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Executive Summary

In this Executive Summary, we present snapshots of the House of Representatives’ FY06 budget proposals in each of the agencies and areas that People First covers. Both here and in the full report that follows, we highlight advocacy priorities that, if achieved, would allow Massachusetts to carry out a comprehensive system of disability service provision. For the sake of clarity, throughout this document, we will refer to the House of Representatives’ FY06 budget as the “House budget.” We will refer to the governor’s FY06 budget, which is always named “House 1,” as “H1 for FY06.” For more details on agencies and programs and the impacts of FY01–FY05 budget cuts, see People First Volume I, available online at www.mass.gov/mddc/peoplefirst/index.html.

1. Department of Early Education and Care (DEE&C)

Both the House budget and H1 for FY06 move to establish the new DEE&C as an independent agency with funding merged from different departments. There is also sufficient funding to maintain current services. While H1 for FY06 would nearly level fund the new agency, the House budget allows for some modest increases. However, both the House budget and H1 for FY06 would transfer Community Partnerships for Children (CPC) and Massachusetts Family Networks (MFN) programs—which include funding for inclusive preschool education—at nearly level funding into the DEE&C. The Parent Child Home Program (PCHP) for families with children at-risk developmentally or educationally is similarly level-funded.

(See the DEE&C chapter on page 7 for details.)

2. Department of Education (DOE) / Special Education / The Circuit Breaker

The Special Education Circuit Breaker account funds the Circuit Breaker reimbursement formula that the legislature created to help school districts cope with extraordinary special education costs. The Circuit Breaker formula is supposed to pay for 75% of special education expenses that are above 4 times the average per pupil foundation budget.

Both the House budget and H1 for FY06 recommend level funding. The House budget includes an earmark designating $8,750,000 for voluntary residential placement prevention programs between the Department of Education and other agencies within the Executive Office of Health and Human Services (EOHHS) that develop community-based support services for children and their families, of which $7,500,000 is specifically for DMR (level with FY05). Another House budget earmark designates $3,000,000 for reimbursing school districts for emergency special education expenses (that are at minimum 25% beyond the previous year’s costs). Other House budget earmarks are discussed within the chapter.

(See the DOE / Special Education / The Circuit Breaker chapter on page 9 for details.)

3. Department of Elder Affairs (DEA)

The House budget contains key positive provisions for seniors and persons with disabilities. A $229.3 million increase is proposed for Senior Care Plans (line item 4000-0600), to pay MassHealth costs for providing care in the community or a nursing home. The 10-day “bedhold” provision for nursing home residents—to preserve stable living arrangements by continuing MassHealth coverage of an individual’s bed for a leave of up to 10 days—is continued with funding of $9 million.

As in H1 for FY06, a House budget outside section provides $50 million for wage increases for nursing home workers. The Prescription Advantage program is fully funded. Neither budget would impose stricter clinical standards for nursing home admission. The bad news is that neither budget includes funding for home health aide wage increases, nor for worker training programs for home health aides and nursing assistants.

(See the DEA chapter on page 10 for details.)

4. Department of Housing and Community Development (DHCD)

The House budget recommends that the Alternative Housing Voucher Program be funded at $3.0 million, a $700,000 increase over both the FY05 funding and H1 for FY06. Although advocates welcome the additional funds, $5.5 million is needed to fully fund the program.

(See the DHCD chapter on page 14 for details.)

5. Department of Mental Health (DMH)

The House budget recommends $24,770,989 (4%) above FY05 funding, which is just $462,506 more than H1 for FY06. As in H1 for FY06, this is a maintenance budget that provides no restorations or expansions to address service cuts or the huge waiting lists of 11,000–20,000 people in need of residential and case management services. The House budget maintains research programs at Harvard and the University of Massachusetts that H1 for FY06 would close, but it does so by sacrificing roughly $975,000 that H1 for FY06 had included under Community Mental Health to start up 15 community-residential placements. The House budget, therefore, fails to fully support DMH’s multi-year Olmstead initiative, which calls for 268 adult continuing care inpatient clients to be moved into community residential placements by the
close of FY06. Neither the House budget nor H1 for FY06 provide new funding for child/adolescent services to address a significant need for more home-based services.

On the positive side, the House budget includes language in the Executive Office of Health and Human Services (EOHHS) operations account (line item 4000-0300) that gives the DMH commissioner authority to approve or disapprove restrictions on medications to treat mental illness, including “prior authorization” requirements.

