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On April 29, 2005, the Massachusetts House of Representatives completed work on its state budget recommendations for fiscal year 2006 (FY06 will run from July 1, 2005 to June 30, 2006). The Massachusetts Senate finalized its FY06 budget on May 26th. Next, a Conference Committee, composed of three representatives and three senators, will reconcile any differences between the FY06 budget recommendations of the House and those of the Senate.
The Conference Committee chooses between language and amounts for line items in the two budgets through a series of compromises. For instance, the House budget might recommend a new policy for a particular program or service while the Senate budget might not make any such recommendation. Another time, the House budget might recommend $10 million in funding for a particular line item. while the Senate budget might recommend $20 million for the same line item (as is the case with the Salary Reserve this year). (A line item is a particular account in the budget and is identified by an eight digit number. )
The result of this process is the "Conference Committee budget," a single set of recommendations for FY06 that the committee reports back to each chamber for a single "up or down" vote. If the Conference Committee budget is approved by a majority vote in each chamber, it is sent to the governor.
In this third People First report for the FY06 state budget debate cycle, we describe and analyze the critical choices to be made by the Joint House/Senate Conference Committee. The report is meant to serve as a complement to our two earlier FY06 budget analysis products-People First Volume I, on the governor's budget proposal and People First Volume II, on the House budget proposal. These two documents provide a comprehensive description of all the disability services funded by the Commonwealth, and should be used as a resource for those who want more information about the programs for which the Conference Committee will need to choose final amounts. People First Volume IV (which will only be available electronically) will examine the governor's veto message and recommend overrides necessary to best support disability services. To peruse other volumes in the series, visit www.mass.gov/mddc/peoplefirst/index.html.
The FY06 budget is being created in a very cautious climate. During House debate, some additional spending was approved with the expectation of Democrats that a bill closing corporate tax loopholes would be passed later. The measure is expected to generate $170 million in new revenues. Still, in spite of new and recovering state revenues, a structural deficit-a mismatch between sustainable revenue and spending needs-is anticipated to continue in FY06 and beyond.
According to recent reports, the fiscal challenges Massachusetts faces are due to a combination of tax cuts enacted during the 1990s and spending growth in 4 areas that are consuming about $1 billion of additional spending each year: health care, public education, capital investments and their debt service costs, and pension costs that exceed the inflation rate. Meanwhile, revenue growth is estimated at about $700 million for FY05 and FY06.
This year there are fewer significant differences to be reconciled between the House and Senate budgets than in past years. There are fewer outside sections that propose major changes in laws unrelated to the budget, and there is a general consensus that spending should be held in check. Still, there are major funding differences between the two branches that are, indeed, "critical" to the disabilities community; and they will require quick and well-focused advocacy.
The House budget for FY06 recommends maintenance funding, level funding, or small increases for most programs and agencies. The Senate budget shows stronger support for rebuilding programs and services that meet basic and unmet human needs, and is more positive for disability services. However, the Senate budget also relies more heavily on one-time revenue sources (as much as $656 million ), while offering few long-term solutions to our structural deficit. The Senate proposal reflects support for closing tax loopholes to generate $100 million in additional revenue, but it falls short of endorsing the full package of loophole closure that would provide an additional $170 million in total.
Certainly some of the "critical choices" presented here do not represent much money, but they would have a big impact on individual lives. For example, the Senate budget acknowledges, for the first time, a 2,500 person waiting list at the Statewide Head Injury Program (SHIP, at the Massachusetts Rehabilitation Commission [MRC]); and recommends roughly $1 million towards beginning to address the needs of these residents with traumatic brain injury. At the Department of Mental Health (DMH), the Senate recommends an additional $3 million for Community Mental Health to address the needs of young adults who are falling through the cracks between youth and adult services. At the Massachusetts Office on Disability (MOD), which has been cut more than $155,000 (22.5%) since FY01 (unadjusted for inflation), the Senate budget provides $100,000 more than does the House budget. The Conference Committee needs to hear from constituents on why these programs matter.
Once you identify an issue in this report that concerns you, the most important step is to contact your representative and your senator to clearly and briefly state your concern and the action you would like your representative and senator to take. There are two additional steps that can add strength to your advocacy effort: first, contact both the representative and senator chairing the Conference Committee; second, contact the House Speaker and the Senate President. To learn more about how you can contact these legislators, please see the "Next Steps in the FY06 Budget Debate" chapter, on page 22 in this report.
Please keep in mind that this year the "window of opportunity" to influence the Conference Committee's decisions on critical choices on disability issues is very limited. Please review this report and then make calls (or send e-mails) to the State House immediately. Every call or e-mail makes a difference.
For example, line item 4110-1000 is the account that funds Community Services provided through the Massachusetts Commission for the Blind. Line item 4120-4000 funds Independent Living services at the Massachusetts Rehabilitation Commission.
