Billings Gazette – September 15, 2017
Back in June, Montanans learned that sudden state budget cuts were going to hit hardest on community health care providers, their workers and the low-income Montanans they served. A Gazette opinion pointed out that Montanans who rely on Medicaid were being told to take a cut that ultimately would cost the state more than it saved, while forcing some providers to ration care or stop serving Medicaid enrollees altogether.
The September plans for possibly cutting 10 percent more from the Montana Department of Public Health and Human Services budget are even more onerous — and they spare no one. If the state actually chopped 10 percent of the DPHHS budget, programs large and small in all 56 counties, state staff and private contractors would share the pain.
In 111 pages, 10-percent cut plan makes the reader wonder what would be left of Montana’s safety net — if the plan was carried out. Given less than a week to propose how to slash $105 million from its biennial budget, DPHHS offered up cuts from every division. If the entire $105 million was slashed, Montana would also lose about $135 million in federal matching funds, according to the Montana Budget and Policy Center.
In the worst-case scenario, DPHHS could be required to leave between 8 percent and 18 percent of staff positions vacant in each DPHHS division for the biennium. Remaining staff members could be required to work fewer hours (get paid for fewer hours) through June 2019. Some proposed furloughs would cut paid employee hours by more than 12 percent.
The list of cutbacks is staggering. Here are a few critical services on the chopping block:
- Child and adult mental health care.
- Programs to help diagnose and treat disabled infants and children.
- Support for employment of disabled adults.
- The state grant that helps fund the Community Crisis Center in Billings.
- The Second Chance Home of the Center for Children and Families. With no safe, supervised shelter for chemically dependent Yellowstone County moms and their kids, these children would have to go into foster care and their mothers would be homeless.
- Nineteen offices of public assistance in rural low-population counties.
- Multidisciplinary child advocacy centers, such as the one in Billings, where law enforcement, health care and social work experts have teamed up to evaluate child victims of violence and sexual abuse. These teams help victims get needed treatment and help gather evidence needed to prosecute abusers.
- Big Sky Rx, which helps Medicare beneficiaries with Part D costs.
- Home and community services for elderly and disabled Montanans.
- Drug addiction treatment.
- Child care scholarships that allow low-income parents to work.
- Programs serving developmentally disabled children and adults. There’s already a waiting list of more than 1,000 Montanans waiting for some of these services.
- The grant that supports the Parents, Let’s Unite for Kids (PLUK) statewide library and referral service for parents of special needs children.
- The Yellowstone Youth Crisis Network, which is working to prevent suicide with a coalition of Billings health care providers and Billings Public Schools.
- Medicaid rates for Montana hospitals and clinics large and small. These rate cuts would be in addition to the rate cut of 2.99 percent already proposed in a process that started in June.
Now that Montanans can see what could be cut, we know that it’s us — our communities and especially our most vulnerable neighbors who could be hurt.
There’s also an economic argument for modest, fair tax hikes. The revenue shortfall is primarily driven by lower-than-expected income tax collections. What will happen if the state reduces spending by $227 million in the general fund along with the loss of more than $135 million in federal matching funds? State employees will have lower income and pay less tax. Private contractors and health care providers will have lower income and lower payroll, thus reducing state income tax collections.
Now is the time to stop that downward spiral. A special legislative session is warranted, but there’s no use convening the House and Senate until a majority of lawmakers is willing to do more than boast of cutting government and refusing to raise any tax.
Republican lawmakers should be open to statutory changes that will increase state revenues. Gov. Steve Bullock cannot raise revenue, and he cannot cut more than 10 percent from the budget. This problem is too big for the governor to fix by himself. The solution must be a compromise between the executive and legislative branches.