February 9, 2014 in Idaho

Eye on Boise: Advocates promote budget that restores Medicaid cuts

By The Spokesman-Review

BOISE – Advocates for people with disabilities say Idaho could both restore cuts made to its Medicaid program in 2011 and fix flaws in the current system if it followed former chief state economist Mike Ferguson’s proposed alternative budget for next year.

“This is not a question of resources,” Ferguson said. “It is a question of will.”

The advocates, who gathered at the state Capitol on Thursday, called for restoring the $35 million cut from specific Medicaid services in 2011, channeling the money into three priorities: building a community-based mental health system in Idaho; keying services for children with disabilities to their needs, rather than to a per-child budget amount; and paying providers “a fair and equitable reimbursement rate to ensure quality, sustainable services.”

“Every study conducted in Idaho has reported a mental health system which is fragmented and concentrated on involuntary hospitalization with a huge percentage of people with mental illness being held in jails or prison,” said Jim Baugh, executive director of Disability Rights Idaho. “From 2009 to 2011 in response to the Great Recession, Idaho decimated its meager array of services for people with serious and persistent mental illness.” Baugh said the cuts have gone so far that “parents are now advised to have their children charged with a crime so that they have the ability to get priority for mental health services.”

He said the Department of Health and Welfare closed nine of its satellite mental health clinics from 2009 to 2011, cutting hundreds of patients off from services from Assertive Community Treatment teams. The teams provide long-term assistance to people with persistent mental illness to help them avoid going into crisis. Baugh said “$5.6 million would restore seven ACT teams and provide ACT to 700 people with serious and persistent mental illness. Instead of the three behavioral health crisis centers proposed by the governor, Idaho could have seven centers serving all geographic regions.”

Katherine Hansen of Community Partnerships of Idaho said a 2007 state study found that Idaho care providers were being paid far less than the cost of their services. In 2009, Health and Welfare asked the Legislature to cover half the $22 million gap that was identified. “The increase was never funded,” she said. “In fact, Medicaid has been cut further.”

Ferguson said his budget proposal, which would shift priorities from tax cuts and increasing reserves to school funding, employee pay raises and restoring Medicaid, shows the state has the money to address those priorities. “There are substantial ongoing revenues available that are not being utilized in the executive budget,” he said.

Baugh said he’s encouraged that the Legislature already is moving to restore adult nonemergency dental coverage that was cut from Medicaid in 2011, and by legislation introduced last week to restore employment supports for developmentally disabled people, another 2011 cut that removed the ability of many of those clients to work.

“I think the Legislature does have the desire to go back and fix some of the unintended consequences of what happened in ’11 with the $35 million cut,” he said. With the approach in Ferguson’s alternative budget, he said, “We could make bigger steps.”

Nullify EPA?

Spurred by angry miners who don’t like a new Environmental Protection Agency permit that’s been required for suction dredging in Idaho since last spring, Rep. Paul Shepherd has introduced legislation to nullify the EPA, declaring its regulation authority “null and void and of no force and effect in this state.” The bill says the EPA is unconstitutional and invalid and calls on the state to “enact any and all measures as may be necessary to prevent the enforcement of regulations” issued by the agency.

Shepherd, a Republican from Riggins, said his bill wouldn’t bar all EPA rules, just those not directly enacted by Congress. “The bureaucrats are making the rules,” Shepherd said.

Idaho, unlike most states, requires all agency administrative rules to come to the Legislature for review and approval. Most states and Congress don’t.

“Show us where it was passed by Congress,” Shepherd said. “We still believe the Constitution and states have sovereignty.”

Shepherd said he’s requested an Idaho attorney general’s opinion on his bill but hasn’t yet received it.

Sub for Ringo

Paulette Jordan, a former Coeur d’Alene Tribal Council member who ran for the House as a Democrat in 2012, filled in for Rep. Shirley Ringo, D-Moscow, for three days last week while Ringo attended to some family business. Jordan, a Plummer resident who calls Ringo a mentor, lost a close race to freshman Rep. Cindy Agidius, R-Moscow, in 2012.

Follow Betsy Z. Russell on her blog, Eye on Boise, at spokesman.com/boise and on Twitter @BetsyZRussell. She can be reached at betsyr@spokesman.com or (208) 336-2854.

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