By Rose Hoban

State House lawmakers provisionally passed a $22.2 billion budget Wednesday that includes more than $5 billion for health and human services needs, which represents a decrease of about $190 million from what was budgeted for the upcoming year.

“The first thing I’d like to say … there’s no harm in this budget,” said Rep. Josh Dobson (R-Nebo), a co-chair of the House Appropriations, Health and Human Services Committee. “There are increased rates where we could make those changes to make the investments we needed to make.”

Rep. Josh Dobson (R-Nebo) headshot
Rep. Josh Dobson (R-Nebo) Photo courtesy NCGA

And it seems like many in the chamber agreed with him. The bill passed 103-12, with many Democrats siding with the Republican majority.

“We didn’t have anything to do with setting the spending cap, which was 2.3 percent over last year’s budget, and I really agree that the appropriations subcommittee chairs did a really great job with the money they were allowed to spend,” said Cary Democrat Gale Adcock.

“It was a bipartisan budget. Why are people surprised when we act in a bipartisan way?”


But Democratic leaders in the chamber said they were disappointed in the budget, such as Chapel Hill’s Verla Insko, who said budget writers set their sights too low, particularly on the health care budget.

“If you have the capacity to be an astronaut and you fly model airplanes, you’ve missed the mark,” Insko said during the debate. “And this budget missed the mark.”

She went on to critique appropriations chairs’ choices to pour an extra $300 million to the state’s so-called rainy day fund, bringing the total to $1.4 billion. Instead, Insko argued, the state should have put more money into the fund used for providing services for uninsured people with mental health issues.

“Historically, that pot of money has been about $350 million. When the downturn came, we pulled that money back,” Insko said. “Currently in the budget bill, you’ll find it says that fund now stands at $247 million.”

She cited increased population, long wait times in emergency departments for psychiatric care and more uninsured people with mental health issues.

“And they end up in our jails, they end up in our prisons, they end up back in our state institutions,” Insko said.

She also criticized the decision not to expand Medicaid to cover as many as a half-million uninsured working poor.

This year, budgeted health and human services expenditures will be $5.07 billion, reduced almost $200 million from what lawmakers planned to spend in the upcoming year when they first created the state’s biennial budget last fall.

No innovation

Another disappointment for disability advocates was budget writers’ failure to include additional “slots” for so-called “Innovation waivers,” which allow people with developmental disabilities to receive enhanced services that allow them to stay in their homes and do things like work and go to school.

But there’s a backlog of between 9,000 and 12,000 people waiting for one of these slots, a wait that can be up to a decade, said John Nash, head of The Arc of North Carolina.

Gov. Pat McCrory’s budget allowed for 250 slots; House lawmakers didn’t make allowance for any.

Rep. Marilyn Avila (R-Raleigh)
Rep. Marilyn Avila (R-Raleigh)

“We’re concerned that the House budget does not have those slots,” Nash said. “We’re hoping that the Senate will address that themselves.”

He said he “gets” that money is tight and that everyone is in competition for dollars. But Nash also argued that the average $50,000 per person, per year for the slot could actually save money.

There’s an expense, he said, “related to not adding those slots when people go into crisis.”

That exclusion from the budget disturbed Raleigh Republican Marilyn Avila as well. As lawmakers amended and debated the bill, Avila offered an amendment that would create a study committee to examine the cost benefit of providing more slots.

“It seems to be so much of a benefit that we actually save money on it, because people are getting the services when they need services; we’re keeping them out of crisis,” Avila said. “We’ll prove to people that people are getting what they need and if we can get more bang for the buck and show that the cost-benefit analysis is on the plus side, then it becomes easier for us to say we’re getting our money’s worth.”


Many Republicans and Democrats, however, said there were a lot of good things in the budget within the financial confines of the budget target.

Some of those highlights include:

  • $350,000 in funding for helping corner stores provide fruits and vegetables survived a challenge during appropriations meetings on Tuesday to stay in the budget.
  • $7.7 million in funding for students from Campbell University’s new medical school to a residency program at Cape Fear Valley Medical System, serving the rural Southeastern part of the state.
  • Restoring $60 million in cuts to fund balances held by the state’s mental health local management entities, funding almost all of McCrory’s $30 million funding request for mental health services.
  • Providing funding to resolve problems in the state’s child welfare system.
  • Providing $750,000 to fund efforts to combat Zika virus and the mosquitoes that carry it.

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Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...

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