(See the DMH chapter on page 15 for details.)

6. Department of Mental Retardation (DMR)

The House budget recommends $58,868,869 more than the FY05 funding for DMR; this amount is just $576,217 more than in H1 for FY06. Both the House budget and H1 for FY06 represent a 5.5% increase and provide for the requirements of the Boulet and Rolland class action settlement agreements. Both also essentially level fund Turning 22 (T22)services for young people who are graduating or aging out of special education services: level funding becomes less adequate to meet the needs of the program, since costs increase every year.

Unlike H1 for FY06, however, the House budget creates a new line item for DMR’s new Autism Division and funds it at $1 million. The House budget also provides $500,000 in restoration funding to the Flexible Family Supports account (for which advocates are seeking $4.5 million). Neither the House budget nor H1 for FY06 funds any new service coordinator positions nor does either budget restore the 18–20 service coordinator positions that were cut in FY05, despite expanding caseload.

(See the DMR chapter on page 21 for details.)

7. Department of Social Services (DSS)

The House budget for total DSS funding in FY06 is $28,544,346 (4.0%) above the final FY05 funding amount and $6,438,348 above H1 for FY06. Both budgets, according to DSS agency staff, would essentially provide for maintenance of services. For services for Children and Families, including essential mental health and substance abuse services, the House budget proposes an increase of $ 9,883,612 (3.8%) over the FY05 funding level, which is $ 992,508 more than in H1 for FY06.

(See the DSS chapter on page 27 for details.)

8. Department of Transitional Assistance (DTA)

The House budget for DTA is more beneficial for persons with disabilities than is H1 for FY06. Both budgets take steps to anticipate pending changes to welfare policy at the federal level during 2005. The House budget largely maintains current policy, and will wait to make changes through regular legislative action. A House budget reserve account (line item 1599-4408) holds $12 million in flexible employment and child care services funds, intended to aid in compliance with federal changes. In contrast, H1 for FY06 would have imposed new work requirements and time limits on about 14,000 program participants—including 5,600 disabled parents—in the Transitional Aid to Families with Dependent Children (TAFDC, line item 4403-2000). H1 for FY06 also would have imposed work requirements on participants in the Emergency Aid to the Elderly, Disabled, and Children program (EAEDC, line item 4408-1000). This change would cause the loss of benefits for an estimated 2,030 disabled immigrants due to failure to comply and a reduction in the monthly grant amounts for an additional 1,220 persons.

(See the DTA chapter on page 28 for details.)

9. Department of Youth Services (DYS)

The House budget proposes a total of $139,907,688 for DYS, which is $4,428,695 (3%) less than in H1 for FY06. House budget funding for residential programs for detained youths (line item 4200-0200) is 1.8% higher than the FY05 allocation. House budget funding for community programs for committed youth (line item 4200-0100) is 1.4% higher than the FY05 allocation. It is possibly less than a maintenance funding level for of these both line items. The House budget falls short about $5.4 million of annualizing the Safety First Plan suicide prevention initiative started in FY05. The House budget represents a major setback in the debate, as compared to H1 for FY06, for the mental health and special education needs of DYS young people.

(See the DYS chapter on page 31 for details.)

10. Massachusetts Commission for the Blind (MCB)

The House budget recommends $62,991 more than in H1 for FY06, which is 2.4% above FY05 funding. Neither the House budget nor H1 for FY06 provides maintenance funding for the Community Services account, nor for needed expansion for the Deaf/Blind Community Access Network waiting list. Both budgets fail to provide the increase needed for Vocational Rehabilitation to enable more students with vision impairments to go to college. Overall, the House budget comes closer than H1 for FY06 to providing for MCB salaries, while both budgets provide for the FY06 Turning 22 students. These budgets also under-fund needed annualization for the FY05 Turning 22 students (to continue services started to new participants in FY05). Both budgets continue to erode the Ferguson Industries program.

(See the MCB chapter on page 33 for details.)

11. Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH)

For MCDHH as a whole, both the House and H1 for FY06 budgets recommend an increase of $108,903 (2%). The budgets would maintain all program services at the FY05 level. Advocates are requesting an increase of $558,903 for MCDHH in FY06.

(See the MCDHH chapter on page 37 for details.)