2 The governor will sign, veto, or veto parts of the budget. He will return it to the legislature, where a 2/3 majority vote in each chamber can override his veto of a line item or Outside Section. Finally, the budget goes back to the governor for his signature.
Mass. Budget and Policy Center data
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 | |
|---|---|---|---|---|---|---|---|
| FY05 | House and Senate Budgets for FY06 |
||||||
| 7030-1000 (DOE)* | See program transfers in rows below |
Early Learning / School Readiness+ | $114,551,675 | $74,605,058 | See program allocations in rows below. | ||
| 3000-1000 (DEE&C)** | CPC & MFN Admin | n/a ++ | n/a ++ | 678,895 | -- | ||
| 3000-4000 (DEE&C)** | Cmty. Prtnrshps. for Children (CPC) | Not more than $68,630,469^ | $68,700,570 | $68,700,570 | |||
| 3000-7050 (DEE&C)** | Mass. Family Networks (MFN) | Not more than $5,295,694^ | 5,295,694 | 5,295,694 | |||
| 7030-1004 (DOE)* | 3000-7060 (DEE&C)** | Parent-Child Home Program | n/a ++ | 1,000,000 | Not more than 1,000,000^ | 1,000,000 ^ | 1,500,000 ^ |
| * Department of Education
(DOE) ** Department of Early Education and Care (DEE&C) + In FY01-FY05 this account includes CPC and MFN. ++ In FY01-FY05 this account was within line item 7030-1000, Early Learning School Readiness, at the DOE. ^ In H1 for FY06, these are in the 3000-3000 account. |
|||||||
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Early Education & Care (DEE&C)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DEE&C chapter in the Volume II table of contents.
Both the Senate and House budgets propose to establish the new DEE&C as an independent, high-level agency. There are two critical choices of particular relevance to disability concerns.
Critical Choices for the Department of Early Care and Education (DEE&C)
Account:
Community Partnerships for Children
Line Item:
3000-4000
Issue Update
In the Community Partnerships for Children (CPC) account, the Senate budget includes language that is stronger than the House budget language for protecting the ability of CPC programs to serve children who are at risk of developmental or learning style issues which need remediation. Unlike many subsidized child care programs which serve children of working parents, the CPC's language makes children whose parents may not be working eligible for services. These programs are particularly important resources for "at-risk" families.
Recommendation for the Conference Committee
The Conference Committee should include the Senate budget "at-risk" language recommendation for this line item.
Account:
Parent-Child Home Program
Line Item:
3000-7060
Issue Update
The Senate budget allocates $500,000 (33%) more than does the House budget for the Parent-Child Home Program account. This program offers intensive home visiting services that target families whose income or education level may put a child at risk developmentally or educationally.
Recommendation for the Conference Committee
The Conference Committee should support the Senate recommendation for this line item.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 7061-0012 | Special Ed Circuit Breaker | 61,941,239 | 201,600,262 | 201,600,262 | 201,600,262 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Education (DOE) / Special Education / The Circuit Breaker
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DOE chapter in the Volume II table of contents.
Critical Choices for the Department of Education (DOE) / Special Education / Circuit Breaker
Account:
Department of Education (DOE) / Department of Mental Retardation (DMR) Voluntary Residential Placement Prevention Program
Line Item:
7061-0012 (DOE) and 5948-0012 (DMR)
Issue Update
Within the Circuit Breaker line item is language that earmarks (in other words, that specifically designates) funding for the Voluntary Residential Placement Prevention Program, operated by DMR. The funds provide the specialized services necessary to help children with severe disabilities remain at home and be educated in their own communities. This successful program currently has a two-year waiting list. Funds from this earmark are collected in DMR's 5948-0012 residential chargeback account. The Senate budget recommendation increases the earmark for this DMR program by $500,000, from $7.5 million to $8.0 million. Advocates have been seeking a $1 million increase for FY06.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this earmark within line item 7061-0012.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4000-0600 | Sr. Care Plans | 1,648,865,000 | 1,697,117,500 | 1,783,969,375 | 1,926,481,999 | 1,926,669,254 |
| 4510-0720 | CAN/HHA Scholarship | 1,000,000 | 0 | 0 | 0 | 250,000 |
| 9110-1455 | Prescription Advantage | 73,684,000 | 110,000,000 | 90,159,453 | 90,249,126 | 90,249,126 |
| 9110-1460 | Presc. Advtg. Co-pay Subs. | new | 5,000,000 | 0 | 0 | 5,000,000 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Elder Affairs (DEA)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DEA chapter in the Volume II table of contents.
Critical Choices for the Department of Elder Affairs (DEA)
Account:
Senior Care Plans
Line Item:
4000-0600 (Office of Medicaid)
Issue Update
For Senior Care Plans, the Senate budget offers $187,255 more than does the House budget recommendation of $1.9 billion. Line item language in the Senate budget would require that a portion of the funds be used to provide wage increases for certified nurses aides (CNAs) at nursing facilities.
