File: Secretary of Human Services Doug Racine speaking with Rep. Patsy French, D-Orange-Addison-1. Photo by Josh Larkin.
In a grim little ceremony, members of the House Human Services Committee went around the room and took a straw poll on which programs they could live with cutting.
Respite care for seniors? Mental health services for the third year running? Or services for developmentally disabled Vermonters?
The 10 members of the committee couldn’t decide. They were tasked with providing the House Appropriations Committee with a prioritized list, and they did so, but with great reluctance.
There wasn’t much to like in the governor’s budget recommendation, which includes $43.8 million in cuts. The bulk of the money comes from changes to health care programs, including a move to fold Catamount Health into the Vermont Health Access Program (VHAP) and an expansion of health care provider taxes. Gov. Peter Shumlin also banks on $3.3 million in savings due to the long-awaited recertification of the Vermont State Hospital, the facility which treats psychiatric patients who are a danger to themselves or to others. The Douglas administration also counted savings from VSH — for many years running — to no avail. Once the hospital has certification from the Centers for Medicare and Medicaid Services, it will be eligible to receive about $11 million a year in CMS funds.
Often, committee members are assigned homework. In House Appropriations, for example, each member of the committee is asked to research a single topic and then give a presentation to the group. The House Human Services Committee takes a similar tack and, on Tuesday, lawmakers gave presentations about the areas of the budget they had researched, and each one defended his or her conclusion.
One by one, representatives made the case to keep most of the programs they reviewed whole. Though they acknowledged the need to balance the budget, in light of the state’s $176 million hole in fiscal year 2012, they told their chair, Ann Pugh, that they didn’t feel it was their responsibility to cut vital programs that, as Rep. Patsy French, D-Orange-Addison-1, put it, “work against our policy goals.”
File: House Human Services Committee Chair Ann Pugh.
Rep. Anne Donahue, R-Northfield, came up with a creative solution for circumventing $1.4 million in cuts to the designated agencies, nonprofits that provide mental health care services. Donahue wants to ensure that mental health is treated equally. Too often, she said, the treatments are not considered to be a part of the health care system. She presented a plan in which the Department of Vermont Health Access would work with the Department of Mental Health to find $1.4 million in savings by integrating mentally ill patients into the health care system through the Blueprint for Health plan and primary care. She said the state could find savings by looking across the board at effective health and mental health expenditures under the state’s federal subsidy program (global commitment).
“Only mental health care access is capped arbitrarily instead of funded in relationship to projected need and use,” Donahue wrote in a report she presented with Rep. Lynn Batchelor, R-Orleans.
Donahue said the governor’s proposed budget cut to mental health comes on the heels of four years of cuts to the designated agencies, and the total amount, including the fiscal year 2012 recommendation from Shumlin, would be 10 percent.
Donahue said the commissioner of the Department of Mental Health, Christine Oliver, didn’t explain where the cuts would come from. “We don’t have different pieces, we have this glob,” Donahue said. “It’s a cut off their heads” approach basically, she said. The department didn’t give the legislature tools to identify the highest priorities or to ensure highest needs are met.
“We’re not accepting a 5 percent cut in mental health agencies,” Donahue said. “We’re saying that amount of savings has to be taken through DMH and DVHA across health care systems.”
Donahue and Batchelor offered “no comment” on the governor’s projected $3.4 million in savings regarding the efficacy of recertifying the Vermont State Hospital, except to say, as Donahue put it: “We go through this every year.”
File: Vermont State Hospital;
French said cuts to programs for respite care and individual assistants for elderly Vermonters could result in 52 additional Vermonters seeking nursing home care, rather than at home.
“I cannot in good conscience support any of the cuts,” French said. “These go against our policy goals, which have been here for some time now. Our highest priority is to restore the budget.”
French said.
She said perhaps the state needs to look at rainy day funds, new revenues or tax expenditures to cover the cost of essential programs for vulnerable Vermonters.
Rep. Sandy Haas, P-Rochester, said: “I don’t think it’s wrong to say after three years of cuts we are finding this very very difficult.”
The representatives went around the room in the legislative version of kumbaya and explained why they couldn’t live with one cut over another. In truth, each of them — even the most conservative among them — seemed to recoil from the act of recommending reductions in any form for what they deemed to be essential programs for the elderly, the mentally ill or the developmentally disabled.
