Good morning and welcome to the 2012 Marie Antoinette awards. This year's grand prize winners: Idaho Gov. C. L. (Butch) Otter and House Majority Leader Mike Moyle, R-Star. And while Antoinette may or may not have famously looked down upon the starving masses of French citizens and declared: “Let them eat cake,” it is certainly more artful than the two-word retort Otter and Moyle may have in store for Idaho's neediest, its injured and its broken: Too bad. Too bad the state went broke a year ago and had to hack away at Medicaid services for Idaho's most vulnerable adults. To save $35 million in state dollars, Idaho had to sacrifice another $60 million in matching federal dollars. Too bad that meant less support for developmentally disabled adults struggling to live and work independently. Too bad the state would devote less effort to helping the mentally ill maintain their equilibrium and their safety. Too bad it meant no preventive dental care, vision or audiology services/Marty Trillhaase, Lewiston Tribune. More here.

Question: Do you think Butch Otter intentionally low-balled revenue estimates last year as part of an agenda to slash state Medicaid funding?

I haven't gotten any feedback from Gov. Butch Otter's office on my previous blog post (and Saturday column preview), taking the governor to task for refusing to reverse $35 million in cuts to Medicaid programs. But Wayne Hoffman of the Idaho Freedom Foundation was quick to take me to task. In this response, he takes me to task — and says there is nothing “compassionate” about perpetuating social programs such as Medicaid. Hoffman is nice about it, though, I suppose. “Hopefully, with a lot of education and a little love, Kevin will learn something useful.” Yup. I feel the love already/Kevin Richert, Idaho Statesman. Wayne Hoffman's response here.

Question: Hoffman makes a good point that federal entitlement money comes from a national treasury that's in a $15 trillion hole and growing. And that there's nothing compassionate about entitlements that make us more dependent on the federal government. What do you think?

Rebekah Casey of Hayden (pictured in Eye On Boise photo) was one of the individuals who testified about Medicaid cuts before the Idaho Legislature budget committee this morning (she's one pictured in Eye on Boise link). Betsy reports on Rebekah's testimony: “My husband and I have adopted two children through the foster care system. My daughter has been receiving PSR services for almost two years now.” The youngster struggles, she said. “Without the PSR services … we would not have been able to maintain her in our home.” Over the summer, Casey said, her daughter suffered a crisis, and was unable to obtain additional psycho-social rehabilitation services due to the new 5-hour cap on such services for children. “Instead we were forced to consider medicating our 4-year-old daughter, when therapy services would have been sufficient,” Casey told lawmakers. More here.

• JFAC members: 'Put a human face on our budget decisions'
• JFAC wraps up after 2 1/2 hours of public testimony
• Testimony: 'I don't know what we'll do'
• Testimony: Parents of mentally ill kids being told to get them into juvie for treatment
• Testimony: School funding, state employee pay, restoring PSR, dental cuts
• Testimony: Impact of Medicaid cuts, funding priorities, suicide hotline…
• Testimony: ‘Medicaid cuts don’t necessarily lead to savings’

Question: Should the Idaho Legislature restore Medicaid cuts?

Suicide is on the increase in rural America—nowhere so much as in western mountain states like Idaho, Wyoming and New Mexico. Mental health professionals attribute it in part to cutbacks in Medicaid funding, to the recession and to the culture of the rural West. In Idaho, somebody kills himself every 35 hours, according to a 2009 report to Idaho's governor by the state's Council on Suicide Prevention. Their report calls suicide “a major public health issue” having a “devastating effect” on Idaho's families, churches, businesses and even schools: 65 students aged 10 and 18 killed themselves in a recent five-year period. Last week a county sheriff in Bonneville told the Idaho Falls Post Register that his department was getting more suicide calls than in 2010—a year in which 290 Idahoans took their own lives. “We're in a spike right now,” he says/Alan Farnham, ABC News. More here. (AP file illustration)

Question: Story goes on to link hike in Idaho suicides to Medicaid cuts. Do you think there's a link?

StateImpact Idaho is beginning to look at the effects of the $34 million Medicaid cut that the Idaho Legislature passed last session.  Related to that, a new report from the National Alliance on Mental Illness (NAMI) tallies the state-by-state changes in general fund appropriations for state mental health agencies since 2009.  According to the report, Idaho is among the ten states that have made the greatest cuts, by percentage, since that year. As advocates for people with mental illness will point out, Idaho hasn’t had a great track record of funding services for the state’s mentally ill. “I think the shocking part is we spend $44 per capita on mental health, and the national average is $122. So we’re about a third of the national average,” said Doug McKnight, president of the Idaho chapter of NAMI/Molly Messick, State Impact. More here.

Question: Do you suppose underfunding mental health services is one of the way's the Otter administration provides good governance?

Click below to read AP reporter John Miller's full report on today's state revenue news, which focuses on Gov. Butch Otter's decision to spend $15 million of the 2011 year-end surplus to reverse this year's decision to put off a scheduled $10 bump-up in the grocery tax credit, instead of calling a special session of the Legislature to restore some of the cuts made to Medicaid in next year's budget. Because every dollar cut from Medicaid means losing twice as much in federal matching funds, reversing some of this year's cuts could have restored tens of millions to the health care program for the poor and disabled/Betsy Russell, Eye On Boise.

