Indian Country Suicide Prevention Receives Attention and Investment

Maybe it’s our relative isolation and inability to easily access sufficient mental and behavior healthcare. Or maybe it’s the elevation or the sigma we often associate with depression. Whatever the reason, Montana has had one of the highest suicide rates in the country for almost forty years.

According to a report by the Montana Department of Health and Human Services, Montana ranked first in the nation for suicides in 2014. Nationally, whites have the highest rate of suicide, followed by American Indians. In Montana, this trend is reversed. Between 2014 and 2015, the American Indian suicide rate was 35.5 (per 100,000 people) compared to 28.1 for whites.

The same report notes that American Indian youth ages 11-17 are especially at risk. In fact, they are almost four times more likely to die by suicide than their white counterparts in Montana. Further, youth suicidal risk assessments for 2015 also show that American Indian youth living in urban areas are more likely than reservation-residing American Indian youth to seriously consider, plan, and attempt suicide.

We know that suicide has been a major public health concern in Montana for years, and particularly in Indian Country. This is why we applaud the legislature’s recent passage of House Bill 118, which invests $1 million in statewide suicide prevention efforts. Of this, $250,000 goes expressly to implement the action steps outlined in the Montana Native Youth Suicide Reduction Plan (MNYSRP). The Indian-owned consulting firm, Kauffman & Associates, in collaboration with both reservation and urban-based tribal communities in Montana, as well as the five urban Indian Health organizations created MNYSRP. MNYSRP came about as a result of an initiative developed by Governor Bullock in 2015, which was funded through the 64th Montana Legislative session.

An official bill signing has been scheduled for Tuesday, April 25, 2017 at 3pm.

Montana Budget Not Ready for Prime-Time

With less than two weeks remaining in the legislative session, the state budget is far from ready for the governor’s signature. Last week, legislative fiscal division released its updated status sheet. Factoring in the current spending bills, tax bills, current revenue estimate, and the budget, the legislature is leaving the state with a mere $162 million in projected ending fund balance. That current level is $138 million below the long-standing precedent for a $300 million ending fund balance. Perhaps even more shocking, it’s $38 million below some Republicans’ counter-proposal for a much lower $200 million ending fund balance.

Thus far, the legislature has:

  • Failed to support nearly all of the governor’s tax fairness measures that would raise needed general fund revenue and provide a pathway for a balanced solution to the recent revenue downturn;
  • Left significant cuts to the budget, particularly in the areas of higher education and social service programs for our seniors and Montanans with disabilities;
  • Passed a myriad of new spending bills that risk leaving an insufficient ending fund balance for dealing with an economic downturn or lower-than-expected revenues; and
  • Increased the revenue estimate simply as a mechanism for balancing the budget.

Any one of these problems should cause concern for the governor and any Montanans who care about the budget and the essential services it funds. The combination of the current problems is simply unacceptable and unsustainable.

The legislature has so far failed to make the difficult choices necessary for a responsible budget. As has been true all session, they have two choices: make further cuts to the budget and other spending priorities or raise revenue. MBPC believes only one responsible choice remains: raising revenue. With significant cuts already proposed by the governor and deeper cuts adopted by the legislature, the legislature must, finally, engage in a meaningful conversation about sensible ways to raise revenue. Options include listening to the dozens of health care professionals and organizations who have asked for an increase in the tobacco tax (which not only raises revenue but also is proven to reduce smoking and decrease health costs) or making sure that millionaires in Montana are paying their fair share for the services and infrastructure that make our families and communities stronger.

It may be that legislators are planning to force the governor to make the additional cuts to popular and essential programs. The governor did his job in proposing a responsible budget, one that included both difficult budgetary cuts but also adequate levels of revenue. Legislators were elected to make the same kinds of hard decisions. If they are going to reject every general fund revenue increase, they need to find other solutions for putting a responsible budget on the governor’s desk.

