MA FY 2011 Budget Process Updates

 

On April 30 the Massachusetts House of Representatives voted on a final budget proposal for fiscal year 2011, based on the House Ways & Means budget reported on last month (“Massachusetts House Ways & Means Budget Proposal”, MGH Community News, April, 2010). Then on May 19 the Senate Committee on Ways & Means released their budget proposal. These budget proposals represents the third and fourth steps in the ten-step annual state budget process. See a schematic of the process. Some highlights are below.

(Skip to Senate Ways & Means)

House Budget Proposal

Through amendments to the House Ways & Means budget proposal the full House made changes to the final house budget including the following:

Immigrant health care coverage/Commonwealth Care Bridge program- an amendment was approved to eliminate the cap for enrollment on the Bridge program.  However, they did not give the program the additional funds, so t is unclear as to how many new enrollees would be able to join if this stands in the final budget.

Emergency Assistance Family Shelter (EA)- An amendment passed that would increase the notice time from 60 days to 90 days before changes could be made in EA program eligibility or benefits. It also would prohibit DHCD from giving notice before December 5, 2010, so as to allow the Legislature to take action after returning to formal sessions on January 5, 2011. This amendment would help protect children and families experiencing homelessness. An additional amendment would protect families that receive a short-term subsidy from losing priority for a state-funded permanent housing subsidy. This amendment would cost nothing, and simply clarify that a priority that already exists is not lost due to the receipt of a short-term subsidy, but, if passed as is, may not apply to a federally-funded subsidy.

TAFDC & EAEDC- Similar to the first part of #2 above, amendments passed that would increase the notice time from 60 days to 90 days before changes could be made in EAEDC & TAFDC program eligibility or benefits. It also would prohibit DTA from giving notice before December 5, 2010, so as to allow the Legislature to take action after returning to formal sessions on January 5, 2011.

Adult Mental Health- An amendment passed that would prevent the closure of crucial Department of Mental Health programs by increasing the line item's funding to provide the minimum funding needed to keep in operation the Partial Hospitalization Programs at the Massachusetts Mental Health Center; the PACT (Program for Assertive Community Treatment) teams in Metro Boston and Western Massachusetts; and the Homeless Community Support/Emergency Psychiatric Services.

More Detail

Health Care

• $31.5 million in funding for the Prescription Advantage program, a $2.8 million cut from FY 2010 budget totals. This is essentially the same funding level recommended by the Governor. There is language in the House budget proposal stating that spending for Prescription Advantage would be reduced by prescription drug savings accruing to beneficiaries due to national health reform.
• Amendment language restoring an Office of Health Equity within the Executive Office of Human Services, with a mandate to report on health disparities across the Commonwealth, and work on the reduction of health disparities.
• A new “outside section” of the budget (Section 47A) creating a MassHealth Cost Control Commission. One of the goals of this commission would be to explore the possibility of instituting co-payments in the MassHealth program for non-emergency use of emergency rooms.

• A new “outside section” of the budget (Section 54) that would automatically put elders who are eligible for both Medicare and Medicaid into a managed care Senior Care Options health program. An elder who did not wish to be in this sort of program would then have to actively disenroll from managed care. Currently, participation in the Senior Care Options program is voluntary, and although the House language does not make managed care mandatory, the new budget language could create disruption in health care delivery for low-income elders. There is also some question as to whether it is legal to automatically enroll Medicare beneficiaries in managed care.

Public health

Highlights of the House public health budget include:

• $36.3 million for AIDS/HIV prevention and treatment. This is approximately $500,000 less than in the FY 2010 current budget.

• $25.4 million for early intervention. This is 14 percent less than in the FY 2010 current budget.
• $8.1 million for sexual assault and domestic violence prevention services, a 4 percent reduction from the FY 2010 current budget. Although not included in this total, there is also $21.1 million in the House budget proposal for support services for people at risk of domestic violence within the Department of Children and Families.
• $84.2 million for substance abuse services, level funding with FY 2010.

