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Social Services Consortium,
Sorry you haven't heard from me for a while but I have found myself going non-stop trying to stay on top of everything that has been happening (or NOT happening). In this update I will be providing a brief overview of the Senate budget and this will be followed by another update that will overview the myriad of bills that we are working on.
Senate Draft Budget
The first draft came out on April 13, 2005 . The Senate used a lower budget target (total amount of money available) than the Governor. There are lots of political reasons why the Senate used a lower target but the general speculation is that the Governor included a litany of revenue options such as: cigarette tax, maintenance of the estate tax, changes to the internal revenue code, maintenance of the 8.25% tax on wealthy North Carolinians, Tobacco Trust Fund Transfer, and maintaining the current tax rate of 4.5%, and the Senate was reluctant to include all of those revenue options in their target from the start. Instead, they would use a lower target that would force them to make significant cuts to the budget which would result in an uprising of concern and protest that would then justify the Senators in taking steps to maintain the taxes that were schedule to end or be reduced, look at new taxes (such as cigarette tax) and consider some radical options such as the lottery . Thus, the first Senate Draft Budget was born. This budget, which I outline below, has a lot less money then the Governor's version but it is still $25 Million dollars over the target they intended to meet. We have been told that the next version will include the additional $25 million in cuts BUT will include some additional revenue from the myriad of choices listed above in red. The House has already passed a lottery bill and the Senate begins formal hearings on it today (although LOTS of behind the scenes happenings!) Word on the street is that another Senate budget will be coming out very soon now that the talks have started on the lottery and that it may be included in the new fiscal target.
If you are thinking to yourself, wow, this seems like a bit of a shell game, you would be correct! Such is politics!
Highlights from Senate Draft Budget:
Freeze Medicaid Rates for SFY 2006-2005. Rate freeze applies to all Medicaid private and public providers with a few exceptions. This could make it more difficult to find Medicaid providers and if costs exceed 06-05 rate it would be a cost shift to counties.
Medicaid Reserve Fund takes $50 million from the reserve on FY 05-06 and )6 -07 . According to HHS, this money is not available as they are required to maintain a certain level in the fund and this would deplete it to a lower level than is allowed.
Medicare Part D Claw Back this is expected to save the state money when Medicare Part D program begins paying for prescription drugs for people who have dual eligibility (Medicare/Medicaid). Save FY 05-06 $11 M, FY 06-07 $22 million.
Increase Co - Payments for Medicaid Is a $3.00 co-payment for chiropractic, optical, podiatry, hospital outpatient, non-emergency ER visit, generic prescription drug and a $ 50.00 co-pay for hospital inpatient.
Medicaid Coverage for Aged, Blind and Disabled This recommendation adjusts Medicaid coverage for Aged, Blind, and Disabled clients with incomes exceeding the SSI income limit. Some of these folks will still receive prescription drugs through Medicare Part D and could receive long term care services under the Medically Needy optional coverage group. However, experts in this work say that 57,000 people will lose services and besides hurting our most vulnerable citizens, it also creates a cost shift to the counties. For example, the Personal Care Services that some of the currently eligible clients receive would be lost. For many older and disabled adults, it is PCS that allows them to stay in their homes. Without this service they would need to go into a facility which would cost a great deal more than the PCS. Saves FY 05-06 $53 million, FY 06-07 $115 Million.
Reduction to Personal Care Services Reduces the funding for PCS by reducing the monthly limit to 50 hrs from 60 hrs for regular PCS and the monthly limit for PCS Plus to 70 hrs from 80 hrs. Reduces the daily limit from 3.5hrs to 3 hrs per day. Saves FY 05-06 $6 M, FY 06-07 $8 M.
Coverage for Children 0 to 5 to 200% FPL Provides funding to transfer children age birth to 5 in families with incomes up to 200% of the FPL from NC Health Choice to Medicaid. Saves the state FY 05-06 $14.5 M, 06-07 $17M but it does create a cost shift to the county.
Small increased in funding for Crisis Intervention Services ($2.5M ) , Adult Day Vocational Program ($1.5M), System of Care for Child Mental Health ($2 M), Intensive Substance Abuse Services for children ($1.5M), and Adult Substance Abuse Services ($1M).
Expand DFS Mental Health Licensure and Inspections 13 new positions in 05-06 and 23 in 06-07 to provide annual inspections of 24 hour residential facilities for the mentally ill, developmentally disabled, and SA population.
Expand DFS Adult Care Licensure Section Provides funding for 14 positions in 05-06 and an additional 17 positions in 06-07 to allow annual inspections of adult care homes. DHHS believes that an annual inspection of ACHs by DFS will significantly improve the safety and security of residents. The Association does not agree.
Complaint Intake Expands DFS Complaint Intake unit by 4.5 positions.
MRS FUNDS YEAAAA!!! This money is for additional CPS workers in counties to reduce the worker/client ratio to 1:10 to assist in the expansion of MRS. It provides FY 05-06 $2 Million and 06-07 $2 Million. We want to reach $5.6 million increase but this is a great start!
Reduction in NC FAST Funding Reduces NC Fast by $5.4 million which was money being carried forward from this fiscal year. This money is CRUCIAL to ensure that NC FAST gets off the ground as we move forward with an RFP on the project! We will have to work hard to see that this money is put back!
No Additional Funds for Child Care Subsidies - The Governor's budget included $2.3 M in FY 05-06 and $7M in 06-07 to maintain the CURRENT level of services being provided. Without this funding we would have to remove about 1000 children that are currently in care. We will need to get this money restored.
No New Money for More at Four The Governor's budget included $16.6 M in FY 05-06 and $29 M in FY 06-07 for More at Four. The Senate budget does not include any funding for More at Four. Instead it recommends that the program be transferred from the Office of the Secretary to the Division of Child Development with a reduction of 5 people from the More at Four staff.