Equal Pay Day and EITC

Now that spring is in the air, 2016 seems like a long time ago. But it took until today – April 4th – for women to finally earn as much money as a man did in 2016. With such a significant pay disparity between men and women, women have to work three months longer into the next year to make the same amount that men make in a single year.

In Montana, women still are paid only about 67 cents for every dollar a man earns in spite of the fact that more women than ever are the primary breadwinner. In about 40 percent of U.S. households with children under age 18, mothers are the sole or primary breadwinner. For female-headed households, it hurts a lot more when women aren’t paid fairly.

The good news is that a state Earned Income Tax Credit (EITC) could help boost the pay of thousands of low income women. The legislature is considering HB391, which would create a state version of the federal EITC, a tax credit paid to working adults. The Center on Budget and Policy Priorities estimates that 22,000 single mothers in Montana would benefit from receiving the EITC.*

But the EITC does far more than just provide a little extra cash for families. Studies show that the EITC has encouraged large numbers of single mothers to increase the amount of hours they work, and reduce their reliance on social safety net programs. In turn, this increase in hours worked leads to higher wage growth down the road, as well as greater Social Security retirement benefits. The EITC’s impact on employment actually doubles the anti-poverty effect of the EITC for families.

Furthermore, the benefits of the EITC for women aren’t purely financial. Research has also shown that it reduces the rate of low-weight and premature births and improves the health indicators of the mothers. In these studies, women who have received increases in their EITC were more likely to receive prenatal care.

For thousands of workers in Montana, a state EITC could have significant impacts for parents and children alike. In total, 80,000 low- and moderate-income families in Montana stand to benefit from this credit. But for 22,000 single mothers, the EITC can provide additional important benefits that will help improve the stability and health of the entire family.

All hard-working Montana families should get the pay they deserve. While we may have a long way to go in order to minimize the disparity in pay between men and women, a state EITC can be a positive step to reduce the harm this gap causes. Our state legislators should enact a state EITC and improve the lives of thousands of working mothers and their children.

 

* CBPP estimates based on data from IRS, unpublished data from the Brookings Metropolitan Policy Program, and CBPP analysis of the Census Bureau’s March 2010-March 2014 Current Population Survey

A Budget Built on a House of Cards?

Today, the legislative fiscal division (LFD) released its weekly general fund status sheet, providing us a glimpse at where we stand with general fund revenue, projected spending, and the resulting ending fund balance. As the legislature takes actions on bills, including HB 2, LFD updates the status sheet to reflect these changes in spending and revenue bills.

This past week, the Senate Finance & Claims Committee took action on HB 2, adding back some of the cuts made in the House. In total, the Committee restored about $10 million in general funds, $32 million in state special revenue, and $12 million in federal funds.

The status sheet answers a big question: is restoration of these cuts sustainable under the current levels of revenue? The answer: no.

As of today, legislative fiscal division estimates an ending fund balance of $154 million at the end of the next biennium. The status sheets factors in SB 354 to raise the tobacco tax, which passed the Senate this week. This measure raises nearly $69 million in general fund revenue, but still needs to pass the House to become a reality. Even factoring passage of SB 354, we are $145 million below the Governor’s requirement of a $300 million ending fund balance. The ending fund balance is important because it is Montana’s only mechanism for protecting against revenue volatility and unexpected emergencies. This is Montana’s savings account.

Those who have been worried about the budget cuts – including cuts to Medicaid services for seniors and people with disabilities, cuts in higher education, and cuts to programs essential for our emergency responders in local communities – still have work to do. Higher education still faces over $11 million in cuts. Just as importantly, the budget still has several important stages to go and cuts can still be reinstated or increased. As it stands now, the budget is built on a house of cards that could collapse at any moment. We need to continue to be diligent in urging policymakers to pass new revenue and update the revenue estimate, to ensure adequate resources to fund programs essential to our communities.

Want to know more about actions taken this past week on the budget? Check out our quick summary here.

Senate Finance & Claims Acts on Budget Bill, Restores Some Cuts

Senate Finance & Claims met on Tuesday to take executive action on HB 2. You can find all the amendments online here (third tab). The Legislative Fiscal Division also updated its budget narrative with actions from Finance & Claims. Here is a quick overview of some of the key actions taken.

