Monday, February 9, 2009

The Budget Again: What have they done this year?

The Massachusetts budget process begins with the filing of H1 by the governor.   That happened last week, and it had a bit of good news with a whole lot of uncertainty wrapped up in its tersely worded lines.  For those of us interested in Children's Behavioral Health,  the good news was in a portion of the bill labeled cryptically OUTSIDE SECTION 17.  (And my thanks to the excellent policy people at Health Care for All for understanding this process much better than I do)  The Governor has proposed bringing the benefit package for the Children's Medical Security Plan up to the standard enjoyed by Medicaid, including dental and behavioral health.  That is very good news for those of us who work with children.
The down side is that a lot of the line items that deal with children's mental health, including the CBHI and other aspects of the implementation of Yolanda's Law, have been rolled into one big line item,  4000-0700,  which includes EI, Nursing Home Supplements, Commonhealth and 6 other things.  On the budget, it looks like an expansion from $1,535M to $3,361M, but when you go back and add up all of the consolidated lines,  last year would look like $4,145M was present in all of the lines that have been consolidated.  That would be a cut, except that some of the consolidated lines were split into two other lines, and it is hard to know exactly how they were split without a really detailed spreadsheet.  Health Care for All felt that the funding for Medicaid expenditures was roughly level, but, I have to say that it is really hard to get a clear idea from reading the budget.
We will keep watching.  It is clear that, until the budget is substantially redrawn, it will be difficult to tell what is being done, and what it being cut in these hard economic times.
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Addendum:  Look at the MassHealth website here-  more detail on the breakdown, and this table make it easier to understand how things fit together.

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