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The House HHS budget: A band-aid for a deep wound

News headlines have made it seem as if the recently-passed House budget for the upcoming fiscal year restores budget cuts included in the legislature’s budget last year.  Nothing could be further from the truth.

Case in point—the Health & Human Services portion of the House budget proposal for FY 12-13.  This is the area of the state budget that touches the lives of virtually every North Carolinian from birth to old age and makes sure our food is safe, our children thrive early, seniors have access to prescription drugs and quality, affordable health care, and people with disabilities have the supports they need to contribute to our communities.

The House budget passed this week adds back in funding to the Health & Human Services budget for FY 12-13 to the tune of a 3.65% increase over the continuation budget passed in 2011.  While any expansion funding for areas hit deeply by cuts is better than no expansion, a funding jump in the single digits is not a resounding victory.  It’s just a small salvo for a few program areas and too little, too late.  For most programs, the expansion items fall far short of making up for the cuts in their entirety.

To dive a little deeper:

Early Childhood: the House budget includes a $15 million recurring increase for NC Pre-K, which should open up at least 1,700 new slots.  However, this funding just goes halfway in making up the $32 million cut for NC Pre-K included in the continuation budget.  Smart Start, which was cut by $37 million in 2011 saw a minor expansion of $3.5 million to test literacy programs in some of its local programs.

Medicaid: There’s $168 million in new funding in the House budget to keep up with projected growth in enrollment in consumption.  But that still doesn’t cover the full Medicaid shortfall of nearly $250 million.  The House budget also includes a $59 million cut to Medicaid due to anticipated savings through Community Care of North Carolina.  If those savings aren’t realized (and this has happened in the past), then that reduction turns into cuts to services.

Tobacco Cessation & Prevention: In the 2011 budget, the award-winning Health & Wellness Trust Fund was eliminated and some its funds transferred for one year only to the Division of Public Health.  The House budget includes $5.5m in one-time funds for initiatives targeting children in grades K-12. This is far short of the $17.2 million needed to continue current anti-tobacco efforts.  Moreover, while it’s good to educate kindergartners on the dangers of tobacco use, evidence shows it’s 18-24 year olds that need the intervention.

Mental Health:  The House budget cuts Mental Health, Developmental Disabilities and Substance Abuse funding by $57 million in 2011 and it was slated to be cut by an additional $12 million in the upcoming year according to the continuation budget.  The revised House budget for FY 12-13 includes some good expansions, including $18 million to increase the number of community hospital beds via three-way contracts and $7 million total for Cherry Hospital and Broughton Hospital, two mental health facilities in the state.  However, the revised House budget also includes a $10 million funding cut for community services and an $8.5 million funding reduction to Local Management Entities.   Pass-through funding for drug courts were also completely eliminated.  On net, Mental Health funding increased by $3.5 million in the House budget passed this week, a drop in the bucket to make up $57 million in cuts last year

If this doesn’t look like a pathway to ensuring North Carolinian are healthy and ready to thrive, it’s because it isn’t.

 

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