Recommendation for the Conference Committee
The Conference Committee should support both the Senate budget amount and language for this line item.
Account:
Certified Nursing Assistant (CNA)/Home Health Aide (HHA) Scholarship Program
Line Item:
4510-0720 (Massachusetts Department of Public Health)
Issue Update
The Senate budget would restore the CNA/HHA scholarship program and fund it at $250,000. The House budget would not restore the program.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget amount for this line item.
Account:
Prescription Advantage
Line Item:
9110-1455 and 9110-1460
Section: Outside Section 62 (Senate Budget for FY06)
Issue Update
Both the House and Senate budgets fund the Prescription Advantage program (line item 9110-1455)
at $90.25 million. Both budgets use Outside Section language to determine what will happen when the Medicare Modernization Act (MMA) is implemented (House budget Outside Section 22 and Senate budget Outside Section 62). Prescription Advantage will continue as a supplemental assistance plan for drug costs of eligible Medicare-enrolled seniors and persons with disabilities, and for those ineligible for Medicare. The Senate budget provides for an open enrollment period next spring.
The Senate budget funds Prescription Advantage Co-Pay Subsidies (line item 9110-1460) with $5 million. The House budget proposes to discontinue this line item in FY06.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation in Outside Section 62. It should also support the Senate budget amount in line item 9110-1460.
Account:
Nursing Home Bed-hold
Sections:
Outside Sections 533 and 701 (FY04); Outside Section 409 (FY05); Outside Section 21 (House Budget for FY06); Outside Section 75 (Senate Budget for FY06)
Issue Update
Outside Section 75 of the Senate budget provides up to 20 days of bed-hold for nursing home residents. Outside Section 21 of the House budget provides up to 10 days of bed-hold.
Recommendation for the Conference Committee
The Conference Committee should support the Senate recommendation in Outside Section 75.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 7004-9030 | AHVP Rental Vouchers | $4,000,000 | $2,300,000 | $2,300,000 | $3,000,000 | $3,000,000 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Housing and Community Development (DHCD)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DHCD chapter in the Volume II table of contents.
Critical Choices for the Department of Housing and Community Development (DHCD)
There are no critical differences that specifically impact people with disabilities.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 5011-0100 | Admin. | $35,892,669 | $35,376,100 | $37,144,330 | $36,789,608 | $37,144,330 |
| 5046-0000 | Cmty. Mntl. Hlth. | 249,588,678 | 274,852,252 | 287,340,397 | 288,219,968 | 293,277,097 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Mental Health (DMH)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DMH chapter in the Volume II table of contents.
Critical Choices for the Department of Mental Health (DMH)
The Senate budget recommendation is by far the superior recommendation for DMH this year, funding the agency with $5,777,798 more than the House budget recommendation. There are two DMH line items that fare better in the Senate budget than in the House budget for FY06.
In addition, advocates support language in an Executive Office of Health and Human Services (EOHHS) operations account that is important to DMH's authority. This EOHHS account is within the Office of Medicaid, line item 4000-0300. Please see the Office of Medicaid chapter, page 17.
Account:
DMH Administration
Line Item:
5011-0100
Issue Update
The Senate budget recommendation is $354,722 above the House budget recommendation for the administration line item. Since 2002, cuts in staff have impacted services. DMH needs increased funds to cover payroll expenses and to cover "chargebacks." Chargebacks are the charges DMH must pay to EOHHS for centralized administrative services.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
Account:
Adult Community Mental Health
Line Item:
5046-0000
Issue Update
The Senate budget recommendation for this line item is very positive news
for the DMH adult community services system. The Senate budget recommends $5,057,129
above the House budget recommendation for this line item. An earmark of $3
million provides services for clients who are aging into the adult system from
DMH's child/adolescent system or from other systems of care, such as the Department of Youth Services (DYS) and the Department of Social Services (DSS), if those clients meet the clinical eligibility criteria for DMH. Children's mental health advocates have been working for this increase to help address problems faced by the "new homeless," young
adults with mental illness who end up falling through the cracks of under-funded
mental health services.
In addition, the Senate budget recommendation provides $1.885 million to
create the final 29 community residential placements required by the close
of FY06 under the Olmstead agreement and to support the associated PACT Teams
(Program of Assertive Community Treatment). This recommendation would fund
the final phase of DMH's Olmstead initiative to create 268 community placements between FY04 and FY06 so that adults "stuck" in
acute hospital settings could be moved into community living. The House budget
recommendation, by comparison, under funds the PACT component, and provides
for only 15 new placements in FY06.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 5920-2000 | Comm. Residences | 353,695,256 | 476,614,523 | 499,491,126 | 499,419,626 | 499,591,126 |
| 5948-0012 | DMR/DOE | 7,500,000 | 7,500,000 | 7,500,000 | 8,000,000 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Mental Retardation (DMR)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DMR chapter in the Volume II table of contents.