• State budget: 'Some pretty harsh things have been done'
• Ferguson on revenue forecasting: 'People's lives and health are at stake'
• Idaho's June tax revenue over forecasts by whopping $19.1M

Question: Do you think Butch Otter & the Idaho Legislature intentionally low-balled revenue forecasts to make draconian cuts to programs they don't like?

Lawmakers have received two Idaho attorney general's opinions on nullification; the first said any attempt by state lawmakers to nullify a federal law through legislation would violate both the U.S. and Idaho constitutions and lawmakers' oath of office. The bill was revised after that, but the second opinion still said the new version likely is unconstitutional; plus, it said HB 117, if passed, could have the effect of opting Idaho out of participation in the federal Medicaid program - including receiving more than $1 billion in federal funds that now provide health care to the state's poorest and disabled residents/Betsy Russell, Eye On Boise. More here.

• Eric Anderson: 'Let's abide by the Constitution'
• Debate: 'This bill is symbolic'
• McGeachin: 'Do not wish to give my opponent undue recognition'

Question: Are 'nullification' advocates in Idaho Legislature playing with fire — and the possibility that they could cost the state $1B in Medicaid funding?

• Weekend Poll: Hucks Nation supports raising taxes to protect essential services, like Medicaid and public education. 111 of 208 respondents (53.4%) support a tax increase to protect services. 92 of 208 (43.2%) oppose raising taxes. 5 (2.4%) were undecided.
• Today's Poll: Should Idaho's anti-discrimination law be expanded to add sexual orientation to its protected classes?

Katherine Hansen of Boise presented lawmakers with 13,740 petitions signed by Idahoans calling for lawmakers to consider a tax increase rather than cut home and community-based services for people with disabilities. The signers, she said, are “13,740 Idahoans from every county and every city in this great state. … The people who signed these petitions urge you to approach the current budget crisis in the same way they approach their budget crisis - everything needs to be on the table”/Betsy Russell, Eye On Boise. More here.

• 'These programs work, so please don't cut them'
• Hearing has drawn up to 1000 to Capitol
• Testimony: Idaho is improving PSR services thru new credentialing requirements
• Testimony: 'Idaho will end up paying more'
• Testimony: 'I want to have a job'
• Quadriplegic: 'Bottom line is quality of life — let me keep mine please'
• Dentists: Proposed changes will cost state more
• Testimony: 'I was a dysfunctional mess'

Question: Would you support a state tax increase to maintain essential services such as Medicaid and schools?

AmyY (re: “Political Game: The least able”): I have a child with a developmental disability and I spend every waking (and sleeping) moment trying to figure out how to support him in the most appropriate way. My days are filled with managing therapeutic care, education plans, medical care, recreational opportunities, managing breakdowns and behaviors, providing “learning opportunities”, researching, implementing, observing, documenting and analyzing everything. Oh - and let's not forget about the thoughts about what will happen to him when I die. Now I'm supposed to manage a cadre of community volunteers to assist me and my child? Volunteers who are not trained or experienced and who may in fact do more harm than good? Full post below.

Question: You still believe that having volunteers from families, friends, and church make up the difference in services provided by the cash-strapped state is a good idea?

Nic's wife, Rebekah, penned the following for today's Medicaid hearing before the legislative budget committee in Boise. It's a must read for understanding the importance of state Medicaid funding:

Christian is six years old. He was recently diagnosed with Asperger’s. He is in kindergarten and he loves school. He is extremely smart and excels in math. His special interests are dinosaurs, animals, and art. He wants to be a Scientist that helps animals when he grows up. Christian can achieve his dreams without a doubt, but not if he does not learn how to cope with the challenges that Asperger’s brings. He currently receives IBI therapy and counseling services. He is making great progress. I am learning so much about how to parent him and help him become a contributing member of our society. Without these interventions I would not have the skills, knowledge, or supports that I need to help him grow into the person he is capable of being/Rebekah Casey, Rants, Raves, & Random Things. More here.

Question: Do you know people who depend on state Medicaid funds?

Sen. Brent Hill, whose colleagues elected pro tem earlier this month, opined in 2005 that Medicaid’s spending is out of control. Wrote Hill, “When a small number of cells in an otherwise healthy body multiply without control, healthy tissue is destroyed and survival of the whole body is endangered. The condition is called cancer. When a small number of programs in an otherwise healthy government multiply without control, the condition is called Medicaid”/Wayne Hoffman, Idaho Freedom Foundation. More here.

Question: Do you consider Medicaid to be a cancer on state government?

Looking ahead, Idaho’s facing a projected state fund shortfall for Medicaid in fiscal year 2012 of $171.6 million. That’s a huge hole, and Armstrong said it’ll likely mean cutting services. Children are protected, so “we would have to focus on adult services – that’s where we’d have to go. We would have to eliminate major categories of service.” Armstrong said “every state in the nation” is looking at the same “Draconian” type of cuts. One suggestion he offered to cope with the crisis: Back in the ‘50s and ‘60s, there was much more use of volunteers in providing services to the disabled and others. Idaho could “see if there could be a resurgence of voluntary assistance, specifically around keeping adults stable in the home environment,” Armstrong said/Betsy Russell, Eye On Boise. More here.

Question: Can volunteers be expected to provide services to disable and others, if Idaho cuts back to much on Medicaid funding?