|4/17/2014 9:09:00 AM|
Eye on Augusta: Legislature Passes Bipartisan Supplemental Budget, LePage Miffed
by Andy OBrienAs the Legislature enters the final stretch in what has been a hyper-partisan session during a bitter campaign season, passing a budget with near unanimous bipartisan support is no small feat. This week, the Maine House and Senate did just that, in spite of Gov. LePage's vows to force them back into session every day until they follow his orders. LD 1858, which passed 136-8 in the House and 35-0 in the Senate, fills a $30 million gap in the state's budget for fiscal year 2015.
"Our bipartisan proposal provides critical funding for seniors, individuals with disabilities, and for those struggling with mental illness," said Appropriations Chair Rep. Peggy Rotundo (D-Lewiston). "It will be life-changing for many of the most vulnerable people we serve."
Rep. Kathy Chase (R-Wells), the ranking House Republican on the Appropriations Committee, said, "In the world of budgets, this $30 million supplemental budget is actually small, but I can tell you it delivers much-needed benefits and with credible funding. That's the best you can probably say in any supplemental budget."
The agreement came after months of political wrangling with minimal involvement from Gov. LePage, who took the unprecedented step of refusing to submit a budget proposal because he blamed Democrats for the shortfall.
Among other provisions, LD 1858 will leverage federal money to provide over $10 million in additional funding to reduce waiting lists for roughly 400 disabled individuals in need of support services.
The measure is designed to eliminate the waiting list for about 70 high-priority adults who qualify for 24-7 care due to the severe nature of their disabilities, but have been unable to receive it up until now due to a lack of state funding. The issue of the waiting lists has been the subject of highly partisan debates during the past year as Republicans and Gov. LePage argued that expanding Medicaid would come at the expense of the disabled waiting for services.
LePage Pushes Back
While legislative Republicans helped deliver a veto-proof majority in support of the bill, Governor LePage has vocally expressed his opposition because two-thirds of the money ($20 million) used to fix the shortfall will come from delaying Medicaid payments to health care providers for up to two weeks in the second year of the biennial budget cycle. In a press conference on April 9, the governor said that after paying back the state's $484 million Medicaid debt to hospitals last year, it was "unacceptable" to delay future payments.
"If they try to do what they've done for the last three years, they will be here until election day because I will call them back every day to fill the hole in the budget," said LePage. "They are playing games."
That same day, the governor submitted a bill that would provide funding to people on the waiting lists by instead cutting revenue sharing to municipalities, a program that the governor tried to eliminate last year despite staunch opposition from Democrats and muncipal leaders. At press time, a spokesperson for the governor had no further comment on the budget.
In addition to delaying MaineCare reimbursement, the supplemental budget also found savings by dropping low-income recipients from the Medicaid rolls earlier this year and by using unallocated funds from the Dirigo Health Fund, the Finance Authority of Maine and an affordable housing program. The budget also keeps some positions vacant and increases payment audits to Medicaid providers, while stepping up marijuana tax collection efforts.
Funds for People with Disabilities
Maine's Office of Aging and Disability Services estimates that there are over 3,000 severely disabled and elderly people currently on waiting lists for various services. While some might be waiting for home-based elder care or community-based supports, about 70 on the Section 21 waiting list are considered "Priority 1," which means they need round-the-clock care. These are the most vulnerable and in danger of being homeless or taken advantage of if not taken care of. In many cases, family members are left to care for these people, which can create profound financial hardships.
Since 2008, the waiting list for these comprehensive services has grown, resulting in a class-action lawsuit against the state for failing to provide residential care and other services mandated in law. However, at an average cost of $102,000 a year per person, these individuals are the most expensive to provide care for.
According to the Maine Association of Community Service Providers (MACSP), with a $4 million appropriation and a $6.5 million federal match, the revised budget would take about 400 people off various waiting lists for services and eliminate the entire Priority 1 waiting list. The budget bill will also eliminate the "Section 29" waiting list, which primarily includes people with developmental disabilities who have left school and are entering the adult world, but need support.
