As legislators, we must treat each taxpayer dollar with the utmost respect, seeking to maximize its effectiveness and efficiency. That is our responsibility as elected officials. As we grapple with a $200 million deficit in the upcoming budget, our top priority must ensure we don’t balance the budget on the backs of the most vulnerable in our state, children and families, individuals living with intellectual/developmental disabilities and/or mental health issues, and seniors. I expect most of my colleagues feel the same.
It is critical we secure all pertinent facts and data, most importantly the policy rationale, surrounding all budget items/initiatives. This is paramount to making objective decisions.
We must continue to personalize each of the budget items, seeing them through the eyes of the clients being served. When General Assembly members discuss how to fund the Department of Children, Youth and Families, we must understand how the agency operates and the challenges the families and children face under the supervision/care of DCYF. Similarly, we should understand the real impact upon clients served by the Department of Behavioral Healthcare, Development Disabilities and Hospitals. Legislators learn from community advocates and residents being served by nursing homes, group homes, child care programs, behavioral healthcare facilities and numerous health and human service programs. After all, the budget document is a policy document first and fiscal document second. It is a reflection of our priorities.
At a recent Senate Finance Committee hearing, Health and Human Services Secretary Eric Beane stated: “Over the last 10 years, our share of statewide general revenue has remained relatively flat … the state’s general revenue has decreased over the last couple of years. While state spending on health and human services has increased in real terms since the worst of the Great Recession, our belts have remained tight, and spending is below where it was in 2008, once you adjust for inflation. I’d also note that medical costs have historically risen faster than inflation, another sign that we continue to drive savings.”
Many will remember Gov. Gina Raimondo’s “Working Group to Reinvent Medicaid.” This effort resulted in saving approximately $100 million in annual Medicaid expenditures, without cutting eligibility or reducing benefits — ultimately saving $1 billion over 10 years. The General Assembly supported this effort to obtain greater efficiency from the investments of taxpayer dollars.
Further, the governor has appointed new directors to both DCYF and BHDDH to reform practices and programs to ensure some of the most vulnerable populations have high-quality programs. We must work to understand how funding patterns in the respective agencies are impacting outcomes for these individuals. Some suggest we are spending too much on these programs and they are part of our fiscal problem. I wholeheartedly disagree. DCYF and BHDDH have been underfunded for many years even as they are transforming programs to do more with less. Recently, the General Assembly passed legislation setting a DCYF System Reform and Rebalancing Goal (RIGL: 42-72-36.1) of “reinvesting the benefits that accrue from the more efficient and effective utilization of congregate care, foster homes and community-based services.” Additionally, DCYF and BHDDH are under intense scrutiny from the federal court as they work to meet the conditions of their respective consent decrees. This underfunding cannot and must not continue. We must ensure the wellbeing and safety of our state’s most vulnerable citizens.
Working closely with our state’s partners — the multiple private and public providers statewide — we certainly need to continue to be smart about how we invest precious taxpayer dollars in early intervention and prevention, including the social determinants of health. And, we need to maximize our use of federal dollars to offset the impact on Rhode Island taxpayers.
We cannot and must not balance the budget on the backs of the most vulnerable in our state. I encourage everyone who cares about these issues to get involved and ensure their legislators are working to protect the well-being of our state’s most vulnerable. It is critical that you make your voices heard.
Louis P. DiPalma is a Democrat representing District 12 (Little Compton, Middletown, Newport, Tiverton) in the Rhode Island state Senate, where he is the first vice-chair of the Senate Committee on Finance.