Legislators to fumble adding new disability spending?

Unfortunately, caught in the crossfire of budgetary struggling between the Gov. Bobby Jindal Administration and the Legislature is funding for several programs dealing with the developmentally disabled, and regardless that one institution remains more culpable than the other,  some potential progress on increased service provision likely is lost as a result.

With Monday being the deadline for gubernatorial decisions on regular and line-item vetoes for legislation passed late in the 2013 regular session, on Friday Jindal announced line-item vetoes for the state’s operating budget HB 1. Although altogether they totaled about $6 million, they involved more than half of all such vetoes cast.

These vetoes were of five kinds. One set, totaling $950,000, excised money from each of the nine human service districts that was earmarked to fund Individual and Family Support Programs, which provide assistance not available from any other of the several other Department of Health and Hospitals programs to help people with developmental disabilities to live in their own homes or with their families in their own community. Another set removed the addition of 200 New Opportunity Waiver slots (which would create a recurring annual commitment of around $25,600 per slot) to allow for the same.

Individually, a third took out an addition of $54,732 to the Louisiana Developmental Disabilities Council, an organization required by federal law and mostly funded by federal grants, which is to advocate for and support people with developmental disabilities to exercise control over their lives and participate fully in the community. A fourth eliminated an earmark of $793,935 for the Children’s Special Health Services Program, which provides medical and family support services for Louisiana children and youth with special health care needs. The fifth wiped out the direct state subsidy of $250,000 to the nonprofit group Louisiana Assistive Technology Access Network, which connects individuals with disabilities and older persons to assistive technology that enables independence in employment, school, and community living.

The veto message for all of these was the same: “In light of the legislative reduction to Medicaid utilization, this program expansion cannot be funded.” Translated, it meant that the Legislature had underfunded Medicaid by what the Jindal Administration said was $20 million, and thus to offset cuts had to come from somewhere. Whether legislators agreed with that assessment was another matter; one, state Sen. Dan Claitor, sent out a Twitter message stating “Wow?? Governor sticks it to the disabled community. Match up the line item cuts to HB1 and see what you get. Yikes.”

Regardless of the rationale, disability advocates were less than happy about these. Within hours they had organized a Facebook web presence called “Stop the Veto” and called upon legislators to initiate an override session to undo these. However, the odds are exceptionally long on that happening, for it never has since the institution of the 1973 Constitution as it requires majorities of the seated membership in each chamber to mail in a ballot requesting the session, and then for each and every item two-thirds majorities are needed in each chamber. Given the daunting hurdles of any successful override of any line items and bills and the time and taxpayer cost involved, legislators are averse to calling such sessions.

In analyzing the situation, both branches of government bear responsibility. In HB 1, there is a passage, which kind commonly appears when the Legislature wants to reduce spending but wishes to avoid taking responsibility for it, that instructs the Administration to cut nearly $27 million at its own discretion in these areas. Other such statements were put in as well, which then had DHH issue decisions on where to cut by spending category within each line item but the rest would have to be made up by line item vetoes on programmatic spending, including these line items inserted by the Legislature that were not in the original version.

The NOW excision was an expansion of spending. The number of NOW slots remains the same, even as the waiting list to receive services is approaching 10,000 – representing currently an eight-year wait – that could have been reduced by this addition; no additions have occurred since 2010.

The line item for CSHSP also is an expansion, if understood in the context of DHH planning. That program is administered by its Office of Public Health, although the line item appeared under the section for its Office for Citizens with Developmental Disabilities. In either case, both agencies are receiving under both the original administration budget and under the one sent to Jindal the same amount of dollars. This is because CSHSP clinics are being closed and their functions transferred to private providers that will get funded out of other parts of the budget. Advocates are concerned the closures will reduce access and quality. (DHH cuts also took away some money to support the new contracting arrangement.)

The LADDC without the line item receives exactly the same amount of money as was originally budgeted. However, choices made by the Council shifted money away from funding the nonprofit Families Helping Families, and the line item was intended to restore their funding in addition to funding new grant initiatives. So while it can be argued that the cut is not for expansion in this instance, the practical effect is that to keep FHF around its same level of funding as for the past fiscal year means to allow adding new programs, and causes expansion, certainly in the Council’s budget. (DHH cuts also took a small amount of money away from the Council’s contracting budget.)

But the LATAN money is a reduction, if to an organization outside of government like FHF. In recent years, the organization was getting hundreds of thousands of dollars of state general fund dollars that dwindled to none in fiscal year 2012. Last fiscal year, they did get an earmark of $250,000 identical to this year’s excised one. That represents roughly three-eighths of their FY2012 total funding. The original HB 1 did not have that request, and now it seems the enacted version won’t, either.

It also appears that the IFSP money may not be at least in part only expansion of the program. Summing the appropriations for the various human services districts in the original bill and comparing them to the requests that went to the governor had them funded $857,089 fewer. That the total removal of IFSP money was $950,000, one could argue that the vast majority of that money disappeared for use from the agencies’ final budgets in the aggregate, although individually some districts actually did have the IFSP money adding to what had been to the original request the amount of which remained the same in the enrolled bill that passed the Legislature. Also, there has been a steady decline in program money spent since 2005.

So to summarize, for the most part service expansion concerning persons with developmental disabilities was inserted into the budget by the Legislature, while it simultaneously afforded the governor discretion as part of a budget-cutting order to remove that. As for items not clearly expansionary, in a technical sense neither was a pure cut. In the case of LATAN, it was a government subsidy to a nongovernmental organization, not a program, that was eliminated, and that could be argued was a return to the status quo of FY 2012. In the case of IFSP, for some districts it was elimination of expansion, while for others it can be argued that their smaller requests means that IFSP could be maintained at anticipated levels, but that cuts would have to come in other areas than originally budgeted.

In all of this, there is an element of hypocrisy among legislators, especially if they now appear willing to argue these actions represent some kind of Jindal hostility to the disabled as Claitor intimated. By ordering cuts in general but putting in more IFSP funds as line items instead of folded in to the larger district budgets, where in fact the Legislature made them smaller even as they carved out those line items, or by putting all FHF funds into the LADDC budget, it was as if they painted targets on these and other specific spending requests, handed Jindal a bow and quiver of arrows, and ordered him to plunk a number of these, meanwhile protecting all other kinds of programs by making them too big in dollar amounts and functional and geographical terms to cut as line items.

Line itemization actually was essential in three cases related to budgetary issues for persons with DDs. First, the very fact that NOW slots were expansion required line itemization. Second, a policy dispute over the presence of clinics meant this needed line itemization in a bill for their restoration. Third, LATAN money needed to be line itemized since it is an earmark that may be in the operating budget only in such a form. Had legislators been serious about the IFSP request to inch it closer to past funding levels and the Council’s request to keep state money going to FHF, knowing they were punting to the Jindal Administration by the order to make cuts, they never would have left these vulnerable by leaving these as line items, unless they distrusted the agencies involved to do what they wished. At the same time, the Jindal Administration by these cuts announced it had higher priorities elsewhere than these particular uses, as some or all of these funds could have been preserved from deeper cuts that could have been made elsewhere such as the DHH reductions that already cut provider rates and contracts; however, this is an option that also could affect adversely the same community that might use the programs with vetoed funds.

So for those looking to understand what caused this series of events, both branches of government bear responsibility, and different legislative action could have retained at least some of this spending if legislators were bent on this kind of expansion of spending. Attempts by legislators to deflect responsibility from themselves on this do not reflect the reality of the situation, and a means by which they may take such responsibility would be for them to call a historic override session and then undo these.