Critical Choices for the Department of Mental Retardation (DMR)
The House and Senate budgets provide nearly identical recommendations for DMR. Both budgets support a new $1 million line item for DMR's Autism Division. Both budgets support a $500,000 increase to the Flexible Family Support account. Overall, both budgets increase DMR's total budget by approximately 5.5% (including support for the Boulet and Rolland class action settlement agreements and funding for Turning 22 students).
The Senate budget recommendation contains three advantages over the House budget recommendation: slightly better funding for Residential Community Programs; an increase for DMR in a Department of Education (DOE) line item for "voluntary residential placement prevention;" and an Outside Section of importance to families of autistic children.
Account:
Residential Community Programs
Line Item:
5920-2000
Issue Update
The Senate budget contains a $171,500 advantage for the Residential Community Programs line item. The funds are not earmarked for any particular need. This account is under funded in FY05 by $600,000, potentially impacting clinical team services: as a result, some portion of the 2,400 individuals who receive counseling, occupational therapy, and nursing services may see cuts. The additional $171,500 for this line item could help restore some of these services.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget amount for this line item.
Issue:
Autism Services Waiver
Section:
Outside Section 97 (Senate Budget for FY06)
Issue Update
Only the Senate budget recommendation contains this Outside Section for FY06. The section would require the Executive Office of Health and Human Services (EOHHS) to apply for a federal Medicaid waiver to allow eligible children with autism spectrum disorder who are institutionalized or are at risk of institutionalization to receive waiver services. These services would support the children in their homes and communities. With the Medicaid waiver, the Commonwealth can receive federal reimbursement for 50% of the cost of such services.
Recommendation for the Conference Committee
The Conference Committee should support the recommendation in the Senate budget Outside Section 97.
Account:
Department of Education (DOE)/Department of Mental Retardation (DMR) Voluntary Residential Placement Prevention Program
Line Items:
7061-0012 (DOE) and 5948-0012 (DMR)
Issue Update
Within the Circuit Breaker line item is language that earmarks funding for the Voluntary Residential Placement Prevention Program, operated by DMR. The funds provide the specialized services necessary to help children with severe disabilities remain at home and be educated in their own communities. This successful program currently has a two-year waiting list.
DMR's 5948-0012 residential chargeback account is used to collect funds from this earmark in DOE's line 7061-0012. The Senate budget recommendation increases the earmark for this DMR program by $500,000 above the amount in the House budget.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this earmark within line item 5948-0012.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4800-0038 | Srvcs. for Chldrn. & Families | 0 | $261,576,384 | $270,467,488 | $271,459,996 | $271,459,996 |
| * FY05 numbers are current through April 19, 2005. | ||||||
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Social Services (DSS)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DSS chapter in the Volume II table of contents.
Critical Choices for the Department of Social Services (DSS)
There are no critical differences that specifically impact people with disabilities.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 1599-4408 | Reserve for Emp. Srvcs. | -- | -- | -- | $6,000,000** | $6,000,000** |
| 4403-2000 | TAFDC | 243,144,221 | 317,762,806 | 309,234,813 | 312,450,771 | 314,150,783 |
| ** The total allocation in line 1599-4408 is $12 million-$6 million each for employment and child care services. | ||||||
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Transitional Assistance (DTA)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations,
click on the DTA chapter in the Volume II table of
contents.
Critical Choices for the Department of Transitional Assistance (DTA)
The Senate and House budgets for the Department of Transitional Assistance have one important difference, regarding the Transitional Aid to Families with Dependent Children (TAFDC) program.
Account:
Transitional Aid to Families with Dependent Children (TAFDC)
Line Item:
4403-2000
Issue Update
During the remainder of the 2005 calendar year, Massachusetts is anticipating the expiration of the federal waiver that has allowed the state to establish certain aspects of its welfare policy apart from federal rules. Massachusetts is also anticipating reauthorization of the federal statute that governs the jointly state- and federally-funded Transitional Aid to Families with Dependent Children (TAFDC) program. In FY06, advocates seek budget provisions that will give the state flexibility to manage these upcoming changes and their (currently unknown) consequences. It is especially important that particularly vulnerable families, many of whom have been certified by the state as having a parent or child with a disability, continue to receive assistance.
The Senate budget would create a separate state TAFDC program funded with existing
state dollars. The strategy will enable Massachusetts to continue using state
guidelines for the work requirements families must meet. These guidelines exempt
families in which the parent has a disability or is caring for another family
member with a disability (along with a number of other groups). The strategy
will also make it possible for the state to more easily meet its federally-mandated "work participation rate" and preserve the state's
ability to receive federal dollars. The House budget does not contain these
provisions and would allocate $1.7 million less than does the Senate budget.
