AUSTIN -- After weeks of deliberation, the Senate Subcommittee on Medicaid delivered its report to the full Finance Committee Thursday, recommending increasing the Medicaid appropriations laid out in the initial Senate version of the budget.
Subcommittee Chair Senator Jane Nelson of Flower Mound said members and staff worked long hours to develop a plan that "meets our responsibility to those who depend on our state services and the taxpayers that expect us to ensure that state government lives within its means."
The subcommittee found $3 billion in efficiency savings that Nelson believes will actually improve the quality of care in many arenas.
The Medicaid subcommittee divided recommendations into two groups; priority one and priority two. The panel recommended full funding for the first group and that any additional funds found should go into priority two. Priority one recommendations total $4.8 billion above the base Senate budget, with priority two adding up to $2.7 billion.
Cuts made to Child Protective Services staff in the base budget were rolled back, as the subcommittee recommended 461 additional full-time employees, 100 more staffers than CPS employs today. The recommendations preserve funding for funds paid to foster parents and preventative and early intervention at the Department of Family and Protective Services.
The priority one group keeps money for HIV medication, smoking cessation programs and substance abuse intervention. It also restored funds for Department of Assistive and Rehabilitative Services for many programs, including occupational rehabilitation and services for blind and autistic children.
Priority one recommendations included smaller cuts to provider reimbursement rates. The original Senate budget called for 30 to 40 percent cuts in the amount of money paid back to doctors and hospitals that treat Medicaid patients. The subcommittee recommended that there be no reduction in reimbursements to doctors and a very small reduction, 3 percent, to hospital and nursing home reimbursements.
Committee Chair Senator Steve Ogden proposed a motion that would move the recommendations regarding hospital and nursing home reimbursements, accounting for about $600 million in general revenue, into a list of pending items. Ogden said that the committee should wait until another subcommittee, the Subcommittee on Fiscal Matters, charged with finding additional sources of non-tax revenue, submits its report. Until then, Ogden said he doesn’t know how the state can pay for the recommended reimbursement rates given the current revenue picture. By pending the items, however, the Finance Committee is obligated to revisit the issue before it votes on a final budget.
Some Finance committee members weren't satisfied with splitting recommendations into two separate tiers of priority. Tyler Senator Kevin Eltife said he believed that priority two recommendations should be funded in the budget. "It may be hard for me to support a budget unless parts, if not all, of priority two gets funded," he said.
Senator Robert Deuell of Greenville said the decisions regarding cuts were very difficult to make. "These cuts are not being made because any of us have a philosophical desire to cut any given area," he said. "These are made becaue of a constitutional requirement to live within our means. They're very painful, I don't think we're funding things as adequately as we should, but I understand why that has to be done."
The House will begin debating its version of the budget on the floor this weekend, but the Finance Committee still has some time before it presents its budget to the full Senate. In that time, more money may become available, if sales tax revenues and the price of oil continue to rise. Ogden said he expects to revisit priority two recommendations once all articles of the budget have been tallied and a final budget picture begins to emerge.