NH CARES
Network for Responsible Budgeting
March 28,
2007
Division III of House Finance Worked all day on Monday the 26th and Got
a Lot Done Including Adding $17.7m in Generla Funds & Has Only Nine
Programs Left to Do
Nine More Programs to Go –
Division III finished ALL the Program PAUs in the DHHS budget except for
the nine below. They will be working to finish these on Thursday and Friday
(all day sessions have been reserved on both days starting at 9:30, and
if the House Session ends early today, they will reconvene afterwards).
They are scheduled to finish on Friday at the latest and report to the
full committee next week.
Significant Additions – They added significant funds to:
- Cancer Treatment and Prevention
- Alcohol and Other Drug Treatment and Prevention, *Family Planning
- Contract Psychiatric Services at NH Hospital.
TOTAL INCREASES as of March 27 –
So far, Division III has increased DHHS General Funds by $7,432,201 for
FY 08 and $10,312,225 for FY 09. Of this increase, $1.4m in FY 08 and
$4.5m in FY 09
was from adjustments that DHHS, the Committee, and the Governor’s Office
agreed on.
The Last Nine Programs to Be Decided On This Week (Page numbers refer
to the Governor’s budget)
Page 753, PAU 5-1-1-2-2 – Tobey School
The only issue here is how much money is needed to maintain the old Tobey School
Building after the program moves to the Thayer Building.
Page 759, PAU 5-1-2-1-3 - OMBP Medicaid Medical Care Services (Provider Payments).
This program uses more General Funds by far ($184m in FY 08 and $197m in FY
09) than any other DHHS Program, so this is always one of the last to be decided.
This is because even the smallest change in projections has a big impact on
total
DHHS General Fund spending. Adjustments have been made here already, but there
are still some questions about putting back direct and indirect medical education
payments, whether to put in some increased Medicaid rates for hospitals and
doctors (none are in the budget), and whether the assumptions on caseload growth
and
utilization are realistic.
Page 790, PAU 5-1-5-3-1 - DPH Rural Health and Primary Care
There is a pending proposal by Rep. McLeod to add $250,000 for each year to
the Loan Repayment Program in Class 93 to help recruit needed medical staff.
Page 824, PAU 5-1-7-6-7-1 - DCYF Child & Family Services
This is on hold to primarily to decide if funds for residential provider rate
increases should be put back in and how any increases would affect the litigation
and negotiations over the rates.
Page 825, PAU 5-1-6-7-2 - DCYF Prevention Programs
The Diversion Incentive funds (Class 90) are 5% of page 824, so this is on
hold until page 824 is decided. Also, the committee will discuss the controversial
Section VI in HB 2 (the “Budget Trailer” bill) that requires that
$40,000 per year of Diversion Incentive Funds in each county be used to fund
Family Resource Centers ($20k) and Child Advocacy Centers ($20k).
Page 862, PAU 5-1-8-4-1 - BEAS Nursing Services (Nursing Homes and Elder Community
Care)
This is almost as large as OMBP Medicaid in Total Funds, and is the second
largest in its use of General Funds ($74m in FY 08) And because the counties
pay as much
as the state for nursing services ($78m in FY 08) and their responsibility
for paying ends under current law on June 30, 2007, the committee is pushing
for
the State and Counties to agree on their shares of costs before they finalize
their numbers this week. Agreement on this has historically been very difficult
and there are lawsuits pending.
This will likely be the most difficult PAU for the Committee not only because
of the county payment issue but because:
(a) the projections in the budget for the decrease in nursing home
residents (and corresponding increase in people served in community
services) have to be confirmed or changed in the face of conflicting
data that does not clearly support the DHHS projections in the
Governor’s budget;
(b) several members are uncomfortable with the lack of rate increases
for FY 09 (because of uncertainty over county share and dispute and
litigation over rate setting)
(c) there is a disagreement on rates for the Crotched Mountain
Rehabilitation Center and whether they should be considered as a
hospital or a nursing home; and
(d) there is a question whether rates and funding for community services are
enough to support projected increases in enrollments and whether they should
be help up because of rate litigation.
Page 869, PAU 5-1-9-2-3 -
BBH Legal and Guardianship Services This is on hold to find if FY 08 and FY
09 projections are realistic in Class 97 Involuntary Emergency Admission Fees
based
on the increase in FY 07.
Page 872, PAU 5-1-9-4-1 - BBH Community Mental Health Services
This is on hold primarily because of the proposal to add coverage for adults
in Class 98 “Family Mutual Support Services.” These services were
previously provided by NAMI. BBH also submitted a large package of additional
information the committee wanted to digest.
Page 886, PAU 5-1-10-1 - BDS Community Developmental Services
This is on hold primarily to decide if more funds should be added to reduce
the waitlist for developmental and brain disorder services. On Monday, Commissioner
Stephen presented a list of 17 cuts and savings in other programs that would
provide enough funds to eliminate the waitlists (DD and Brain Injury) by June
30, 2009 ($3.3m for FY 08 and $3.9m for FY 09). Note: Some of these (my guess
is in $1m range) seemed possible while others were not consistent with the
Committee’s
votes in approving program budgets.
Major ADDITIONS of $12.1m in General Funds (not including adjustments) in Program
PAUs Approved on Monday
Page 781, PAU 5-1-5-2-7 – DPH Comprehensive Cancer Services
$2m for each year (FY 08 and FY 09) in General Funds was added to Class 90
Cancer Screening. The Democrats voted in favor and the Republicans against.
Page 787, PAU 5-1-5-3-1 – DPH Alcohol and Other Drug Treatment and Prevention
through the Governor’s Commission
$3.1m per year was added to General Funds for each year (FY 08 and FY 09) in
Class 98 and Class 99 for prevention and treatment. The Democrats voted in
favor and the Republicans against.
Page 801, PAU 5-1-5-3-15 – DPH Family Planning Program
$250,000 per year (FY 08 and FY 09) was added to Class 92 Grants to Family
Planning Programs.
Page 918, PAU 5-1-12-3 – NH Hospital Acute Psychiatric Services
$651,519 in General Funds for the Dartmouth Contract was added for FY 08 and
$505,986 was added for FY 09. The vote was unanimous with Rep. Nordgren abstaining
and recusing herself.
For more information, the NH CARES detailed comparison spreadsheets on
these program lines are available on the NHCares website and the official
Governor’s budget is on line in several formats at
http://admin.state.nh.us/budget/
And . . .Don't forget the Regular CARES MEETING this Friday at 9 AM.
