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Children's Health

Governor’s Budget has Rough Cuts for Health & Human Services

At the short session begins, state officials and advocates are bracing for painful cuts to the health and human services budget, and preparing to push back.

By Rose Hoban

State health officials presented the governor’s proposed budget before the House Health and Human Services Appropriations Committee today, and while there were a few bright spots in the budget, there’s a lot of pain, especially in children’s services.

Secretary of Health and Human Services Al Delia delivered the good news first: money to increase the number of community mental health beds around the state, funding for the NC Pre-K program, and the introduction of ‘smart cards’ to identify recipients of Medicaid and social service payments and reduce fraud.

Division of Social Services head Sherry Bradsher (left) explains some of the cuts to her budget after Wednesday's meeting
Division of Social Services head Sherry Bradsher (left) explains some of the cuts to her budget after Wednesday’s meeting

But the pain comes quickly in this year’s budget, even if a proposed three-quarters of a cent sales tax could make it through the legislature. And though the governor has proposed to spend $20.9 billion, up from $19.7 billion last year, there still are plenty of cuts.

Republicans in the General Assembly have vowed not to increase taxes, so the budget they propose later this week is likely to be even more painful.

Nothing in Wednesday’s meeting got as much attention as cuts to children’s services around the state. Those cuts come, in part, as the result of automatic spending cuts mandated by Congress’ debt ceiling deal struck last summer. Congressional leaders were unable to come to an agreement on ways to trim the federal budget, so automatic cuts to defense programs and to social service programs will be included in this next federal fiscal year.

And the cuts are also the result of steady reductions in federal allocation to states for the welfare program, known as Temporary Aid to Needy Families (TANF). Congress has kept funding flatlined for the past few years, and supplemental dollars for the program have not been reauthorized by Washington.

“We are going to experience a significant reduction in the TANF program,” Sherry Bradsher, director of the state Division of Social Services told the committee.

Bad for children

Bradsher told lawmakers that county officials had asked for ‘maximum flexibility’ in how the state allocates dollars to counties. She went on to detail how state officials are working with county social services directors to strategically move money from block grants around, in order to protect the most vital services.

Block grants are large chunks of money given to counties to pay for services. Some grants have strict guidelines for spending, while others allow local officials more ability to prioritize, while still meeting mandated services.

Children’s protective services will see a total of about 20 percent taken out of state dollars. But Bradsher said actual cuts won’t be so bad, because county managers are permitted to move money from the Work First (welfare-to-work program) block grants to children’s protective services to make up some of the losses. Even still, she admitted the cuts would be deep.

“Without question, i believe we will lose child protective serves workers across the state,” Bradsher told legislators. “These cuts are bad. They’re bad for children. and they’re bad for our chiidren’s protective services program.”

Some counties have more resources to make up for their losses.

“Many have contracts with not for profits to do prevention, some have contracts with employment agencies, such as Goodwill, to support their employment programs, some are spending 70 percent of their Work First block grants on child welfare, some are spending 40 percent of their Work First block grants on child welfare…” Bradsher said. “It varies from county to county across the state.”

Committee members expressed their commitment to preserving services for children.

“I agree this isn’t the best place to be cutting and understand that the federal government needs to be cutting back on dollars,” said committee co-chair Justin Burr (R-Albemarle) “i think that’s critical… that as a committee we meet that obligation and keep those dollars that are going to making sure that children are protected and safe in their communities.”

Other cuts to children’s services:

  • Child care subsidies will be cut, but Bradsher said the cuts will primarily affect families on the waiting list for child care. “There won’t be any adverse impact on kids currently being served in the program,” she said.
  • Teen pregnancy prevention services will see a 19 percent cut. According to Bradsher, that will mean a reduction in services. North Carolina’s teen pregnancy rate is 49.7 pregnancies per thousand girls between the ages of 15-19, down from a peak of 105.4 per thousand in 1990.
  • Adoption and foster care services will see cuts, some of which will be mitigated by federal money.

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