Recommendation for the Conference Committee
It is vital that the Conference Committee support the Senate budget language for this account, as well as the Senate budget amount.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4200-0200 | Residential: Detained | 14,474,980 | 18,907,464 | 19,642,022 | 19,252,964 | 19,642,022 |
| 4200-0300 | Residential: Committed | $79,115,860 | $86,305,310 | $98,864,256 | $95,467,061 | $98,864,256 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Department of Youth Services (DYS)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DYS chapter in the Volume II table of contents.
Critical Choices for the Department of Youth Services (DYS)
There are two line items that can significantly impact the mental health care of youth in DYS custody. There is also an Outside Section in the Senate budget that has language relevant to the mental health service needs of youth in DYS custody.
Account:
Residential Services for the Detained Population
Line Item:
4200-0200
Issue Update
There is a great need to improve the mental health services available to youth in detention. Additionally, DYS education specialists emphasize that, if funding were sufficient, better educational assessment of youth in detention would result in identification of and educational planning for undetected serious learning disabilities that may underlie the behavior of many youths in DYS custody. The House budget allocates $19,252,964 for this account, which may not be enough to maintain services. The Senate budget allocates $389,058 more (2%) than does the House budget.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget amount for this line item.
Account:
Residential Services for the Committed Population
Line Item:
4200-0300
Issue Update
In FY05, DYS initiated the Safety Initiative for suicide prevention. This initiative calls for DYS to add intake staff, upgrade all clinical positions to appropriate licensing levels, increase the number of staff for suicide watch on-call teams, add a new training program, and improve facilities. Most of the funding for this program is within line item 4200-0300.
The Senate budget provides sufficient funding for DYS to continue the improvements to mental health services that have been implemented as a result of the Initiative. The House budget allocates $3.4 million less in this line item than does the Senate budget. DYS agency staff report that if the service improvements are to be maintained, the House budget allocation would necessitate cutting the number of residential placements and reducing the length of stay.
Recommendation for the Conference Committee
The Conference Committee should support the Senate recommendation for this line item.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4110-2000 | Turning 22 | $7,798,576 | $8,074,775 | $8,891,043 | $8,611,435 | $8,648,243 |
| 4110-3010 | Voc. Rehab | 2,675,450 | 2,588,521 | 2,588,521 | 2,588,521 | 2,661,326 |
| 4110-4000 | Ferguson Ind. | 2,125,949 | 1,885,073 | 1,847,796 | 1,843,525 | 1,885,073 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Massachusetts Commission for the Blind (MCB)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the MCB chapter in the Volume II table of contents.
Critical Choices for the Massachusetts Commission for the Blind
The Senate budget provides slightly higher recommendations for the Massachusetts Commission for the Blind (MCB) line items for FY06, allocating $151,161 (.5%) more than does the House budget. The additional funds are spread out among three important service accounts.
Account:
Turning 22
Line Item:
4110-2000
Issue Update
The Senate budget recommendation for the Turning 22 account is $36,808 above the House budget recommendation. The line item funds community-based support and residential services for older deaf/blind and multi-disabled individuals and those who have turned 22 years of age in the previous year. The line item should grow each year to annualize services to enrolled young people (i.e., to pay for a full year of services for those young adults brought into the adult services system during the previous fiscal year). The House budget recommendation is at least $20,000 below what the Commission needs to continue services to the young adults brought into the adult services system in FY05. The Senate budget recommendation fully covers the needed "annualization" funding.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
Account:
Vocational Rehabilitation
Line Item:
4110-3010
Issue Update
The Senate budget recommends $72,805 more than does the House budget for the Vocational Rehabilitation account. The House budget recommends level funding only. MCB needs an additional $175,000 in FY06 to serve an additional 60 blind college and university students with the supports and technology they need to succeed. Neither budget provides adequate funding, but the Senate budget goes further.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
Account:
Ferguson Industries
Line Item:
4110-4000
Issue Update
For Ferguson Industries, the House budget recommends an additional 2.2% cut ($41,548) to this account from the FY05 funding level. (Since FY01, the program has been cut nearly 14%, unadjusted for inflation.) The Senate budget recommends funding level with the FY05 appropriation.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4125-0100 | MCDHH | $5,656,825 | $5,264,267 | $5,373,170 | $5,373,170 | $5,373,170 |
| 4125-0101 | Interpreter Srvcs. Ret. Rev. | 105,000 | 175,000* | 175,000* | 175,000 | 175,000 |
| 4125-0122 | Interpreter Chargeback | 120,000 | 160,000* | 160,000* | 160,000 | 160,000 |
| * Note: MCDHH collects about $15,000 less than the combined ceilings for these revenue accounts. | ||||||
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the MCDHH chapter in the Volume II table of contents.