Dept. of Public Health and Human Services. The committee restored the $14.9 million legislative cut to senior & long-term care (SLTC) division, which provides Medicaid services to seniors and individuals with disabilities who are living in their homes or in nursing homes. A third of this restoration was a shift in funds from Health Resources Division, which provides Medicaid services. SLTC division is still $11.6 million below the executive budget. The committee also reduced the vacancy savings required by the Department from 8% to 6%.

Office of Commissioner of Higher Education. All in all, the higher education budget is largely in the same spot as it was when it passed out of the House. Legislators moved amendments to restore the deep cuts to the universities, but those amendments failed. To date, higher education is still about $11 million below the executive budget, and university officials are indicating we are likely to see 18 percent increases to tuition if the levels of funding remain where they are now. Despite those persisting cuts to higher education, the funding formula for community colleges was fixed to reflect a slight increase in the state’s share of the formula. 

Office of Public Instruction. Legislators moved an amendment to add an investment for preschool programs, but it failed on a party-line vote. However, the committee did pass amendments to provide an inflationary adjustment for special education funding (albeit smaller than previously proposed), and restored funding for both the Montana Digital Academy and the Data for Achievement payment. However, in total, OPI’s budget was reduced by approximately $13 million over the biennium.

Dept. of Labor & Industry. Department of Labor & Industry saw restorations, including state special revenue funds added back for Jobs for Montana Graduates Program, which provides graduation support and job training for high school students across Montana. The Committee also restored some funds for the Employment Relations Division, which is good news for workplace safety in Montana.

Dept. of Military Affairs. The Committee restored some funds within the Department of Military Affairs, including support for Air National Guard and Army National Guard. However, the Committee did not restore the funds provided to help train local emergency response teams handling hazardous material disasters and cleanup.

What is the Earned Income Credit?

This session, the Montana legislature is considering legislation to create a state earned income credit – the Working Families Credit – to provide assistance for low- and moderate-income working families, modeled after the successful federal Earned Income Tax Credit (EITC). Doing so could help boost incomes for thousands Montana working families. Today we are going to give a little more background on what the EITC is, and how it works.

History

The EITC was first created in the 1970s, but was expanded significantly in the 1980s by President Ronald Reagan, who called it the “best anti-poverty, the best pro-family, the best job creation measure to come out of Congress.” The measure had broad bipartisan support because it improves the lives of low-income families while encouraging work. In 2013, the federal EITC lifted more than 6.2 million people, including 3.2 million children, out of poverty.

How it works

The credit is based on the amount of money that an individual earns, helping to encourage work. The credit begins with the first dollar earned, increasing before reaching a maximum amount where it plateaus, and then tapers off. This model helps to encourage workers to increase their hours and wages, without punishing them for earning too much. The credit also increases with the number of children in a family, maxing out at three children. Low-income workers without children are eligible for a very small credit, but majority of the benefit goes to adults with children.

Figure 1 _EITC. 3-17 (1)

The federal EITC in Montana

In Montana, 80,000 families receive the federal EITC, with an average amount of $2,168. Rural counties especially benefit from the credit – 21 percent of federal households in rural counties receive the EITC, compared to 17 percent in the rest of the state. In 2014, the federal EITC brought in $173 million into Montana’s economy.

State EITCs across the nation

Because the EITC has been so successful at reducing poverty and encouraging work, 26 states and D.C. have enacted state versions set at a percent of the federal credit. The state credit helps to further support for low-income working families.

Montana’s families would likewise benefit from the Montana Working Families Credit. Two bills are making their way through the process – HB 391 and SB 156. Our legislature should act now to help improve the incomes of working families across the state.