Late in the afternoon, they took a straw poll to see if they could prioritize a list of programs they thought should not be cut. In the end, the lawmakers were divided between mental health, which has seen $15 million in cuts, including Medicaid matching funds, over the last three years, and $2.2 million worth of reductions in respite care and other supports that enable elderly Vermonters to stay in their homes and avoid nursing home care. Five members voted for mental health, and five voted for programs for the elderly.
Earlier in the day, members decided to recommend reducing state subsidies for school substance abuse counselors by 75 percent, according to Pugh. The governor had asked for the elimination of the program.
The House Human Services committee will finish its recommendations to House Appropriations in a day or so. HAC is marking up the human services portion of the budget this week.
Permalink |
Dear members of the H&W Committee: – Was there no exploration of finding additional funds, of supporting H.401 which would tax folks with high incomes who received the federal extension of tax cuts after our own congresspeople voted against that?
Permalink |
I’m glad someone said that. The State can’t continue to balance the budget with cuts to services, or more cuts to state workers for that matter.
Permalink |
Excellent reporting, as usual–Thank you!
Perhaps if each of us wrote a letter, sent to each member of this committee suggesting their report to the governor, House Appropriations and Ways and Means Committees insist that they cannot cut deeper into these programs; that Vermont must raise revenues… just perhaps they would do this.
What if we each sent these letters to the editors of newspapers, including mention and a link to this report (and John Perry’s letter of a few days ago)…
What if? Who’s willing?
Permalink |
If Vermont’s government got out of the energy business which keeps about 100-200 state employees busy wasting the people’s money on foolish renewables projects, there would be plenty of funds to cover shortfalls in social programs for years.
Example of a foolish renewables project:
BOLTON VALLEY SKI AREA WIND TURBINE
A Clean Energy Development Fund Project:
The CEDF provided a $250,000 subsidy to the Bolton Valley Ski Area so it could install a 100 kW, Vermont-made, wind turbine for $750,000.
According to Bolton Valley’s website, the wind turbine generated 204,296 kWh from October 2009 to-date, about 17 months. Capacity factor is (204,296 kWh/1.4 years)/(8,760 hr/yr x 100 kW) = 0.17.
The wind turbine was sold to Bolton Valley on the basis it would produce 300,000 kWh/yr, for a capacity factor of 300,000 kWh/yr/(8,760 hr/yr x 100 kW) = 0.34.
It is somewhat like selling a car and telling the new owner it will do 34 mpg, whereas it actually does only 17 mpg.
It seems the CEDF should do more due diligence before giving the people’s money to such foolish projects.
This was NOT an award based on economics; it was a political award, a social award, a cultural reward, an insider’s award.
Remember, WITH significant subsidies, the CF must be at least 0.35 to have a positive cash flow for such a project.
Bolton Valley making such wind turbine decisions will lead to bankruptcy; by subsidizing foolishness the state is helping out.
Several former CEDF board members, who are owners of major Vermont renewables energy companies, decided to resign because of conflicts of interests after “setting up” and securing funding for the CEDF.
When Tom Evslin suggested during a CEDF board meeting that projects requesting CEDF subsidies be ranked on rate of return and subsidized accordingly, he was told it was against the CEDF rules which were “first-come, first-subsidized” (an insider’s dream), which I, and Evslin and others, think is economically absurd. For the legislature to know of and agree to such rules is irresponsible.
It takes a while, may be 3-6 months, before the people-at-large, including myself, learned of the CEDF rules and their implications, even though public hearings, attended mostly by interested parties while others are at work, were held according to the law to create a semblance of democratic process.
Permalink |
When will we go around a committee room asking how the wealthy, greedy and selfish among us could contribute their fair share so that the neediest in our communities receive the care that they need?
Permalink |
I do not understand the logic of forcing more of our elders into nursing homes as a way of saving money. Nursing home care costs much more than home care. This recommendation does not make sense.
Permalink |
I agree with you Judy. This policy is short sighted. Also, without adequate resources for community mental health, more people enter the corrections system. Mental health treatment in a community setting is more cost effective than mental health treatment in prison.