Critical Choices for the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH)
There are no critical differences that specifically impact people with disabilities.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4512-0103 | AIDS Prevntn. Trtmt. & Svcs. | 49,569,025 | 33,344,099 | 34,697,303 | 35,297,303 | 35,453,770 |
| 4512-0500 | Dental Health Services | 1,305,021 | 1,556,150 | 1,556,150 | 1,678,150 | 1,556,150 |
| 4513-1000 | Family Health Services | 12,775,715 | 7,010,000 | 8,332,196 | 7,652,196 | 8,570,196 |
| 4513-1010 | Early Intervention (Ret. Rev.) | 2,414,628 | 2,700,050 | 2,700,050 | 2,700,050 | 3,500,000 |
| 4513-1020 | Early Intervention | 29,663,816 | 29,270,778 | 29,840,024 | 29,840,024 | 30,840,024 |
* Final FY05 numbers include Prior Appropriations continued in the September FY04 supplemental budget.
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Massachusetts Department of Public Health (MDPH)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the DMH chapter in the Volume II table of contents.
Critical Choices for the Department of Public Health (MDPH)
Account:
AIDS Treatment and Prevention
Line Item:
4512-0103
Issue Update
Neither the House nor Senate budget recommendations are adequate to meet the needs of the growing population to be served by the HIV/AIDS Bureau. The Senate budget provides a slightly higher recommendation, proposing $156,467 more than does the House budget. Advocates warn, however, that $800,000 more is needed to fully fund the HIV Drug Assistance Program (HDAP) in FY06. (HDAP is funded in this account and in 4512-0106.) Advocates warn that interruptions in medical care due to budget cuts contribute to the development of drug-resistant strains of the virus.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
Account:
Dental Health Services
Line Item:
4512-0103
Issue Update
The House budget provides the higher amount for Dental Health Services to the Office of Oral Health. This line item includes funding for the Tufts Dental Program that serves people with developmental disabilities. The House budget provides $122,000 more than does the Senate budget.
Recommendation for the Conference Committee
The Conference Committee should support the House budget amount for this line item.
Account:
Family Health Services-Primary Care
Line Item:
4513-1000
Issue Update
The Senate budget provides the higher recommendation for Family Health Services, which includes Primary Care Programs for Pregnant Women, Children, and Adolescents. The Senate budget recommends $918,000 more than does the House budget. The increase is entirely earmarked for particular programs, including "$450,000 for Community Health Centers for maternal-child health services through combined primary care."
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
Account:
Early Intervention Services
Line Item:
4513-1010 and 4513-1020
Issue Update
The Senate budget is significantly better for Early Intervention (EI) than is the House budget. EI is a statewide, comprehensive, developmental service available to families of children from birth to age 3 who have or are at risk for developmental delays. The Senate recommends a $799,950 higher ceiling for the EI retained revenue account (line item 4513-1010) and a $1 million increase to the EI general appropriation account (line item 4513-1020). The combined Senate budget increases are $1,799,950 greater than the House budget recommendation.
The Senate budget increase for line item 4513-1020 is earmarked for "the provision of cost reimbursement funding to certified Early Intervention Programs" as recommended by advocates. This language and the additional funding are needed to restore cost reimbursement cuts which have had a direct impact on EI program stability and services provided to EI families (such as translator services and parent/family liaisons). In addition, the current ceiling on the retained revenue account (line item 4513-1010) is inadequate. The governor has filed a supplemental budget request to raise the ceiling for FY05 and the Senate's
FY06 budget recommendation acknowledges the need for this increase.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation and language for this line item.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4120-4000 | Ind. Living | $7,023,433 | $7,520,512 | $7,798,601 | $7,869,714 | $8,040,597 |
| 4120-6000 | SHIP | 6,923,277 | 6,000,568 | 7,218,168 | 6,955,515 | 8,093,237 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Massachusetts Rehabilitation Commission (MRC)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the MRC chapter in the Volume II table of contents.
Critical Choices for the Massachusetts Rehabilitation Commission (MRC)
The Senate budget provides the higher recommendations for the Massachusetts Rehabilitation Commission (MRC) for FY06, allocating $1.3 million more than does the House budget. Most of the additional support is for the Statewide Head Injury Program (SHIP), although there is also increased funding for the Independent Living account.
Account:
Independent Living
Line Item:
4120-4000
Issue Update
The IL account funds a host of programs that support independent living.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
Account:
Statewide Head Injury Program (SHIP)
Line Item:
4120-6000
Issue Update
The Senate budget recommendation for the Statewide Head Injury Program (SHIP) is very positive for MRC. The recommendation is $1,137,722 above the House budget amount and represents new progress for this program (that provides community services for people with traumatic brain injury (TBI)). The Senate budget recommendation acknowledges the need for the Commonwealth to begin to address the long SHIP waiting list for urgently needed services (2,500 people with traumatic brain injuries are waiting). The Senate budget recommendation would provide approximately $1 million in new services beyond the needs of annualizing current services.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 4000-0300 | Administration* | $101,490,422 | $121,670,981 | $123,723,502 | $130,341,223 | $126,159,490 |
| 4000-0500 | Managed Care | 1,490,620,301 | 2,319,197,919 | 1,977,150,989 | 2,074,169,186 | 2,123,892,166 |
| 4000-0700 | Indemnity/3rd Party Plans | 736,800,329 | 1,239,530,000 | 1,498,059,398 | 1,580,139,483 | 1,571,143,395 |
| 4000-0990 | CMSP | 16,210,797 | 21,374,000 | 20,207,603 | 21,078,379 | 21,078,379 |
| 4000-1405 | MassHealth Essential*** | -- | O.S.: $160,000,000 | 119,377,890 | 129,567,170 | 152,154,120 |
| * Office of Medicaid and Executive
Office of Health and Human Services administration were consolidated
in FY04. ** These line items fund programs overseen by the Department of Elder Affairs. See DEA chapter for analysis. *** MassHealth Essential was moved on budget in H1 for FY06. ^ This amount includes a September 2004 supplemental appropriation for elderly and disabled immigrants only. |
||||||
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Office of Medicaid (MassHealth)
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the MassHealth chapter in the Volume II table of contents.
