First Look at the Final State HHS Budget
Lawmakers presented a compromise budget plan late Sunday evening. A first look at what’s in the budget for health and human services.
By Rose Hoban
Lawmakers released their compromise state budget late Sunday night, a document that provides for $20.6 billion in state spending over the upcoming year.
The 546-page document not only provides the amounts being budgeted for programs this coming year but also sets policies, changes the way departments are organized, cuts and adds jobs and creates new programs in the 71-pages of language that address health and human services.
Legislative leaders have said they plan to pass the budget and adjourn their session by mid-week.
Adoption services – The budget allocates $3 million over the biennium to create an Adoption Promotion Fund that will be used to fund private organizations that encourage adoption of foster children. Lawmakers also allocated $3.75 million in a “Permanency Innovation Initiative Fund” over the coming two years to support the Children’s Home Society of North Carolina in finding permanent homes for foster children.
Child Fatality Task Force – After being eliminated in the original House budget, and later slated for sunset in 2014, the compromise budget makes no mention of the task force, which was established in 1991 as a mechanism to reduce infant mortality and child deaths.
Since that time, the state’s child mortality rates have dropped from a rate of 105 deaths per 100,000 children in 1990 to a low of 57.5 deaths per 100,000 children in 2010.
Some of the policies proposed by the task force have met with controversy over the years. During this past legislative session, the task force opposed measures to remove a requirement for motorcycle riders to wear helmets and supported a measure to ban the use of tanning beds for children under 18, positions which raised the ire of some lawmakers.
Not-for-profits – A number of not-for-profit organizations offer programs ranging from food banks to camps for kids with autism to supporting the state’s Senior Games, using money allocated by the legislature.
This year, the not-for-profits all see small increases in funding, but will be subject to a new, competitive grant-making procedure that will start in FY 2014-15.
Group homes – Changes made by state lawmakers to eligibility criteria for Medicaid personal care services reduced the number of people living in small, six-person group homes for the mentally il who could qualify for the service.
Group home operators and advocates have been pressing legislators to create a temporary fund to cover the group homes while they study a new mechanism for supporting people who live in the facilities.
Advocates have been asking lawmakers for $10 million to cover about 1,500 group home residents across the state. In this final budget, legislators allocate less than half that amount.
Group home manager Jenny Gadd, who works for Alberta Professional Services, called the $4.6 million allotted “disappointing.”
“I don’t think that’s going to be enough to take care of all the people who need it,” he said. “It’s about 800 people that this would support, as opposed to the 1,500 who need it.”
Gadd said the allocation would amount to at least a $10,000 cut for most group home operators, an amount she said could put some out of business.
“We’re holding it together with duct tape and bubble gum as it is,” she said.
The budget does create a pilot program to study different ways of funding group homes for people with mental illness, but does not detail which counties are included.
“If the pilot included Alamance and Wake, that’s about 75 group homes,” said Gadd, adding that might help cover the loss of statewide funding.
Eugenics compensation – The budget includes a one-time allocation of $10 million to compensate victims of the state’s eugenics program, which ran from 1929 to 1973.
Language in the budget creates an Office of Justice for Sterilization Victims, which will assist victims in substantiating their claims and gives victims until June 30, 2015 to come forward to claim compensation.
Past plans included giving each victim $50,000 in compensation, but the plan laid out in the budget would divide up the $10 million among all of the people who can substantiate a claim of having been forcibly sterilized by the state.
Allocation of the dollars are a win for House Speaker Thom Tillis (R-Cornelius), who vowed to fight for the eugenics compensation after the dollars were stripped out of last year’s budget by Senate negotiators.
Medicaid – The budget creates a Medicaid Reform Advisory Group to study and create a plan for “significant reforms” to the state’s program that serves 1.7 million low-income children and their parents, people with disabilities and the elderly.
Budget writers instruct the group to come up with a detailed plan that would include integrating mental and physical health services, creating better cost forecasting, the possibility of regional pilot programs to test new ways of funding Medicaid and delivering services and creating a “reasonable time line for implementation.”
Earlier this year, Gov. Pat McCrory and Department of Health and Human Services Secretary Aldona Wos proposed a Medicaid privatization plan that would take effect in mid-2015.
Any Medicaid reforms would have to be approved by the General Assembly.