Permalink |
Anne….Here’s a place where you (and your readers) can do some independent “digging” to give bottom line factual context to the narrative and financial claims in your budget stories. On the JFO site is this document, which is quite straight forward and easy to follow:
http://www.leg.state.vt.us/jfo/appropriations/FY09_-_FY12_Gov__Total_Appropriations.pdf
It profiles the state budget section by section for 2009, 2010, 2011 budget adjustment and the Governor’s 2012 recommendation. The human services appropriations are sections B. 300 through B.345. Section B.345 profiles the totals for the Agency of Human Services (AHS). Here you’ll see that the AHS budget was not cut, but grew from 2009 through the Governor’s recommend from $1.742 billion to $1.963 billion or $220.5 million. The annual growth rate during this period was 4.1%. The Governor’s recommended budget for 2012 is $32 million higher than the 2011 budget adjusted amount.
Permalink |
How does it account for increased need, federal shortfalls, and fixed incomes in the face of rising inflation?
Permalink |
If it is not raining now then what will it look like when it rains? Perhaps when we start calling the, Great Recession a Mini-Depression?
Meantime, while more slice the shrinking pie for a sliver more of draconian cuts, more people slip into despair.
We have to realize that the term “mental illness” is an example of misleading nomenclature. Consider the analogy that the brain is to mental illness as the hard-drive of a computer is to the software. Software won’t run on a computer properly if the is a glitch with the hard-drive.
Thus, that twist of neuro-linguistics, assists with the continued lack of economic parity for “mental illness” which we seek. If we don’t start paying more attention to the manipulation of language, for the marketing of our own repression, than we will never break free of the social malaise that we languish under.
Permalink |
Soak the rich, damnit! They’ve soaked us long enough!
Permalink |
Renee….unfortunately, it’s a basic condition of life that “needs” go unfulfilled. In this case, in a very trying economy, it seems the state is trying hard to meet as much of the AHS need as possible. ARRA funds fueled a very rapid growth in AHS spending of almost $200 million from 2009 to 2011, but now they are gone as ARRA funding was never meant to be permanent. So, state funds are mostly filling the gap. You can see from the JFO link that for 2012 over 2009, general funds are up almost $94 million or 20%, special funds up almost $11 million or 16%, and SHCRF funds up $75 million or 51%. This level of growth in the application of state funds is extraordinary, and well beyond any measure of growth in the Vermont economy. Increasing the application of state funds to AHS, especially general funds by 20%, means the needs of other segments of state government (environmental, public safety, state employee wages, etc.) were sacrificed.
At the federal level, it’s only going to get worse. Under Carter, the federal deficit was 40% of Gross Domestic Product; under Clinton, 57% but now has risen to 93% at $14.1 trillion. Put simply, the federal well has run dry. Higher federal taxes are going to be needed, but for the foreseeable future, not to increase spending or bailout state budgets, but to reduce the annual federal deficit. What this means for Vermont is what tight times have always meant, that we must give specific definition and priority to the truly “most vulnerable”, and focus resources there, and for the rest, demand both greater efficiencies in our delivery systems (think education, healthcare, affordable housing, etc.) and expect lower levels of benefits and services for those that are not among the “truly needy”. The fundamental reality is that limits have been reached. Federal taxes will have to be restored to the Clinton era levels for both the wealthy and middle class to address the federal deficit. At the state level, middle class benefits, such as income sensitivity which is now a $160 million program, are going to have to be trimmed and inefficient organizational structures such as education, healthcare and affordable housing must be revamped to free up resources to support high priority needs. It’s only a matter of time.
Permalink |
Mr. Pelham, I get that the deficit is much higher compared to GDP than in previous times, but at the same time the distribution of wealth extremely favors the extremely rich. Can’t they afford to pay a little more? For example the top 3% of Vermonters ‘gained’ $190 million in tax cuts this year due to the Bush tax cut extension. This is more than the entire State budget deficit. So we are panicking over a deficit when the solution is staring us in the face. We are cutting services to needy Vermonters and taking more from State workers who have already given up more than most. Governor Shumlin steadfastly refuses to raise taxes on the rich based on the proven to be wrong fear they will leave Vermont. We need to raise revenues. It’s that simple.
Permalink |
I am willing to pay more in income taxes to make sure that Vermont is good place for all our people to live. How about you, Tom?