Critical Choices for the Office of Medicaid (MassHealth)
Account:
Administration
Line Item:
4000-0300
Issue Update
There are two issues of importance within the Administration account (line item 4000-0300).
First, the Senate budget restores eligibility for dental services for pregnant women and mothers of children under age 3. The House budget does not restore any dental benefits.
Second, the Senate budget retains existing language in the Executive Office of Health and Human Services (EOHHS) budget that gives the Department of Mental Health (DMH) commissioner oversight over MassHealth Behavioral Health funding. Advocates believe that the DMH commissioner is in the best position to provide oversight of the complex task of navigating between the health care and mental health care systems so that they may best serve the chronically mentally ill.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget language for this line item.
Account:
Managed Care Plans
Line Item:
4000-0500
Issue Update
The Senate budget allocates $2.123 billion for line item 4000-0500, $49.7 million more than does the House budget. This account pays for enrollees in several MassHealth programs and includes claims for mental health and substance abuse services.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget amount for this line item.
Account:
Indemnity and Third Party Plans
Line Item:
4000-0700
Issue Update
The House budget allocates $1.580,139,483 for line item 4000-0700, an amount almost $9 million more than the $1,571,143,395 allocated by the Senate budget. Approximately 85,000 of the 130,000 adults and children covered through this account are people with disabilities.
Recommendation for the Conference Committee
The Conference Committee should support the House budget amount for this line item.
Account:
Children's Medical Security Plan
Line Item:
4000-0990
Issue Update
Many children with disabilities are covered through the Children's Medical Security Plan. The Senate budget restructures the Children's Medical Security Plan to eliminate premiums for children in families with incomes below 200% of the federal poverty level (fpl). The Senate budget also restores more affordable premiums for enrolled families with incomes between 200-300% of the fpl. The House budget does not restructure these premiums.
Recommendation for the Conference Committee
The Conference Committee should support the Senate recommendation for this line item.
Account:
MassHealth Essential
Line Item:
4000-1405
Issue Update
The Senate budget increases the total appropriation for line item 4000-1405 to $152.2 million, an amount that is $22.6 million over the House budget allocation. The Senate budget funding would allow MassHealth Essential to add up to 10,000 more individuals, including long-term unemployed low-income individuals and long-term Department of Mental Health (DMH) consumers. This change would bring total enrollment in FY06 to about 53,000 individuals. The House budget funding level maintains an enrollment limit of about 43,000 people, which would result in a continued waiting list.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget dollar amount for this line item.
Account:
Enrollment Caps
Section:
Senate Outside Section 39
Issue Update
The Senate budget recommends repealing enrollment caps for the CommonHealth and MassHealth for People with HIV programs. The House budget does not. So far, neither program has hit its maximum cap. When a program hits its cap, it may mean that many eligible persons would lose coverage when the program is "full." The CommonHealth account (line item 4000-0430) is currently in danger of reaching its cap. Eliminating the enrollment cap for the MassHealth for People with HIV (line item 4000-1400) program would reduce pressure on the Massachusetts Department of Public Health (MDPH) HIV Drug Assistance program.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget language in Outside Section 39.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 0321-1600 | MLAC Total | $4,276,799 | $7,564,142 | 0321-1600 | $8,064,142 | $8,564,142 |
| 0321-1610 | MLAC Gen. Support | 4,800,000 | 0321-1600 | 8,565,227 | 0321-1600 | 0321-1600 |
| 0321-2000 | MHLAC | 546,412* | 587,860* | 0321-1610 | 538,905 | 585,905 |
| 1102-3305 | State House ADA | -- | -- | -- | -- | 250,000 |
| 1107-2400 | MOD | 741,355 | 573,469 | 586,967 | 605,280 | 705,280 |
| * FY01 and FY05 include supplemental budget appropriations of $43,000 and $86,775 respectively. | ||||||
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Other Disability Advocacy and Information Agencies
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the Disability Advocacy and Information chapter in the Volume II table of contents.
