Family Assistance Administration https://www.azdes.gov/appreports.aspx. Fiscal year annual average figures are calculated.

Personal income is estimated quarterly by state by the U. S. Department of Commerce, Bureau of Economic Analysis http://www.bea.gov/regional/index.htm. It is released about three months after the end of the quarter; revisions to estimates for prior quarters are made every quarter.

The calculation of per capita personal income for the fiscal year uses annual population estimates as of July 1. Through 1999, the source is the U. S. Department of Commerce, Census Bureau. Their time series of population estimates is most easily accessed from the BEA: http://www.bea.gov/regional/index.htm. Since 2000, the source is the Arizona Department of Administration, Office of Employment and Population Statistics: http://www.workforce.az.gov/population-estimates.aspx. Both sets of estimates are released in December.