Editorial: Why DHHS budget is greater than expected

Posted Wednesday, October 26, 2011 in Opinion

Editorial: Why DHHS budget is greater than expected

On Monday, DHHS Commissioner briefed members of the Appropriations Committee about the department's expenses and revenues for the first quarter of FY 2012.

From July 1 to Sept. 30, DHHS expenses were supposed to equal about a quarter of the budget. Instead, expenses were closer to 30 percent, a trend that would be unsustainable over the entire fiscal year.

Mayhew didn't have answers on Monday when pressed about why the expenses were higher than expected.  Instead, she said she'd ask for a supplemental budget in January, something the Republican majority just didn't want to hear. 

But they'll keep asking, and she'll have to figure it out.

We can probably help her out a bit.  While some things are beyond her control or anyone's control -- such as the high cost of health care -- other things can be solved with a little careful thought.

Ms. Mayhew, DHHS has never been able to meet all the needs of its protected classes - children, the elderly, the poor, the homeless, the mentally or physically disabled, the mentally ill.  So it has, historically, asked other entities to help.  For various reasons, these entities have been able to do the job within the budget set by DHHS, and often does them better than DHHS would have done them.

Why is that? Is it a tacit acknowledgement that privitization works?  No.  But when, say, a foster child is serviced by a nonprofit agency (such as Casey Family Services) that also gets funding from other sources, the pool of funds grows.  The state can't ask for other funding, so it has to try to make do with less.

Now, in the case of these nonprofit entities, such as Sweetser's wraparound program, which works with kids who are facing multiple issues - legal issues, foster care issues, mental or physical health issues, a team can be assembled to deal with all the child's needs.  A child doesn't have to be transported from one facility to another, or from one foster program to another.  They just go to one site, and the professionals come there.

When an elderly patient is served at home, with day nursing, it is much better for the patient than the alternative -- going into a nursing home. 

When a homeless person can be served at one location with health care, a bed for the night, addiction treatment, support for the family, and food and clothing, it gives the person a sense of worth, and encourages him or her to rise above whatever issues he or she is facing.

DHHS knows agency-based foster care, wraparound, home health, and homeless service centers ... and other similar services ... work and are more cost-effective than the alternatives, which too often include putting a child in a long-term, 24/7 treatment program, sending an elderly patient to a nursing home, sending a homeless man to jail, or paying for residential drug or alcohol treatment. It's better for the client, better for the family of the client, and ultimately, better for the state, to allow agencies who know what they're doing to do their job.

And yet, these are the programs on the chopping block, Ms. Mayhew.  It may look, on paper, that you are saving a few dollars here and there by cutting these valuable programs, but in fact, it's costing you money.  And now you know that.

We hope that Ms. Mayhew looks hard at the efficacy of community programs, and rethinks the budget to accomodate them.  She may find her budget a little easier to explain next time if she does.

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