Critical Choices for Other Disability Advocacy and Information Agencies
Account:
Massachusetts Legal Assistance Corporation Accounts
Line Item:
0321-1600
Issue Update
The Massachusetts Legal Assistance Corporation (MLAC) funds 18 legal services programs serving low-income people. The Senate budget recommends $500,000 more for MLAC than does the House budget. The Senate's recommendation would restore $1 million (out of the $1.5 million that has been cut since FY01) to General Support legal services (line item 0321-1600, formerly line item 0321-1610). General Support services provide day-to-day civil legal help to low-income people, including people with disabilities.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendations for these line items.
Account:
Mental Health Legal Advisors Committee
Line Item:
0321-1600
Issue Update
The Massachusetts Legal Assistance Corporation (MLAC) funds 18 legal services programs serving low-income people. The Senate budget recommends $500,000 more for MLAC than does the House budget. The Senate's recommendation would restore $1 million (out of the $1.5 million that has been cut since FY01) to General Support legal services (line item 0321-1600, formerly line item 0321-1610). General Support services provide day-to-day civil legal help to low-income people, including people with disabilities.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendations for these line items.
Account:
Mental Health Legal Advisors Committee
Line Item:
0321-2000
Issue Update
MHLAC provides advocacy, information, and referral for individuals with disabilities in the state mental health system and for individuals seeking insurance coverage for mental health services. The Senate budget recommends a total of $585,905 for the Mental Health Legal Advisors Committee (MHLAC). This Senate budget amount, which is $47,000 above the House budget recommendation, still represents a maintenance budget for the agency.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
Account:
State House Americans with Disabilities Act (ADA) Renovations
Line Item:
1102-3305 (Bureau of State Office Buildings)
Issue Update
Only the Senate budget includes new line item 1102-3305, an account to be jointly controlled by the Bureau of State Office Buildings and the House and the Senate. Originally, a budget amendment for $1 million was filed to help address renovations at the State House that are needed to make the building compliant with the Americans with Disability Act (ADA). The $250,000 recommendation represents a compromise figure.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for creating and funding this line item.
Account:
Massachusetts Office on Disability
Line Item:
1107-2400
Issue Update
The Senate budget recommendation of $705,280 for the Massachusetts Office on Disability (MOD) is significantly higher than the House budget recommendation. The Senate budget amount is $100,000 above the House budget recommendation. The additional $100,000 is provided to "develop training materials for use with employees working in the State House on the Americans with Disability Act and how to assist people with disabilities within the building" (Senate budget amendment 191).
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget recommendation for this line item.
4 For more information on advocacy priorities for line items 1102-3305 and 1107-2400, see: Disability Policy Consortium. 2005. State House Accessibility Review and Evaluation Report (January). Available at: www.dpcma.org.
| Line Item | Description | FY01* | FY05 | H1 for FY06 | House Budget for FY06 | Senate Budget for FY06 |
|---|---|---|---|---|---|---|
| 1599-6901 | Salary Reserve | $15,000,000 | $20,000,000 | $0 | $10,000,000 | $20,000,000 |
For additional information on the impacts of FY01–FY05 budget cuts and
more details about program services, go to the People First website at www.mass.gov/mddc/peoplefirst/index.html and
click on the
Salary Reserve
chapter
in the Volume I table of contents.
To learn more about the House of Representatives' FY06 budget recommendations, click on the Salary Reserve chapter in the Volume II table of contents.
Critical Choices for the Salary Reserve
Account:
POS Salary Reserve
Line Item:
1599-6901
Issue Update
The Senate budget allocates $20 million for the Salary Reserve, while the House budget allocates $10 million. In FY06, advocates had been seeking $35.7 million for this account.
Recommendation for the Conference Committee
The Conference Committee should support the Senate budget amount for this line item.
Many readers of People First reports are seasoned advocates. For those who may be new to advocacy work on disability issues, we offer suggestions and information below.
How to Communicate with Your Elected Officials
Each step in the budget debate process is a window of opportunity for advocacy efforts to improve programs and services for persons with disabilities. The most important advocacy relationship any person can have is with his or her own state representative and state senator. A call, email, letter, or visit from a constituent in the district is always the most influential. To be most effective, an advocate establishes an ongoing relationship with his or her state representative and state senator.
Window of Opportunity: The Conference Committee
Because the House and Senate budgets vary in their funding and policy recommendations, the two budgets have been sent to a Joint House/Senate Conference Committee, composed of three senators and three representatives and chaired by both Ways & Means Committee chairs. While they are not formally members of the Conference Committee, House Speaker Salvatore DiMasi and Senate President Robert Travaglini will have great influence over the Conference Committee negotiations.
The Conference Committee should complete its work by mid-to-late June 2005. Its single reconciled set of budget recommendations, known as the Conference Committee Report for FY06, will be returned to each chamber for a single "yea" or "nay" vote of approval. After it has been approved by each chamber, this Conference Committee budget will be sent to the governor's desk.