House Appropriations Passes Budget But Leaves Devastating Cuts

Following two lengthy days of hearings, the House Appropriations Committee made amendments to HB 2 on Thursday and Friday and passed it out of committee. The full House of Representatives will begin debate on HB 2 later this week. While the Committee passed several amendments to partially restore some funds, the budget still includes devastating cuts to programs critical to Montana’s students, seniors, and our most vulnerable communities.

To recap, legislative leaders began the budgetary process in January, by adopting cuts in the governor’s proposed budget and then taking additional deep cuts to nearly every state agency. Subcommittees worked through January and February and added back some funds. However, most of those additions simply reflect present law adjustments, or the amount of funds needed to continue existing services into the next biennium, and did not restore the deep cuts to the underlying programs.

Areas facing the deepest cuts include senior and long-term care, which provides Medicaid services to seniors and Montanans with disabilities, and higher education, with major cuts to Montana’s colleges and universities.

Here is an update on what happened in House Appropriations last week:

  • The deep cuts to Senior & Long-Term Care (SLTC) largely remain. While the Committee passed an amendment to add back some (but not all) federal funds, it did not add general fund dollars. This action is meaningless. In other words, if the legislature fails to appropriate state general fund dollars, Montana will not receive the federal matching funds. Therefore, SLTC continues to face a budget hole of $53 million in total funds below the present law budget. The Committee considered amendments to: fully restore legislative cuts to SLTC; pare back the current 8% vacancy savings; provide an increase to direct care worker wages; and restore funds for respite services for family caregivers. All of these amendments failed. The committee did add back about $200,000 in funds for independent living contracts within the Disability & Employment Transition Division.
  • Deep cuts to higher education remain, even with the additional $11.6 million in higher education funding, but this represents only 1/3 of the cuts below a present law budget. Of this $11.6 million, about $9 million will go to the MUS units (MSU, UM, and satellite colleges and universities). With this restoration, community colleges received of $1.7 million, and Tribal colleges received $81,000. Amendments to add back additional funds for the university units, funds for the Montana Seed Lab, and funding for the Governor’s Best and Brightest Scholarship fund, all failed to pass. Prior to full Committee action last week, the higher education budget sat about $30 million below present law budget. This includes the $23 million in cuts taken in early action, as well as a $7.8 million present law adjustment that the Subcommittee did not take. Again, simply looking at a comparison of present law budget with legislative action so far, the Committee action last week restored about one-third of the total $30 million in cuts below the present law.
  • The Committee restored funding to support child care providers and improvements to quality care. The STARS to Quality program is a voluntary program for child care providers to improve quality of early childhood education and care. Previously, the subcommittee added back the one-time-only funds for STARS to Quality, but made the funding contingent upon the passage of a bill to legalize and tax blackjack. The full Appropriations Committee stripped that contingency language, providing $2.4 million in OTO funds for STARS to Quality.
  • The Committee failed to pass an amendment to restore funds for workplace safety programs. Subcommittee action included cuts to the Employment Relations Division, cutting about $1 million within the workplace safety division. Legislators noted that Montana has ranked as one of the worst states for the number of workplace accidents. This cut will result in greater pressure on the Department of Labor and will likely increase accidents in the workplace. An amendment to restore the funds failed to pass.
  • Efforts to restore funding for Department of Military Affairs failed, including funding to support regional response teams. The early cuts in the session included across-the-board reductions to Department of Military Affairs and cuts to the 6 regional hazardous materials teams with Disaster & Emergency Services, which provides training and assistance to local response teams handling hazardous material. The cut in state funding results in additional loss of federal funds. An amendment to restore these funds failed.
  • The Committee restored funds for the Governor’s airplane.

The full House of Representatives will hear HB 2 later this week, presenting another opportunity to restore these deep cuts, and ensure that our seniors and Montanans with disabilities can continue to receive the services they and their families in need.

Blog Series: Who Has the Most to Lose With a Capped System

Who has the most to lose from capping Medicaid spending?

In yesterday’s blog, we talked about some of the recent proposals by Congress to impose a block grant or per capita cap on federal Medicaid spending. We also wrote about the disastrous impact it would have on state budgets and ability to provide affordable health coverage for families. Today, we are going to take a deeper look at who has the most to lose under a capped system.

