Oversight for the Medical Assistance Program may shift from the Department of Health to the Department of Human Services. The two departments discussed the potential switch with senators Thursday while defending their budget proposals to the Committee on Finance. The Bureau of Motor Vehicles also presented their budget proposal.
Acting Commissioner Darice S. Plaskett testified on behalf of the Health Department. She said her department’s total requested budget for Fiscal Year 2013 is $50,722,195, which is $25,347,549 or 33 percent less than last year. Of that, only $21,684,309 is being requested from the General Fund. That is $9,148,224 or 30 percent less than last year. The rest of the money will be drawn from various special funds and federal grants.
Plaskett said the reduction in costs came primarily from decreased personnel costs as well as the requested transfer of the Bureau of Health Insurance and MAP to the Department of Human Services.
The department’s budget reported a 7.6 percent increase in revenues from the previous fiscal year. Plaskett credited the increase to the establishment of a Revenue Cycle Committee, which meets twice a month to brainstorm ways to reduce operating expenses and increase payments.
Plaskett took the opportunity to highlight some of her department’s successes over the last year, including opening farmer’s markets to the Special Supplemental Nutrition Program for Women, Infants, and Children, the winning of a national award for the department’s “Fight the Bite” dengue fever awareness campaign, and the completion of a 5-year plan to address the mental health consent decree.
She also identified some continuing challenges facing Health, such as an ongoing shortage of emergency medical technicians.
Sen. Carlton “Ital” Dowe took special exception to this point, saying he had put a line item to hire two EMT trainers in the department’s previous budget. Dowe grilled the Health representatives on why those positions remain unfilled.
“This situation that exists, all of us should know by now that it’s costly, it’s wrong and it’s a lifesaving issue,” Dowe said.
During the question session, several senators expressed frustration with Health for its slow progress on a variety of issues ranging from the writing of a new financial plan to the expansion of the availability of mammograms on St. Croix.
Sen. Samuel Sanes dressed down the acting commissioner for her department’s continued failure to create a cancer registry, which was mandated in a law passed in 1999.
“I certainly understand the frustration and the feedback we’re receiving from the senators in regard to prior year’s progress or failure,” Plaskett said. “It’s something that we have discussed at the executive level.”
“But funding is critical to execute and meet a lot of the performance measures,” she said, adding that the department does not have the technology to be able to aggregate or produce information the way it should.
Dowe said he recognized that Plaskett had inherited many of the issues facing her department and Health had improved in some areas, but he said if the department is going to resolve its issues, everyone must take personal responsibility.
“Health is a monster, and the only way we are going to make things happen is through serious accountability, not skirting over things, recognizing that we have problems,” Dowe said.
Commissioner Christopher Fitch of the Department of Human Services received a kinder reception from the committee, as several senators lauded the efficiency of his department.
Finch said that DHS is seeking $57,285,345 from the General Fund in FY13, which includes $6,449,570 for the MAP program if the legislature approves its transfer from Health. Even without the MAP funds, the proposed DHS budget is a 3 percent increase from FY12.
The DHS is seeking an additional $14,642,450 in local funding from various special funds and expects to receive $45,542,862 in federal grants. Human Services will also be responsible for distributing $52 million in Supplemental Nutrition Assistance Program funds (formerly known as food stamps).
Finch spent much of his testimony detailing the need for the MAP transfer to his department. He testified that many people covered by MAP also participate in programs currently overseen by his department, such as SNAP and the Temporary Assistance to Needy Families program.
He argued that bringing all of these programs under one roof and combining their application processes would be more efficient and ultimately less costly to the government.
“It allows us to improve customer service by creating a one-stop application process for persons applying for multiple aid programs,” he said. “Staff will be cross trained to handle each program.”
Finch added that the federal government has offered to provide 90 percent of the funding for the implementation of new software that would determine a person’s eligibility for multiple programs at once.
“This has the potential to enhance efficiency, speed up decision making, improve coordination between programs, reduce eligibility errors and reduce personnel costs,” Finch said.
The DHS presentation was not all good news, however. Finch testified that some federal funding was in jeopardy.
The Temporary Assistance program, for instance, is topped out, he said. The federal government refuses to pay more per year than they are currently paying, so the local government would have to fund the cost of any additional individuals admitted to the program.
The territory is also being forced to re-compete for its Head Start funds along with 199 other programs around the country as part of a national campaign to raise standards. The Virgin Islands program was added to the list of competing programs due to a handful of missed criminal background checks dating from 1994-2005.
Finch testified that once the oversight was realized, the checks were done and no problems were found.
Over the last year, DHS has had to cut back its services in a number of areas. The community rehabilitation centers on St. Thomas and St. Croix were closed and the number of beds at the Herbert Grigg Home for the Aged was reduced to 43 from 50.
The fiscal downturn has also caused the department to reduce the number of security guards it employs and is seeking to consolidate its programs in fewer buildings to save on rent.
During the question period, senators expressed their confidence in Finch’s ability to lead the department through difficult times and Sen. Nereida Rivera-O’Reilly and Dowe voiced their support for the MAP transfer.
When asked what could be done to further help DHS, Finch said a lump sum budget would give his department the most flexibility. Dowe and Sanes said they would vote for such a concession.
The hearing closed with a presentation from the Bureau of Motor Vehicles. Director Jerris T. Browne said his department was requesting $1,728,432 from the General Fund. This is a decrease of $216,121 or 11 percent from FY12.
The BMV is also seeking $1 million from the BMV Fund, and Browne estimated his department would receive $536,545 from the Personalized License Plate Fund for a total budget of $3,264,977.
Browne said his department’s primary goal for the following year would be to finish implementing the Real ID ACT of 2005, which standardizes the issuing process for driver’s licenses across the country and increases security measures.
The territory has received a $2.3 million of federal grants to implement the plan, of which $821,136 remains currently unspent and will be rolled over into the next fiscal year.
The federal deadline for the project is Jan. 13, 2013. Browne said his department was on schedule to hit that date.
The BMV also wishes to build a new headquarters on a 6.6 acre parcel in Estate Anna’s Hope on St. Croix. Their goal is to break ground by June 30, 2013.