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Deep Cuts Proposed to State Health Department Budget

Republicans seek up to $93 million in cuts, but specifics not set in stone

By Molly Priddy
Rep. Al Olszewski addresses members of the House during the 64th Montana Legislative Session in Helena. Beacon File Photo

Though the issues that spring forth from the Montana Legislature often seem like ancient Greek hydra — when one issue ends, several more sprout up in its place — there’s only one task state lawmakers must perform.

Producing a sound budget is the lone constitutional requirement of the Legislature, and it’s a process that begins long before the lawmakers take their seats in the Helena Capitol building.

Gov. Steve Bullock released his budget proposal for the 2019 biennium in November 2016, calling for $74 million in cuts and tax increases, plus one-time transfers to balance the budget and increase the state surplus to $300 million by 2019.

Republicans responded with proposed cuts deeper than the governor’s, saying they would like to reduce state spending by $120 million and that such cuts could be uncomfortable.

But last week saw the first real movement on the state budget, contained in House Bill 2, as the Legislature’s committees got to work. In the Joint Health and Human Services Appropriations Subcommittee, Republican lawmakers suggested making deep cuts to the state Department of Public Health and Human Services to the tune of about $93 million.

With an annual operating budget of nearly $523 million, DPHHS accounts for about a quarter of the state’s yearly expenditures. The department oversees the Child and Family Services Division, the Child Support Enforcement Division, the Medicaid and Health Services Management Program, the Senior and Long-Term Care Division, the Developmental Disability Division, and many more.

At its Jan. 11 hearing, the Joint Health and Human Services Appropriations Subcommittee voted on a starting point for making cuts within DPHHS.

That so-called starting point shows $37.1 million in cuts from the general fund, along with $1.4 million from the state special fund. When taking into the account the federal dollars tied to these state dollars, the total reduction is about $93 million.

The cuts, carried in a motion by Rep. Rob Cook, R-Conrad, included eliminating $14 million from Medicaid Core Services, compared to Bullock’s suggested $9.4 million. Those services include programs for seniors and long-term care.

Sheila Hogan, director at DPHHS, said in a statement that her department worked with the governor’s office to make cuts and that the cuts suggested in the subcommittee would be detrimental for many Montanans.

“We’ve worked with the Governor’s Office over the course of the last year to make strategic and thoughtful decisions about the Department’s budget,” Hogan said. “The additional, unnecessary cuts made in subcommittee will strip vulnerable Montanans of critical community services, putting Montana families, seniors, and children at risk.”

During the hearing, Sen. Mary Caferro, D-Helena, expressed her concern over eliminating millions of dollars for programs that were only represented in line items and otherwise not discussed in the committee or by the public.

As a member of the subcommittee, Kalispell Republican Sen. Al Olszewski said he shared Caferro’s concerns, and that a new data system has changed what used to be detailed line-item data and consolidated it. Lawmakers have asked for an adjustment, he said.

But Olszewski, a physician, said the budgeting process has only just begun and called the subcommittee’s starting point just that — a place to begin.

“The key thing here is, this is the earliest part of the poker game,” Olszewski said. “They needed a number from every part of the budget that would then allow us to be structurally balanced.”

Olszewski said the subcommittee adjusted the line items that the governor’s budget already pinpointed, and those are far from concrete.

“Do I support these cuts in senior long-term care and developmental disability (programs)? No, I don’t,” he said. “As a provider who’s been in the system and have had patients who are developmentally disabled and who need these waivers, I’ve seen firsthand how important the system is.”

The DPHHS system is inefficient and broken, Olszewski said, and it would be too expensive to kill it and start over. It needs resuscitation, which Olszewski said should come before anything else.

“We need to fix this before we need to put money toward one more government building,” Olszewski said. “We need to invest in the infrastructure of our people, our human infrastructure.”

Cook, chair of the subcommittee on health and human services, said he made the motion for this specific starting point because it’s the lowest the department’s budget would have to go.

“From my perspective, I’m as low as I could possibly need to go unless we have a disaster in our updated revenue estimate,” Cook said in an interview last week. “It’s been my thought to take everything you need to take to get to the initial (point) and rebuild the budget back up from there.”

Cook said the next few weeks and months will be spent looking at the intricacies of the proposed cuts and the programs they effect, and prioritizing from there. This will include public testimony.

“Where these cuts happen, we’ll move around. We’ll address the most egregious cuts for certain,” Cook said. “If I put a penny back into (services for the blind), I’ve got to take another penny from somewhere else.”