Children & Families (Formerly Department of Social Services)

The FY 2011 final House budget proposal includes $744.7 million in funding for the Department of Children and Families (DCF) and the child and family services it administers. This recommendation maintains $12.6 million in FY 2010 mid-year cuts and includes an additional $28 million decrease from the current FY 2010 budgeted amount. The final House proposal falls $39.1 million, or 5 percent, below FY 2010 GAA funding levels and $15.3 million below the FY 2011 Governor’s budget proposal.

Elder Services

The House budget proposal includes $219.5 million for elder services. This total is $1.6 million less than in the FY 2010 GAA, and is essentially level-funding compared to FY 2010 current budget totals. (For funding for the Prescription Advantage program, funding for nursing homes, and funding for MassHealth Senior Care, see the “MassHealth (Medicaid) and Health Reform” section of this Budget Monitor.) It is important to remember that by level-funding elder services, the House is not restoring funding that had been cut last fall or during FY 2009 by the mid-year 9C reductions. Although during floor debate the House did not add additional funding for elder services, there were certain changes in line item language.

• The elder home care program, which provides community-based long term care services allowing elders to remain in the community and helps keep them from moving into nursing homes, receives a total of $136.3 million in the House budget. The enhanced home care program for more frail elders receives $45.8 million. Both of these proposals are level with the Governor’s funding recommendations and with the FY 2010 current budget totals. There are currently close to 2,500 elders waiting for home care services, and with these funding levels it is possible that there will be waiting lists for the enhanced home care program in FY 2011 as well.
• The protective services program, which provides services for elders at risk of neglect or abuse, receives $15.3 million in the House budget. In the FY 2010 GAA, protective services were funded at $16.3 million, but there were 9C cuts of $1 million during the fall. Both the Governor’s and House FY 2011 budget proposals continue this reduced funding, which will require reductions in service for these vulnerable elders.

Transitional Assistance

The FY 2011 final House budget proposal recommends $776.7 million in funding for the Department of Transitional Assistance (DTA) and the programs it administers. This proposal represents a $17.4 million, or 2 percent, increase over current FY 2010 budget levels. The final House proposal is $3.3 million above the Governor’s FY 2011 recommendation.

Housing

• $4 million for a new Housing Stabilization Initiative for homeless families. This new program, which provides housing vouchers to help families move out of shelters and hotels/motels into more permanent housing, is expected to reduce reliance on the Emergency Assistance program (see below).
• $112.9 million for the Emergency Assistance (EA) Program which provides shelter and services to homeless families. This is $38.8 million below the total amount appropriated in FY 2010. While the FY 2010 GAA appropriated only $91.6 million for this program, the deterioration of the economy led to increased homelessness and more families needing to access shelters. To pay for the added costs of serving these families, the Legislature appropriated $60.1 million to meet current costs. In FY 2010, as demand for services to homeless families increased, the state lowered eligibility for EA services from 130 percent of poverty to 115 percent in order to reduce costs. The House budget keeps this lower eligibility requirement. The budget also requires that DHCD continue to keep track of the services it provides to homeless families under the program and to keep track of the effectiveness of those services in helping homeless families move to more permanent housing.

The House budget recommends level funding most of the state’s affordable housing programs including:

• $62.5 million for subsidies to public housing authorities. This is the same level as the FY 2010 GAA and is also the amount the Governor recommended in his FY 2011 budget.
• $35.4 million for Massachusetts Rental Voucher Program (MRVP). While this level is $5.4 million more than the FY 2010 GAA it is the same amount the state expects to spend in FY 2010. In his mid-year 9C cuts the Governor transferred $2.9 million from Residential Assistance to Families in Transition program (RAFT) to MRVP (see below for a discussion of RAFT). In addition an outside section of the FY 2010 budget required that MassHousing provide $2.5 million to support the vouchers.
• $3.5 million for the Alternative Rental Voucher program and $4 million for vouchers provided to clients of the Department of Mental Health. These levels are the same as the FY 2010 GAA and the Governor’s FY 2011 budget proposal.

