Governor Baker’s FY18 Budget Proposal: Core Public Health Remains Underfunded

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On Wednesday, January 25, Governor Baker announced his budget proposal for fiscal year 2018. Governor Baker’s budget proposal includes a 4.3% increase in funding over FY17 spending. While the proposal includes an overall 2% increase in state spending for the Department of Public Health (DPH), funding for community-based programs had proposed modest cuts.

The Governor also proposed drastic cuts to HIV/AIDS prevention and treatment services, Transitional Aid for families with dependent children, decreased funding for the Bureau of Environmental Health by 5%, and proposed increased funding for the Bureau of Substance Abuse Services.

We are disappointed to see that core public health infrastructure remains underfunded. Reinvestments in neglected infrastructure  are necessary to protect the health of Mass. residents, and are underrepresented in the governor’s budget proposal.

Mixed Bag for Public Health Infrastructure

The Governor proposes decreasing funding for The Bureau of Environmental Health (4510-0600) by 5%. In last fiscal year’s budget proposal, Governor Baker had proposed a 10% increase for the Bureau of Environmental Health (BEH), a funding increase which did not make it into the final FY17 Budget.  This year’s proposed 5% decrease in BEH funding in the Governor’s Budget would put increased pressure on BEH to perform necessary public health protections with a limited staff.  Some core protections did see increases in Governor Baker’s budget proposal.  Funding for the State Lab (4516-1000) was increased by 2% and Health Care Quality and Control (4510-0710) is increased by 7% in the proposed budget.  However, the State Lab has been underfunded for years. The proposed 2% increase would do little more than keep up with inflation.

Drastic cuts to HIV/AIDS

HIV/AIDS Prevention Treatment and Services received a drastic cut of $4.8M (14%). In the AIDS Action Committee’s statement on the Governor’s budget proposal, Executive Director Carl Sciortino states that the Commonwealth’s most vulnerable populations, including Black and Latino, transgender, homeless, incarcerated and youth, will be most impacted by these cuts.

Substance Use Funding Increased

The Bureau of Substance Abuse Services primary line item (4512-0200) is increased by $2M  over FY17 funding. This increase comes after receiving $1.9M in emergency unilateral cuts by the Governor in December 2016. Family and Youth Intervention (4512-0203) was cut by $15K (1%).  Clinical Stabilization Services (4512-0201), Naloxone/NARCAN for First Responders program (4512-0204), and Recovery High Schools (4512-0211) line-items are level funded in the Governor’s proposed budget. Despite the overall increase in substance use services, the Governor’s budget falls short of funding levels recommended by substance use advocates. More funding is needed to increase access to services and recovery high schools and create three new Recover Centers across the state.

To learn more, read the Association for Behavioral Health’s analysis of the budget proposal.

Cuts to Nutritional Programs and Family Services

Women Infant and Children (WIC) Food Nutritional Service (4513-1002) was moderately decreased by 2% because of declining births in Massachusetts.  In addition, funding for Health Promotion and Disease Prevention (4513-1111) was decreased by 12%.  This decrease could also impact the Mass in Motion program, which is funded through Health Promotion and Disease.  Transitional Aid to Families with Dependent Children (4403-2000) received drastic cuts. Governor Baker’s budget proposal includes $43M in cuts (22%) from FY17 funding. Part of the reduction comes from cutting off or drastically reducing TAFDC for families where a member receives Supplemental Security Income (SSI) benefits because of a severe disability. Governor Baker’s budget proposal for FY17 included a similar proposal, which was blocked by the legislature.

View the Massachusetts Law Reform Institute’s analysis of the budget proposal to learn more.

Outside Sections

The Governor’s budget proposal includes outside sections aimed at increasing data sharing among public health departments.

These sections are also aimed at containing the costs of MassHealth for the state by having employers that do not offer adequate health insurance and have a full-time staff greater than ten contribute an annual assessment of $2,000 per worker. The proposal also includes language that would place limits on increased costs negotiated between providers for the next three years.

Next Steps and Opportunities for Action

The budget process moves on now to the House of Representatives. The House Ways and Means Committee will be developing their budget proposal over the next six weeks, and the full House will debate the budget in late April. MPHA will be working hard to advocate for adequate funding for DPH and the programs that help Massachusetts residents stay healthy.

We need your voice! Stay tuned over the next few weeks for the release of the MPHA complete list of funding priorities and to learn how you can get involved to speak up for public health in the state budget. Follow MPHA on twitter and  Facebook  for updates on upcoming actions.