Budget Improves Medicaid and Children’s Services

The Missouri General Assembly fulfilled its most important obligation to the people last week by truly agreeing and finally passing the fiscal year (FY) 2015 budget.

Most of the recommendations approved by the Appropriations – Health, Mental Health, and Social Services Committee, which I chair, were included in the final budget. Our committee prioritized programs that serve Missouri’s most vulnerable citizens efficiently and offer the state a return on its investment.

The Department of Social Services’ Children’s Division is responsible for some of the most important operations in the state, including protecting children who must be removed from their homes for their safety. Unfortunately, the division has a very high turnover rate due to the difficult nature of the work. The recently passed budget includes funding for a career ladder initiative to offer experienced and qualified workers more opportunities for internal promotion. These dollars will encourage the best children’s workers to remain with the state to serve children in need.

To improve Missouri’s broken and bloated Medicaid system, the FY 2015 budget allocates money for reforms that will better the services available to Missourians in need while saving taxpayer dollars. These reforms include basic dental care for adults on Medicaid, coverage for rehabilitative therapies, and asthma education and home assessments for families of children with asthma. These changes will offer recipients more comprehensive care while lowering long-term Medicaid costs through prevention and improved recovery processes.

Through the 2015 budget, the legislature also reaffirmed its commitment to caring for children in foster care. These children rely on the state to act as their parent while they are removed from their homes. The Appropriations Committee recommended a pilot program to create coordinated health homes for foster children to improve their medical care. The final budget also included money to establish an electronic health record system for children in foster care and a funding increase for the foster parent licensing and training pilot program.

Medicaid is the largest state government program, and it consumes 36% of Missouri’s operating budget. To mitigate the wasteful payments that plague the system, we included funding for a state-of-the-art healthcare fraud detection system to proactively identify improper payments. I also added an amendment to allocate $250,000 to create the Joint Committee on Mo HealthNet Oversight to monitor Missouri’s Medicaid program. This independent body will examine enrollment numbers, review Medicaid studies, and provide legislators with nonpartisan research and data on the program.

In House Appropriations Committees, members must offer a decreasing amendment before they can increase funding for a particular program. This process ensures a balanced budget and requires legislators to prioritize programs based on their return on investment and performance metrics.

The Senate budget process operates very differently from the House, so not all of the budget recommendations developed in the House are included in the final budget. Even if we did not accomplish all of our priorities this year, our work is not in vain. We are still making progress incrementally as we seek to improve the outcomes of departmental programs and wisely allocate state resources.

I am very proud of the reforms and improvements made in the 2015 budget. Members of the Appropriations Committees and the House Budget Committee worked diligently for months to develop a budget that meets the needs of Missourians while eliminating wasteful spending. Throughout the interim and into next year, I will continue requesting that departments provide outcomes and performance measures to prove that they are using the money appropriated by the legislature for the benefit of our state.

Other Budget Highlights Include:

K-12 Education

1. $278 million increase for the Education Foundation Formula ($122 million general revenue and $156 million from the surplus revenue fund), which makes the K-12 education budget the largest in state history.
2. $4 million for the Missouri Preschool Program in unaccredited and provisionally accredited districts
3. $3.5 million for reading programs in unaccredited and provisionally accredited districts
4. $1 million increase for Parents as Teachers
5. $1 million increase for Teach for America
6. $15 million increase for transportation funding

Higher Education

1. 5% increase to the core budgets for universities and community colleges
2. $6 million in equity funding for community colleges
3. Full ride loan forgiveness for Bright Flight recipients who stay and work in Missouri
4. $15 million increase for Access Missouri
5. $6.7 million increase for the A+ Scholarship Program

Economic Development

1. $4.5 million for matching funds to Early Stage Business Development Grants
2. $5 million increase to the Missouri Technology Corporation
3. $400,000 to Certified Work Ready Communities
4. $8.5 million increase to tourism
5. $5 million to Kansas City, contingent upon receipt of the 2016 Republican National Convention

Moving Missouri Forward

1. $7.2 million in payments to the biodiesel incentive fund
2. Funding to eliminate the developmental disabilities waitlist
3. Money for an extra day of courier service to the state lab for newborn screening test results.  The budget also expands stops to include eight additional birthing hospitals and testing on Saturdays.
4. $14 million bond payment for the new Fulton State Mental Hospital