Residential Assistances to Families in Transition (RAFT), which provides one-time vouchers to families who have become homeless or are at risk of becoming homeless was essentially eliminated in FY 2010. The House proposal recommends providing $260,000 to RAFT which received $2.8 million in the FY 2010 GAA. When he made his 9C cuts in October 2009, the Governor moved $2.9 million in funding from RAFT to MRVP (see above) leaving $160,000 in the RAFT account for FY 2010. The state is using the Homelessness Prevention and Rapid Rehousing funding, included in the federal American Recovery and Reinvestment Act for FY 2010 and a portion of FY 2011, to provide short-term assistance to homeless families and to families at risk of becoming homeless. Once the federal assistance is spent by February 2011, the state will have to reassess funding for RAFT.

Senate Ways & Means Budget Proposal

Early Education & Care

The FY 2011 Senate Ways & Means budget proposal includes $506.7 million in funding for the Department of Early Education and Care (EEC) and the services it administers. The Senate Ways & Means recommendation is $14.1 million, or 3 percent, below current FY 2010 budget levels. Compared to FY 2011 budget proposals submitted thus far, the Senate Ways & Means recommendation for EEC funding falls $10.8 million below the final House proposal and $14.1 million below the Governor’s proposal.

The Senate Ways & Means budget proposal offers $441.6 million in total funding for child care subsidies, which is $14.4 million below current FY 2010 budget levels. When compared to FY 2011 budget proposals thus far, the Senate Ways & Means proposal for child care subsidies falls $9.1 million below the final House proposal and $9.6 million below the Governor’s proposal. Like the final House proposal, Senate Ways & Means prioritizes funding for the two child care entitlement accounts in order to address caseload increases and anticipated FY 2010 budget shortfalls while decreasing funding for income-eligible child care.

In terms of child care subsidies, the Senate Ways & Means proposal more specifically:

• Increases child care funding for children with active cases at the Department of Children and Families (DCF) by $7.9 million, or 10 percent, over current FY 2010 budget levels.
• Increases child care funding for families served by or transitioning from Transitional Aid to Families with Dependent Children (TAFDC) by $11.1 million, or 10 percent, over current FY 2010 budget levels.
• Reduces child care funding for income-eligible families by $33.4 million, or 13 percent, below current FY 2010 budget levels. This proposed reduction in income eligible child care will likely continue or even exacerbate long waiting lists for income-eligible families.

MassHealth

The Senate Ways & Means budget includes $11.24 billion for MassHealth (Medicaid) and health reform (see table). Funding for MassHealth and health reform encompasses a number of health programs, the largest of which is MassHealth, the state’s Medicaid program. The Senate Ways & Means proposal is 6 percent higher than the FY 2010 current budget.

The SWM budget also follows both the Governor and House proposals to restrict adult dental coverage. MassHealth has already informed members that starting on July 1, 2010 (FY 2011), adult dental services will no longer cover fillings, dentures, and other restorative services. There will be coverage only for emergency and preventative services. Adults who are clients of the Department of Developmental Services, however, would continue to be eligible for full dental coverage. Although SWM anticipates that this will “save” more than $56 million, this estimate does not account for additional dental costs associated with forgone dental coverage. Moreover, this $56 million is not actually the amount that the Commonwealth will net back to the General Fund. With $56 million in reduced program costs for adult dental care, Massachusetts will spend $21.6 million less in state funds, but the state will also receive $34.7 million less in federal Medicaid reimbursement (see discussion of Medicaid reimbursement below.)

Commonwealth Care Bridge

The Governor’s FY 2011 budget had proposed $75 million for this program, but SWM – like the House – recommends only $60 million. Materials accompanying the SWM budget proposals suggest that $60 million for this program should allow for some new enrollment.

Human Services

Children & Families (Formerly Department of Social Services)

The FY 2011 Senate Ways & Means proposal provides $764.8 million in overall funding for the Department of Children and Families (DCF), $7.8 million below current FY 2010 budget levels and $18.9 million below the FY 2010 GAA. Although the Senate Ways & Means proposal for DCF falls below current budget levels, it is $20.1 million above the FY 2011 final House budget proposal and $4.9 million above the FY 2011 Governor’s budget proposal. In all, each proposal thus far falls below the funding levels needed to maintain services for children and families in FY 2011.