12. Massachusetts Department of Public Health (MDPH)

The FY05 MDPH budget is currently 23% below the FY01 funding level, unadjusted for inflation. The House budget for FY06 provides primarily maintenance—not restoration—funding. Environmental Health (including lead poisoning), the Special Supplemental Nutrition Program for Women, Infants, & Children (WIC) program, and Universal Newborn Hearing Screening are all level-funded. Early Intervention, Dental Health, and Family Health Services would receive modest increases. The HIV/AIDS Bureau is also proposed for a small increase, though not enough to prevent wait-listing of persons in need of life-sustaining drugs.

(See the MDPH chapter on page 40 for details.)

13. Massachusetts Rehabilitation Commission (MRC)

The House budget is $174,582 below funding in H1 for FY06 and $1,282,143 (3.48%) above the FY05 funding level. As in H1 for FY06, the House budget offers some progress for funding Turning 22 (T22)—the adult services provided to students who graduate or age out of special education or other youth services. The House budget provides $712,550 for new T22 program participants, but inadequate funding for full annualization to continue services to all current clients. H1 for FY06 had fully funded both annualization and new T22 participant needs.

In addition, the House budget proposes no relief for the Independent Living Centers (ILCs) nor for the Home Care crisis. The ILCs have had level funding for 5 years. Home Care has a 4- month processing list for services. Vocational Rehabilitation (VR) and its long waiting list would also make no progress under this budget.

(See the MRC chapter on page 44 for details.)

14. Office of Medicaid (MassHealth)

Proposed House budget spending for MassHealth in FY06 is about equal to that of H1 for FY06, with a difference in how the two budgets account for carry-over funds from the current fiscal year. The House budget is meant to accommodate an enrollment increase from 980,000 to 1 million people. Given health care inflation rates close to 8%, this goal may be unrealistically optimistic within the proposed allocation. Neither budget has major initiatives to address the health care coverage needs of the 500,000 uninsured residents of Massachusetts.

The House budget does not restore coverage for adult dentistry and eyeglasses, a priority for disability advocates. Enrollment caps remain in place for CommonHealth, the MassHealth HIV Program, and the Insurance Partnership. An enrollment freeze is likely for MassHealth Essential. On a more positive note, last June’s restoration of coverage to 3,000 elderly and disabled legal immigrants was continued and $86 million was restored to the “off-budget” Uncompensated Care Pool.

(See the MassHealth chapter on page 49 for details.)

15. Other State Disabilities Agencies and Programs

The House budget rejects the H1 for FY06 attempt to consolidate three civil legal services agencies—the Massachusetts Legal Assistance Corporation (MLAC), the Mental Health Legal Advisors Committee (MHLAC), and Massachusetts Correctional Legal Services. MLAC is allocated a much-needed $500,000 restoration. MHLAC receives a below maintenance budget.

The Governor’s Commission on Mental Retardation still does not have its own line item nor does it have any earmark funding. The Commission has been moved to EOHHS, but its budget is now unknown. Staff have been reduced by one-third in recent years.

For the Massachusetts Office on Disability, the House budget recommends $18,313 more than in H1 for FY06. This House budget amount is 5.5% above the FY05 funding level. This recommendation would support a maintenance budget for MOD’s current staffing level only. Since FY01, MOD has been cut $167,012 (22.5%), unadjusted for inflation.

The Disabled Persons Protection Commission would receive a modest increase of 2.5% over FY05 funding, an amount that falls $3,122 below the amount in H1 for FY06.

Similarly, for the Massachusetts Commission Against Discrimination (MCAD), the House budget recommends a 6.4% increase over FY05 funding, but $2,790 less than in H1 for FY06.

The Architectural Access Board, funded as part of a larger line item in the Office of Public Safety and Homeland Security, still has no earmark or separate line item indicating its budget.

(See the Other State Disabilities Agencies and Programs chapter on page 55 for details.)

16. Salary Reserve

The House budget allocates just $10 million for the Direct Care Worker Salary Reserve that provides modest but important salary increases for direct care workers. These workers are employed by service providers that contract with state agencies under the Executive Office of Health and Human Services (EOHHS) and the Department of Elder Affairs (DEA). An amendment to raise the amount to $35.7 million did not pass. H1 for FY06 provides no Salary Reserve funding.

(See the Salary Reserve chapter on page 59 for details.)