"By eliminating [the Section 29] wait list, the hope is that if these young adults can receive employment and other support services before they lose the skills they worked so hard to acquire in school, the greater the likelihood that they won't need more comprehensive services because they'll be able to work and maintain their ties in the community," said MACSP lobbyist Charlene Kinnelly.
Funding for Finacially Strapped Nursing Homes
The amended budget also provides $5 million in additional funding for the state's nursing homes, which have been chronically underfunded for the past decade as reimbursements for MaineCare patients have not kept up with expenses. According to the Maine Health Care Association, which represents 107 nursing homes and 135 assisted-living facilities in the state, long-term care facilities have been underfunded by $100 million over the past five years. According to the organization, on average about 70 percent of the funding comes from MaineCare, the state's Medicaid program, while 30 percent is split between Medicare and private-paying residents.
With MaineCare reimbursements not keeping up with the cost of service, long-term care facilities have relied on shifting costs to private-paying residents, who pay an average of 45 percent higher than the MaineCare rate. However, as MHCA President Richard Erb pointed out in testimony before the Health and Human Services Committee on March 5, in addition to being inequitable for private-paying residents, some homes have up to 95 percent of their residents on MaineCare, which does not allow facilities to shift costs to private payers. Therefore, he said, the nursing homes most reliant on MaineCare funding are the most in danger of closing their doors. With 25 percent of Maine's population projected to be over 65 by 2030, it's an issue that will continue to loom large in future budget discussions.
The supplemental budget also includes about $2.5 million for contracted clinical staff at Maine State Prison, $908,000 for safety and security at Riverview and Dorothea Dix psychiatric facilities, and $2 million to address the state's commitment to mental health services under the court-ordered AMHI Consent Decree. The bill also provides additional funding for Head Start, the Jobs for Maine's Graduates program, career and technical education teacher retirement, indigent legal services, waste water treatment, the Homestead tax reimbursement program, repairs to the National Guard Headquarters in Augusta, and the Bridge Year Program, which allows high school juniors and seniors to earn University of Maine credits while attending high school.
Attempts to Amend
As usual, Republican and Democratic lawmakers both attempted to amend the budget to get their own messages out, even though their proposals had no chance of passing. On the Republican side, Rep. Larry Lockman (R-Amherst) submitted an amendment to exempt pensions of up to $30,000 from the income tax, which would be paid for by eliminating the state's Office of Information Technology.
"We're also losing retirees because we tax the daylights out of their pensions," said Lockman.
The measure failed 97-43, but was supported by Rep. James Gillway (R-Searsport), Rep. Deb Sanderson (R-Chelsea), and Rep. Ellen Winchenbach (R-Waldoboro).
On the Democratic side, Rep. Peter Stuckey (D-Portland) submittted a grab bag of progressive proposals which he proposed to be funded by repealing the 2011 GOP-led legislature's tax cuts as well as by collecting tax revenue sheltered by multinational corporations in overseas tax havens.
"I do not believe that it's MaineCare that is cannibalizing our budget," said Stuckey. "I believe it's the $400 million unfunded income and estate tax cuts handed to us by the 125th Legislature."
Stuckey's proposal would have used $41.3 million of the revenue to entirely eliminate the waiting lists for individuals with disabilities, $6.3 million for low-cost drugs for the elderly programs, $3.7 million for property-tax relief, $42 million for education, $4.6 million for public health programs for the youth, $11.1 million for longevity pay and cost-of-living increases for state employees, $6.3 million for Headstart, $11.6 million to fully reimburse nursing homes, $31.5 million for the state Earned Income Tax Credit, and $51 million to restore revenue sharing to municipalities. The measure failed 115-26, but was supported by Rep. Lizzie Dickerson (D-Rockland), Rep. Mick Devin (D-Newcastle), and Rep. Jeff Evangelos (U-Friendship).
At press time, the Legislature is expected to adjourn as early as Friday, April 18, but it will likely reconvene in the coming weeks to reconsider Governor LePage's expected vetoes. So far, LePage has vetoed 133 bills during his tenure, smashing Maine's record of 118 set by former Governor James Longley.
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