As a quick refresher, if Congress votes to cap the federal government’s contribution to states’ Medicaid programs through either a block grant or per capita cap, states will then have to take up a greater share of their Medicaid costs as health care costs increase, to the tune of over $560 billion over the next decade. In turn, states would likely face significant budgetary pressure to begin cutting Medicaid services, critical to millions of families across the country.

Impact on the State Budget

As Montana sees diminishing contributions from the federal government, our state will have to pick up an increasingly larger share of costs. This could put a significant strain on the state’s budget, making it likely that at some point the state will have to reduce benefits. As the state’s share of Medicaid costs grows, Montana would be faced with difficult decisions to limit Medicaid costs moving forward, including: (i) cuts to the level of benefits under Medicaid; (ii) cuts to the number of Montanans enrolled in Medicaid; and/or (iii) cuts to Medicaid payments made to doctors, hospitals and other providers. All of these options will hurt Montana families trying to access Medicaid coverage.

Block Grant

Cuts to benefits

Medicaid currently provides more benefits than private insurance, and does so at a significantly lower cost for beneficiaries. While proponents of block grants tout the “flexibility” that states will have, the flexibility essentially means that states will be able to cut important services. For example, to save costs, states may cut a pediatric benefit known as Early Periodic Screening, Diagnostic, and Treatment (EPSDT) that assesses the health and development of children and covers the services they need. Covering fewer services is a shortsighted move that would reduce the overall health and well being of thousands of Montanans and potentially lead to much larger statewide health care costs down the road.

Cuts to enrollees

Montana would most likely have to cut the number of people it enrolls through Medicaid, including some of the most vulnerable recipients.

Those most at risk of losing coverage would be the over 70,000 Montanans who have gained affordable coverage through the Montana HELP Act, the state’s Medicaid expansion program. Congressional House legislation could effectively end Medicaid expansion, by eliminating the current 90% federal match after 2019. The Health and Economic Livelihood Partnership (HELP) Act, designed with bipartisan support, has expanded health care to over 70,000 Montanans, who now risk losing that coverage.

Montana currently provides Medicaid to pregnant women with incomes up to 150 percent of the federal poverty level (FPL), even though federal law only requires coverage up to 138 percent. As costs rise, Montana may be forced to drop coverage for pregnant women with incomes above the federal minimum.

Cuts to payments for doctors, nurses, health care clinics, and hospitals

Spending caps could also mean that Montana would have to reduce the payments it sends to providers. The Urban Institute has estimated that block grants could cause states to reduce reimbursements, which are already lower than what private insurance pays, to providers by more than 30 percent. In turn, this could cause a decrease in the number of providers willing to accept Medicaid payment for services. For rural Montanans, fewer providers could drastically reduce their ability to access affordable health care.

Block granting Medicaid or implementing per capita spending caps would wreak havoc in Montana and reduce our ability to provide comprehensive, affordable health care coverage to people in need. Capping Medicaid spending does nothing to improve health care, but rather only limits Montana’s options and flexibility.

Blog Series: Medicaid Block Grants and Per Capita Caps

This week, House Republicans are aiming to begin marking up the repeal of ACA. House leaders have announced a plan that would drastically alter states’ Medicaid programs by putting a cap on the federal contribution for Medicaid. This change could significantly reduce access to health care for tens of thousands of Montanans. Nationally, these changes could result in cutting federal Medicaid support by over $560 billion over the next decade.

There are two ways that the federal government can cap spending – Medicaid block grants and per capita caps. Both of these measures would limit the amount of money the federal government sends to states for Medicaid, while increasing cost for state governments.

These two options are structured differently, but have similar long-term results.

How does Medicaid spending work now? Currently, Montana receives a fixed share of its Medicaid costs from the federal government. On average, a state receives about 64 percent of this cost. (Under Medicaid expansion, which has helped over 70,000 Montanans get access to health coverage, the federal share is even higher, a minimum of 90%.) In the past, if a state spends more on Medicaid one year, say due to a bad flu season, the federal government would send more money, keeping the percentage the same.

