When it comes to legislative responsibilities such as the 2014-2015 budget the "devil is in the details." Some of the details that have come to light in the process are cause for concern.
When the Legislature adopted the policy, several terms ago, for the counties to fully finance long-term care for people who are elderly and/or permanently disabled, a promise was made to "hold the counties harmless" financially by setting a cap on the amount the counties would have to pay. In the current budget plan the cap will be raised, therefore increasing the financial liability of the county. That is an automatic increase in the property tax.
The Medicaid Enhancement Tax (a tax on hospital patient revenues) was initiated some 20 years ago to maximize the federal 50 percent match for Medicaid dollars. The full tax was then returned through the payments for Medicaid services. Two years ago the Legislature decided to keep a significant portion of the tax for the General Fund. When the level of under compensated and uncompensated care rises, insurance premiums also rise in order to maintain the level of care the insurance company wants to assure its beneficiaries.
If the providers and health care institutions cannot sustain their services, the services will disappear.
The proposed budget is attempting to restore some mental health service money. The cutbacks of previous legislatures have left the behavioral health system in a crisis state. There are a lack of crisis beds and severe limits on the availability of care. The proposed budget is only the first step in restoring the system and getting the Ten Year Plan back on track.
Some say it is like a personal budget. If the money is not there, you cut back on the expenses. That might work on a personal basis, but when individual lives are a stake, the problem takes on a different hue. There is a level beyond which the consequences are unmanageable.
Scott R. Clarenbach
Secretary, Board of Trustees