As stated
previously, the good news concerning the Louisiana House of Representatives
decision, in its iteration of next fiscal year’s budget, to dump out all of the
“one-time” money is that, in doing so, it began to take a little more responsibility
in setting priorities and thereby inviting consequences for its actions,
establishing minimally increased accountability on its part. But the bad news
is that this is not going to work as planned and thereby will create major
policy problems that negate this approach’s usefulness in this instance.
To reiterate, the state’s fiscal structure, because well over half of
its revenues from its own resources are dedicated in some fashion, creates a
financial straitjacket that poorly matches money to priority – low priority
items get over-funded and create unused pots of money, while especially the
areas of higher education and health care get squeezed in terms of dollars available.
The typical solution has been to sweep idle funds out of those over-funded
areas – most of what is termed in total as “one-time money” – to approximate
reallocation on the basis of genuine need.
However, many self-proclaimed fiscal hawks, rather than fix the system
that would fix the allocation problem, want to prohibit the correction method
in an attempt to force smaller, more efficient government onto the state, which
by any metric does need right-sizing. Yet in doing so, they foist an unhealthy
starvation diet in those two areas because their replacement strategy is
incomplete and unworkable.
For one thing, tactics of targeted reductions in
various areas across all agencies and programs using general fund proceeds, not
just health care and higher education, simply cannot produce the nearly $268
million in savings envisioned as requested in the general appropriations bill HB 1.
For example, reducing funding for vacant positions in state government and reducing
service contracts funding of vacant positions already largely had been
eliminated in the budget, and that the contract cut represented 80 percent of
those funded through the general fund, likely taking out some contracted
functions of high necessity instead of those of low necessity funded by
dedications outside of the general fund. If it even is possible mathematically,
this meat cleaver approach would end up slicing out areas of relatively great
need while those of lesser import remain funded.
For another thing, the bill already has a provision in it that follows
the prior method of inducing cuts before last week’s excursion into actually designating
general program activities to slash, a statement leaving it up to the
Commissioner of Administration to hack off $43 million in spending, meaning
that both areas will see further cuts of at least $20 million each. Even if the
pie-in-the-sky savings orders issued to the commissioner in the bill somehow
can be made to work without sacrificing high priority items and leaving lower priority
ones untouched, this provision still will hit important functions hard.
For example, in the past three years because of other cuts forced by
revenue declines or slow growth in them, one of the triad in providing health
care to the elderly and disabled in the state, home-based, has had its
reimbursement rate cut 22 percent. Of the other two, community homes’ rates
have been held stable and nursing homes’ rates – with an occupancy rate of only
75 percent statewide – have had an increase of 7.5 percent (and this doesn’t
even include those going to empty beds). Home-based providers have suffered
this even though they are at capacity and then some – the waiting lists for the
programs they service now has 19,000 individuals on them.
This spiral downwards has caused over 20 percent of in-home providers
to go out of business. While this is not necessarily bad, flushing out weaker
performers and closing out those that didn’t follow the law while other
agencies take up the slack, agencies have had to respond by keeping salaries
low (which legally can be below minimum wage for the direct support workers)
and forgoing pay raises, if not cutting wage rates. The latest enforced cut proposed
in HB 1 will put even greater pressure on contracting the available labor force
for in-home care, as 85 percent of agency expenditures are on direct support
workers who are the ones providing the care directly in homes.
Besides crimping needed service delivery, this creates a future
potential legal problem for the state. Federal law, backed by federal and
Louisiana state court decisions, mandates that services be provided in the
least restrictive setting. The
state already has had to settle suits because of earlier efficiency
measures not well-implemented, and potentially more would occur if, as is
becoming increasingly obvious, that further rate cuts create such a supply
crunch that provision in the least restrictive setting may become impossible to
achieve.
2 comments:
IT HAS NOW BEEN BEEN TEN DAYS SINCE A SERIOUS, REASONABLE AND RESPECTFUL REQUEST WAS MADE TO YOU TO DETAIL AND SOURCE YOUR ASSERTED "FACTS" ABOUT STATE EMPLOYEES AND CERTAIN COMPARISON TO THE PRIVATE SECTOR -
WITHOUT ANY RESPONSE FROM YOU.
TEN DAYS AND COUNTING.
Yes, they just can't manage it, can they?
That's what a lot of us have been saying and thinking for a long time.
I thought they were smarter than everyone else.
Seems not, and you, Gofer, have to continue to TRY to apologize for it and to make it seem that it is someone else's (anyone but the Scorecard and his minions)doing or fault.
Getting harder and harder, huh????
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