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Loss of fed. $ means Bay State seniors, caregivers will suffer

BOSTON —

A holdup of federal stimulus money is largely to blame for the $27.6 billion budget Gov. Deval Patrick signed that negatively impacts the state’s oldest citizens and their caregivers.

“Programs that help vulnerable seniors … now operate at bare bones levels,” said Jessica Costantino, AARP Massachusetts director of advocacy. “Our vulnerable residents should not be bearing the brunt of budget cut after cut – especially in tough economic times.”

State aid to cities, towns and schools has also been cut for the new fiscal year that began July 1, at the same time vetoing $457 million in spending, much of it anticipated from the extended federal stimulus funds (FMAP) that Congress has yet to approve.

There are no new taxes in the budget that took effect July 1. The spending plan also relies on diverting nearly $200 million from the state’s rapidly dwindling rainy day savings account.

Although Patrick said the budget is balanced, it depends on a $300 million debt-restructuring plan that the Legislature has yet to pass. That plan awaits a final vote in the Senate.

While that leaves the budget out of balance, the governor said he expects the Senate to approve the plan in the next few days. He said budgets are always balanced using anticipated revenues.

Both lawmakers and Patrick built into their budget projections for the 2011 fiscal year on an anticipated $687 million in additional FMAP dollars. Democrats in Congress supported the measure, but a GOP filibuster in the U.S. Senate — which included Sen. Scott Brown — blocked it. “Gov. Patrick has been forced to make even deeper cuts to programs and services, including public safety and education, because the state has not received … anticipated extended federal stimulus funds” said Costantino.

“It’s been a bad afternoon for home care services in Massachusetts,” said Al Norman, executive director of Mass Home Care, with regard to the governor’s signed budget.

AARP Massachusetts and Mass Home Care joined more than 300 groups and individuals at a rally recently outside Brown’s office in Boston to persuade him to vote, “yes,” on FMAP.

The loss of those federal dollars forced state lawmakers to draft two versions of the budget — one anticipating that Congress eventually approves the money; the other assuming it won’t be approved. Patrick chose to sign the lower budget, assuming the money isn’t coming. (see graph below)

That decision accounted for $372 million of the $457 million in cuts, according to Patrick’s Secretary of Administration and Finance Jay Gonzalez. Additional cuts include a $20 million reduction to programs for developmentally disabled children and other cuts to health services.

The home care and protective services program are losing more than $12 million combined.

“The big losers are home care, care management and protective services. Basically any of the accounts that the General Court tainted with FMAP money at the Conference Committee stage, are losing big,” said Norman.

Home Care lost $7.9 million, case management $2.8 million, and protective services $1.48 million.

Norman — whose group represents 30 non-profit home care agencies across the state — said the $7.9 million in home care funds would have allowed “a whole year’s worth of home care services for 2,470 elders.” He said, the remaining $95 million operating budget for basic home care means that a waiting list will stay in place for the next 12 months. “Our spending has dropped to that level of annualization.”

Norman said the $1.5 million cut to the protective services account, means more protective/elder abuse cases will fall through the cracks.

Though Prescription Advantage funding escaped the governor’s veto, the state’s pharmacy assistance program is still operating at a bare bones level, going from an allocation of 50.6 million in 2009 to 31.5 million today. “Already 40,000 seniors have lost prescription drug benefits, said Costantino, of the program that works with Medicare Part D, to help 60,000 older residents pay for drugs.

Also safe is the $2.5 million in the Long Term Care Options account, which helps seniors and caregivers make informed choices about long-term services, supports, and living options.

The state’s nursing homes also took a hit with the loss of $27.2 million in supplemental funds that were contingent on FMAP money.

According to a release by the Mass. Senior Care Association, which represents the state’s nursing homes, the group will urge state lawmakers to override the governor’s veto of the Medicaid supplemental funding, so that if Congress votes to allow FMAP distribution, Patrick would be required to adjust upward Medicaid nursing facility rates. — BY SONDRA SHAPIRO

Associated Press and Mass Home Care material was used in this report.

FY 2011 House 2/Governor Patrick’s Vetoes and w/o FMAP June 30, 2010

FY 2010 Budget Request

( in Millions)

FY 2009

Final after 9c cuts

Oct 08

FY 2010

Final after 9c and impoundments

FY 2011

Gov

House 2

FY 2011

Conference Comm

FINAL

FY 2011

Gov Vetoes no FMAP

6/30/10

1599-6901 Salary Reserve $ 23.0 $0 $0 $0
4000-0600 LTC Options screening $     .270 $2.5 (not funded) $0 $2.5 M earmark*
4000-0650 Community First $6.5 $0 $0 $0 $ 0
4000-0640 NF Bed tax $288.5 $288.5 $288.5 $288.5 $288.5
9110-0100 EOEA Admin $    3.641 $2.120 $2.062 $    1.994 $    1.994
9110-1455 Rx Advantage $  50.633 $40 $  31.515 $ 31.542 $   31.543
9110-1500 ECOP $  48.199 $45.789 $  45.789 $ 45.789 $   45.789
9110-1630 purchased services $102.747 $100.3 $100.3 $103.251* $   95.311
9110-1633 CM & ASAP operations $ 37.568 $36.068 $  36.068 $  37.194* $   34.312
9110-1640 Mental Health $     .125 $0 $ 0 $    0 $     0
9110-1650 Family Caregivers $    0 $0 $ 0 $    0 $     0
9110-1900 Meals on Wheels $   6.602 $  6.279 $  6.277 $   6.321*
9110-1604 Supportive Housing $    4.153 $4.014 $  4.014 $    4.123 $    4.015
9110-1660 Congregate Housing $   2.161 $1.503 $  1.503 $    1.573* $    1.504
9110-1700 Homeless $     .153 $  .136 $   .136 $      .136 $    0
9110-1636 protective services $ 16.246 $15.252 $15.249 $  16.733* $   15.251
9110-9002 Councils on Aging $  7.543 $  8.115 $  8.115 $  8.265* $    7.904

* Line items that were tagged with FMAP Budget Relief Fund

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