The New Hampshire Department of Health and Human Services is the state’s largest department – and it faces some complex challenges.
This department is tasked with health coverage, expanding the state’s drug and alcohol treatment capacity and helping fix a Division of Children, Youth and Families that has recently come under fire after the death of two young children in the agency’s care.
As Gov. Chris Sununu unveiled his budget address Thursday, he made clear his priorities included fighting the opioid crisis, eliminating the state’s developmental disabilities waiting list and adding staff to DCYF.
Department of Health and Human Service Commissioner Jeff Meyers said he is also pleased with the end result.
“We worked very closely together, I was very pleased with the process,” Meyers said. “They really did address a lot of the needs that had to be addressed.”
New Hampshire’s developmental disabilities program is looking at the largest boost under the governor’s proposal – a little over $57 million doled out over fiscal year 2018-19.
That money is aimed at reducing or eliminating the state’s waiting list for the program, which is growing as more individuals with disabilities turn 21.
The department is on track to serve 488 people, 73 more than was budgeted for.
At the end of December, the waiting list totaled 177 people. Part of the reason for the high number was the closing of Lakeview NeuroRehabilitation Center in Effingham two years ago, after reports of abuse and neglect there.
The cost of services per person has also increased; it was budgeted at $44,000 per person in past budget cycles, but is closer to $50,000, according to department officials.
Developmental disability advocates said the proposed addition of $57 million to reducing the waiting list was welcome news.
“We’re so encouraged,” said Jennifer Bertrand, policy chairwoman for the New Hampshire Developmental Disabilities Council. “Given that we haven’t seen any increase in about 10 years, this is great news.”
Bertrand said the current amount of funding often puts burdens on family caregivers.
“Families are doing the heavy lifting, and they’re important partners to the state,” she said.
When it comes to New Hampshire’s opioid crisis, Sununu pledged to add a specialist focused on treatment, recovery and prevention to work in the Office of Substance Abuse.
He also pledged to double the state’s contribution to the chronically underfunded alcohol fund, which diverts revenue from the New Hampshire Liquor Commission into treatment, prevention and recovery programs. The change would put about $3 million additional money into the fund.
Sununu’s changes were also welcomed by recovery advocates, who added they were waiting to see what House budget writers would put forward next week.
“I commend the governor for including significant resources in his budget for prevention, treatment, and recovery services, and for development of the behavioral health workforce,” said New Futures President Linda Saunders Paquette in a Friday statement.
Sununu also talked about the “crisis” at the Division of Children, Youth and Families in his budget address, and promised to increase the amount of staff to levels recently recommended by an independent report.
“This is not a choice, but a moral obligation, and is the start of transformational changes needed within the department, and within our state,” Sununu said.
An independent report done on the agency last year recommended DCYF add 35 child protection workers to its current 85 to help manage a growing number of caseloads.
DHHS’s budget request included $6.3 million over two years to hire more than 50 workers and the department has already hired people to staff the agency around the clock.
Outgoing DCYF Director Lorraine Bartlett recently told reporters her staff are increasingly seeing complex cases, especially given the state’s opioid crisis.
Other big health issues – namely, the future of New Hampshire’s expanded Medicaid program – were not so clearly laid out in Sununu’s address.
That’s in part because expanded Medicaid is in a uncertain position at the federal level. President Donald Trump and Congressional Republican leadership say they want to repeal the Affordable Care Act but have not yet proposed a replacement plan.
The only mention of Medicaid in Sununu’s budget speech was a call for more transparency about how the program spends its money. The budget will require Meyers to make quarterly reports to the governor and legislative leadership.
The lack of a discussion on the program’s future rankled some in the state’s Democratic leadership.
“Fifty-thousand people’s health insurance, 10,000 people getting substance abuse services...what is the plan?” asked Senate Minority Leader Jeff Woodburn on Thursday. “This was our greatest bipartisan achievement over the last four years, was passing Medicaid Expansion. How are we going to move foward on this?”
(Ella Nilsen can be reached at 369-3322, email@example.com and on Twitter @ella_nilsen.)