Week of February 21 Budget Update

House and Senate budget chairs released targets for budget subcommittees this week.  You can view the full document here.  Not suprisingly, the numbers are lower than those in the Governor's budget  - about $1.4 billion lower - and the subcommittees have been given lists of items to consider for cuts.

Education:

Base Budget (what it would likely take to continue services at current levels) - $11.913 Billion
Legislative Spending Target - $10.483 Billion
Difference - $1.43 Billion
Items to consider:

• Consolidate/eliminate Smart Start and More at Four. (In consultation with the HHS Subcommittee
• Determine alternative salary schedule based on performance. (Full Chairs item with Subcommittee Chair consultation).
• Cap university enrollment.
• Encourage more attendance at community colleges during freshman and sophomore years.
• Reduce or eliminate higher education funding for less essential classes/degrees.
• Fund higher education based on performance (i.e. graduation rates, measures of learning).
• Tuition waivers.
• Financial aid.

Health and Human Services:
Base Budget - $4.927 Billion
Legislative Spending Target - $4.336 Billion
Difference - $491 Million
Items to Consider:

• Consolidate/Eliminate Smart Start and More At Four. (In consultation with the Education Subcommittee)
• Provider Assessments.
• Managed Care.
• Maximize federal funds (block grants).
• Evaluate federal maintenance of effort requirements.
• Consolidation of divisions.
• Medicaid parity with State Health Plan/Health Choice.
• Copayments.
• Consider closing facilities.
• Eliminate structural redundancy (restructure the organization to streamline services).

The Health and Human Services committee heard two days of public comment this week.  Commenters included lobbyists for advocacy organizations, as well as individuals with disabilities and their caregivers.  The committee also heard from several vendors on cost-saving strategies today.  Handouts from today's presentation are available on the committee website here.  At this time, one presentation, from the ex-Georgia Medicaid Director is not posted (he discussed managed care in Georgia, which did not include Aged, Blind, Disabled).  The other presentations included a respresentative from the Amerigroup Corporation, who proposed a managed care program for a small subset of the Long-Term care population, low acuity nursing home residents; MedSolutions, a group that currently contracts with NC to provide prior authorizatuon for radiology and ultrasound services; Triad Healthcare, a group focused on reducing the cost of musculoskeletal care; and Value Options, who proposed competitive bidding for a statewide behavioral health managed care waiver.

Justice and Public Safety
Base Budget - $2.207 bil
Legislative Spending Target - $2.067 bil
Difference - $140 mil
Items to Consider:

• Justice Reinvestment Strategies.
• Eliminate/modify programs or services.
• Reduce inmate medical costs.
• Shift/consolidate medical/treatment to State Health Plan or DHHS.
• Close or consolidate facilities.
• Consolidation of departments proposed by the Governor.
• Policy changes to assure the lowest cost for housing misdemeanants.