Commentary

Children’s advocate: Senate budget proposal does little for kids

In case you missed it last week, Rob Thompson of the advocacy group NC Child generated a nice summary of some of the highlights and lowlights of the Senate budget (a proposal he described as generally worse than the House’s proposed version). House and Senate negotiators are expected to put together a budget conference report next week. This is from Rob’s summary:

Medicaid—The budget proposal includes deep cuts to Medicaid that would jeopardize the effectiveness of the program. According to NC DHHS, this budget would create a $100M shortfall in the Medicaid program.

Mental Health—The budget cuts $15M out of mental health services.

Foster Care—The budget increases the reimbursement rate for foster parents, which is important for the recruitment and retention of foster parents.

Juvenile Justice—There is insufficient funding for ‘Raise the Age’ community programs. In FY21, the Senate budget includes only 1/4 of what’s in the house proposal–$2.2M vs. $8.8M.

Public Health—There is no funding for firearm safe storage, a new office state fatality prevention, the nurse-family partnership, or youth tobacco prevention, all of which were included in the House proposal.

Early Education—The Senate continues a trend of supplanting state funding with federal dollars. According to NC DHHS, the legislature has supplanted $100M in state funding for early education with federal funding over the past 5 years. This means that if we had held state spending steady during that time period, we would have an additional $100 M invested in early education.

Senate Budget Overview

Health and Human Services

Public Health

Oral Health Prevention Services—The Senate cuts $301k recurring due to a funding reduction in the federal block grant. This cut is also in the House budget.

Teen Pregnancy Prevention—The Senate budget includes a $250K recurring increase in both years for teen pregnancy prevention initiatives. This increase is included in the House budget.

Women and Children’s Health Services—The Senate cuts $2.1 million recurring funding in both years from Women and Children’s Health Services of the Division of Public Health. This reduction is included in the House budget.

Public Health items in the House Budget not include in the Senate Budget:

-Nurse-Family Partnership: $3.8M in FY20; $1.8M in FY21
-Youth Tobacco Prevention: $980K in FY20; $680K in FY21
-Firearm Storage Awareness: $90K in FY20 and FY21

Child Development and Early Education

Smart Start – The Senate budget for Smart Start is similar to the House proposal but slightly reduced.

Subsidized Child Care—As a result of a variety of federal and state funding shifts, the overall allocation for child care subsidies is ~$4.2 million recurring in both years, though state funding for the program is replaced with federal funding as with NC Pre-K. This is ~$3.3 million less than the House’s recommendation.

NC Pre-K—Allocates $1.7 million recurring in both years to increase the NC Pre-K rates for child care centers by 2% in FY 2019-20, which is less than the House’s recommended $1.7M in FY20 and $5.3M in FY21. Replaces $4.1 million recurring in the first year and $6.1 million recurring in the second year with federal TANF block grant funds, which is larger than the House’s recommended replacement of $2.5 million in the first year and $4.5 million in the second year, and continues a problematic trend of replacing state funding with federal funding.

Child Development and Early Education items in the House budget not included in the Senate budget:

-Funding for Reach Out and Read

Social Services

Child Advocacy Centers—$418,000 in additional recurring funding for both years to Child Advocacy Centers. The House budget includes $500,000 in non-recurring funding in the first year.

Intensive Family Preservation Services—$1 million in additional recurring funding in both years for Intensive Family Preservation Services which work to reduce out-of-home placements. This is less than the House’s recommended $1.9 million recurring funding in both years.

Work First Family Assistance—Senate budget cuts $4.1 million in recurring funding in the first year and $6.1 million in recurring funding in the second year from the Work First Family Assistance program funded by the TANF block grant. This cut is in the House budget.

Youth Villages—$500k in non-recurring funding in FY20 for the Foster Care Transitional Living Initiative Fund for Youth Villages to provide services to improve outcomes for youth (ages 17-21) who transition from foster care through the implementation of Transitional Living Services. House did not include this additional funding.