Elder Services

The Senate Ways and Means (HWM) budget proposal includes $225.3 million for elder services. This total is $4.2 million more than in the FY 2010 GAA, and is $5.7 million more than FY 2010 current budget totals.

• The elder home care program, which provides community-based long term care services allowing elders to remain in the community and helps keep them from moving into nursing homes, receives a total of $140.4 million in the SWM budget. This is 3 percent more than in the FY 2010 current budget. The enhanced home care program for more frail elders receives $45.8 million, level with the Governor’s and House proposals and level with FY 2010 current budget totals. There are currently close to 2,500 elders waiting for home care services, and with these funding levels it is possible that some elders will be able to move off the waiting list and receive services.
• The protective services program, which provides services for elders at risk of neglect or abuse, receives $16.7 million in the SWM budget. In the FY 2010 GAA, protective services were funded at $16.3 million, but there were 9C cuts of $1 million during the fall.

Transitional Assistance

The FY 2011 Senate Ways & Means recommends $771.1 million in funding for the Department of Transitional Assistance (DTA) and the programs it administers, $11.7 million above current FY 2010 budget levels. This recommendation falls $5.7 million below the final House budget recommendation and $2.3 million below the Governor’s budget recommendation.

• $88.2 million for Emergency Aid to Elders, the Disabled, and Children (EAEDC), $4.8 million, or 5.8 percent, above current FY 2010 budget levels. The Senate Ways & Means recommendation for this account is $3.6 million more than the final House recommendation.

Housing

The Senate Ways & Means Committee (SWM) budget recommends spending $279.0 million on housing programs for FY 2011. This level is $30.6 million more than the FY 2010 GAA but is $36.4 million below the current budget for FY 2010. The SWM budget is also $8.7 million higher than the Governor’s budget proposal and $2.5 million higher that the House’s final budget. In inflation-adjusted dollars, funding for housing programs has fallen $36.8 million or 11.6 percent since FY 2001.

The SWM proposal requires that $3.5 million within the EA account be directed to helping families find housing in order to reduce their reliance on shelters including hotels and motels. In contrast, the House budget included a new $4 million line item on flexible housing that would serve the same purpose as the Senate’s $3.5 million earmark. In its line item the SWM budget recommends that DHCD have 45 days, rather than 90 in both the House proposal and the current budget, to notify the Legislature of any proposed changes to eligibility or regulations for EA. Finally, in Outside Sections 13 and 14, the SWM budget proposes moving language that has traditionally been included in the line item into the General Laws. This language includes requiring that DHCD:

• Provide up to 30 days of shelter while families gather the information they need to prove their eligibility.
• Work to ensure that children moving to shelters can continue attending the schools in the communities where they had lived.
• Provide EA services only to U.S. citizens and to immigrants who are legally residing in the United States.

The Senate Ways & Means FY 2011 budget recommends providing the same level of funding in FY 2011 for other homelessness services.

• $2.3 million more for the Massachusetts Rental Voucher Program (MRVP) for a total of $35.2 million. The SWM proposal is $5.2 million over the FY 2010 GAA as well as $2.5 million more than the FY 2011 amount proposed by the House and the Governor. Outside Section 116 of the SWM budget also directs MassHousing to contribute $2.7 million to MRVP which is the same amount that the Governor proposed in his budget and is $200,000 more than MassHousing contributed in FY 2010. (The FY 2011 House budget did not include a contribution from this quasi-public agency in its proposal.) While MassBudget does not include this funding in its total for housing programs, MassHousing’s contribution combined with the Senate’s recommendation of $35.2 million will allow the state to continue funding existing vouchers to low-income renters.
• $840,000 in additional funding for Residential Assistance for Families in Transition (RAFT) for a total of $1 million. While this amount is larger than the current FY 2010 budget ($840,000 greater), the House budget ($740,000 greater) and the Governor’s ($940,000 greater) it is $2.1 million below the FY 2010 GAA after the Governor transferred most of the RAFT funding to MRVP when he made 9C cuts in October 2009.

 

 

5/10