Under a block grant, states would receive a fixed amount of federal funds for Medicaid. Anything above that amount, the state would be responsible for paying. Under a block grant, Congress eliminates the set federal matching rates, and instead, the states will receive a total fixed amount of funds to run their Medicaid programs.

Per Capita Cap

A per capita cap is similar, but instead of setting a dollar limit for the entire Medicaid program, it would cap the amount of spending per beneficiary. If a beneficiary’s health needs exceeds that capped amount, the state would be responsible for the entire amount of those costs. The per capita cap would likely be set using current per-beneficiary spending and grow only slightly over time using an inflationary adjustment (but highly unlikely to keep pace with rising health care costs).

So why are spending caps so dangerous?

On a federal level, block grants and per capita caps are designed to do the same thing: create savings for the federal government in the long run, primarily by passing the cost along to the states. They achieve this by setting a cap below what the federal government is projected to spend, and then increase that cost each year only slightly, at or less than the rate of inflation. As noted above, health care costs have grown faster than inflation. The cost of Montana’s Medicaid program would increase over time, but the federal contribution would not. After a few years, the federal government would be contributing a much smaller percentage than it is now, leaving Montana holding the bag.

We have historical evidence of how disastrous block granting can be for social safety net programs critical to low-income families. The most direct example of block granting is the federal Temporary Assistance for Needy Families (TANF) program, which Congress implemented in 1996 to replace the Aid to Families with Dependent Children (AFDC). Because federal support was capped, the TANF program in Montana now serves about 13 of every 100 families experiencing poverty in the state. Before TANF, AFDC served 63 of 100 Montana families living in poverty.

Why would health care costs increase?

Historically, health care costs have increased faster than inflation. Although the rate at which they have increased has slowed down, lawmakers cannot be sure if this slowdown is permanent or temporary, especially while they make other changes to the Affordable Care Act.

Montana also has a rapidly aging population, and the health care costs for older adults is significantly more expensive than it is for younger adults. By 2030, Montana is expected to be the fifth oldest state in the nation, and many older Montanans are served through the Medicaid program.

Last, with new diseases and new treatments, per-beneficiary costs could increase. For example, if researchers discover a new treatment for cancer, people’s lives could be saved but costs could increase. Similarly, if there is an outbreak of a new disease – such as Zika, or an epidemic similar to HIV/AIDS in the 1980s – per-person treatment costs could increase.

So what happens?

If the amount of money the federal government sends is capped, the state would have to either spend more of its own money, or reduce the amount of health care it provides. This could leave thousands of Montanans without access to affordable health care.

Tomorrow, we will talk about who has the most to lose from putting a cap on Medicaid spending.

Budget Troubles Loom Large Second Half of Legislative Session

This week the Legislative Fiscal Division released a 694-page HB 2 Narrative summarizing final Joint Appropriation Subcommittee action, comparing the current legislative budget to the executive proposed budget and to the last biennial budget. The Narrative includes a 12-page summary as well as more in-depth analyses of each agency. The summary section is a helpful overview of changes the legislature has made so far compared to the executive budget. However, this year the overview could easily lead a reader to believe that legislative subcommittee action left the state budget and the programs, services, and infrastructure it funds in much better shape than it actually is.

Here are the main highlights from the LFD Narrative:

  • The legislature cut general fund appropriations by $43.8 million from the executive’s budget and $19 million from the 2017 biennium budget.
  • The legislature’s appropriations of state special revenue cut $46.7 million from the executive’s budget and $44.8 million from the 2017 biennium budget.