Child Welfare/Behavioral Health Pilot—$300k in non-recurring funding in the first year for a child welfare and behavioral health pilot project to provide easier access to comprehensive health and trauma related services for children in foster care. House did not include this additional funding.

Permanency Innovation Initiative—$1.5 million in non-recurring funding in both years for the Permanency Innovation Initiative, which works to improve permanency outcomes for children living in foster care settings. This is ~$700,000 less than the House’s recommendation for both years.

Child Welfare Program Improvement—~$500k in recurring funding in both years to create 5 new positions to increase the State’s capacity for technical assistance and program monitoring of county child welfare services. This is ~$600,000 less than the House’s recommendation for both years.

Foster Care Rate Increase—Allocates $20.7 million in recurring funding in the second year to increase the rates paid for foster care, effective July 1, 2020. House did not include a rate increase for foster parents.

Social Service items in the House budget not included in the Senate budget:

-Standardized Assessment in Foster Care Pilot

Mental Health/Developmental Disabilities/Substance Abuse

Single Stream Mental Health Funding—The Senate budget includes a $15M recurring cut to mental health funding. This cut is not included in the House budget.

Children’s Mental Health Services—Senate agrees with House and recommends $661k in recurring funding in both years for mental health services to children, from federal Mental Health Block Grant receipts.

Substance Abuse Services—Senate agrees with House and recommends $5 million in additional non-recurring state funding for substance abuse services in both FY20 and FY21.

Substance Abuse Treatment for Adults and Children—~$1.1 million cut in recurring funding in both years for treatment services and recovery support through the federal Substance Abuse Prevention and Treatment Block Grant. The House recommended cutting ~580k in recurring funding in FY20 $1.5 million in recurring funding in FY21.

Adult and Child Mental Health Services—$1.9 million increase in recurring funding in both FY20 and FY21 for Adult and Child Mental Health Services due to federal block grant availability. This is slightly less ($100,000) than the House’s total recommendation for both years.

Medicaid and Health Choice

Increase in Medicaid Copayments—The Senate budget increases the Medicaid copayment to $4. This change is also in the House budget.

Innovations Waiver—The Senate budget allocates $10.9M in FY20 and $21.7M in FY21 to expand the number of Innovations Waiver slots by 1000. The House budget includes an expansion of only 150 slots.

Medicaid Budget—The Senate Medicaid budget is substantially worse than the House proposal. According to NC DHHS, the Senate budget would create a $100 M shortfall in the Medicaid program. Of particular importance is the large “Administrative Reduction” ($30.7M in FY20 and $42.7M in FY21), which would decimate Medicaid staff within HHS.

Medicaid items in the House budget not included in the Senate budget:

-$10.4M for Medicaid Transformation Ombudsman

Education

Teacher Pay—The Senate budget provides teacher raises up to 3.5% over two years, which is approximately what the House approved for the first year of the biennium.

Classroom Supplies—$15 million recurring funding for classroom supplies. With additional funding, teachers would receive approximately $300 per year for supplies. This is similar to the House’s recommended $15 million in non-recurring funding ($145 per teacher per year).

School Mental Health Support Personnel Grants—$10 million recurring and $8.2 million non-recurring for FY20 and $10 million recurring for FY21 to public schools to add mental health support personnel as well as to contract for other health support services. This is significantly less than the House’s recommended $19M recurring for FY20 and $30M non-recurring for FY21.

School Safety Funding—$12.3 million non-recurring and $6 million recurring for the first year and $6 million recurring for the second year to allow districts to invest in safety equipment for schools, employ and/or train resource officers, and contract for training to address trauma and stress among students. Total funding for both years is slightly less than the House’s $9M for FY20 and $18M for FY21.

Students in Crisis Grants—$4.5 million non-recurring in the first year for evidence-based student crisis support services. This is ~$2M less than the House’s recommendation for the biennium.

School Psychologists—The Senate budget provides funding to hire an additional 100 school psychologist positions. The House did not include this additional funding.

Juvenile Justice

Implementing Raise the Age—The Senate budget proposal is largely similar to the House budget for Raise the Age with an important exception: the funding for community programs is dramatically less than the House budget.

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