While the legislature appears to have provided a far greater amount of federal funds in HB 2, this requires some additional clarification:

  • The Governor proposed to appropriate $359 million in federal funds for the Supplemental Nutrition Assistance Program (SNAP) through a statutory appropriation, rather than HB 2. After discounting this fund shift, the increased federal dollars from the executive budget is only about $207 million.
  • Of this $207 million in federal funds, $193 million is federal funds for highway dollars tied to matching state dollars. In order to restore federal highway dollars, the legislature has made state funding cuts to the Montana Department of Transportation. (See below for more info.)
  • Finally, over $50 million in federal Medicaid funds were added to the DPHHS budget for Health Resources Division in late subcommittee action as a result of updated caseload estimates, a routine process that occurs throughout the budget creation process. This adjustment does not restore the almost $90 million in cuts made to DPHHS alone.

Some additional commentary on subcommittee action

An important comparison to consider is how the legislature has funded programs compared to the present law budget, or the level of funding necessary to maintain current government services. As LFD notes, “present law gives the legislature a baseline budget presentation and illustrates a beginning point of the legislative budget decisions that require legislation.”

In early action by the legislature, subcommittees cut hundreds of millions of dollars in total funds to agencies. While subcommittees have added back some funds, nearly all of these additions reflect present law adjustments needed to continue existing services. So it is helpful to look at the present law budget as a baseline and then factor in the cuts or additions made beyond these adjustments. An initial take shows that the legislature has cut more than $100 million from the core programs and services that help make our communities and families safe, healthy, and economically secure.

Below are some initial thoughts on how things are faring for programs essential to our communities. These aren’t just numbers and dollar signs. They represent devastating cuts to services for seniors and people with disabilities and probable double-digit tuition increases for students and their families.

The slight budgetary increase to DPHHS reflected in the LFD Narrative is a result of standard inflationary adjustments and additional federal funds for caseload adjustments. Essential programs for seniors and individuals with disabilities continue to face deep and devastating cuts. While the present law adjustments for DPHHS reflect an increase of total funds of about $97 million, the Department is also taking a cut of $89 million in total funds in “new proposals.” These cuts represent $2.2 million cut to Disability and Employment Training Division that provides services to people with disabilities, including counseling, career training, transportation, adaptive equipment, and independent living services.

Senior and Long-Term Care, which administers Medicaid services for seniors and persons with disabilities, including Meals on Wheels, transportation services, in-home assisted living services, and nursing homes, continues to see the deepest cuts in DPHHS. In addition to negative present law adjustments, the legislature has cut $53 million in total funds for programs, potentially impacting provider rates, worker wages, and services for seniors living in their own homes and those in nursing homes. Montana’s population continues to age, and projections show that by 2025, nearly one-fourth of the state’s population will be over the age of 65. We should be very concerned about how these cuts will harm seniors and their families today, but also concerned about how these cuts set the stage for declining services in communities over time.

The legislature has funded Montana’s colleges and universities at $33 million below the past biennium, risking double-digit tuition increases for students and families in the next biennium. As discussed in our past report, early actions by the legislature reduced higher education investment by approximately $23 million. On top of this, the legislature did not provide the standard present law adjustment to the university system, representing an additional $7.8 million in cuts to a fully funded budget.

The Legislature’s effort to restore federal highway funds relies heavily upon deep cuts to the Department of Transportation, which could impact the health and safety of all drivers and future federal funds. Some legislators and the broad Montana Infrastructure Coalition have called for an increase to the state gas tax in order to avoid losing $193 million in federal matching funds used for construction and maintenance of roads, highways, and bridges. Instead, the budget subcommittee that oversees the Department of Transportation (MDT), dramatically cut state funding for MDT and used those savings to shore up the state highway account used to match federal funds. This plan would eliminate 75 vacant positions and cut overtime pay. MDT has raised concerns that this level of cuts could impact safety, which could result in failing to meet federal standards and a corresponding further loss of federal funds.

 

The Legislature will come back from its break next week and will have 45 more days to ensure we continue to invest in the services our families rely upon. Seniors, people with disabilities, students, and families who want a better life for their children shouldn’t be asked to shoulder the entire burden of our state revenue downturn. Montana can get to a balance budget while funding essential services, by ensuring we have adequate revenue and that everyone is paying their fair share.