Wednesday marked the second day of the third round of hearings in Jackson for the budget working groups, and by mid-afternoon, state legislators were ready to make cuts.
In these working groups, the budgets of 13 state agencies and the state’s tax structure are up for evaluation. The $9.4 million devoted to the Department of Health’s tobacco control program was one of the first items to raise a few eyebrows.
Mary Currier, the state health officer, explained that Mississippi Code requires all tobacco funds to be spent on tobacco control. But as Lt. Gov. Tate Reeves pointed out, state laws can be changed.
“So if the law is passed it can also be changed,” Reeves said. “Looking at funding challenges your department has had, do you think there could be more efficient uses? All these programs are good programs for the state, but all of us are in the business of making choices. We have scarce resources; we’ll never have as much … to spend on things as we need.”
This theme was echoed in several legislators’ questions during sessions with other agencies. In addition to the Department of Health, legislators heard from representatives of the Department of Mental Health, the Department of Human Services and Child Protective Services.
Reeves also asked Diana Mikula, executive director of the Department of Mental Health, why the department spends $60,000 per-patient annually. Rep. Becky Currie, R-Brookhaven, followed with questions about the department’s reliance on contracting doctors outside the department. Currie also warned Child Protectives Services not to slip into the patterns of carelessness that had led to the department’s recent realignment.
“I’m not hearing things are changing out there; I’m not hearing on a ground level that foster parents are feeling better,” Currie said. “So I guess I’m asking if your people will have a tendency (of) going back to doing things the same old way.”
During Wednesday morning’s hearings on IT and Medicaid, Dr. David Dzielak, executive director of the Mississippi Division of Medicaid, testified that the only real way to reduce Medicaid spending would be to improve the economy. Medicaid eligibility is based on two factors: income and family size.
“Our expenditures are tracking with medical inflation. If everyone got super healthy we’d save a little money, but really the bigger issue is if the economy of the state does a little bit better,” Dzielak said. “One in four (Mississippians) receive benefits – that’s higher than other states.”
Reeves quickly responded that the problem wasn’t the availability of jobs in Mississippi but Mississippian’s willingness to take them.
“I think what you’re implying, rather than a comment on the economy, is if we had more people employed. There’s more than one reason why people aren’t employed. We have jobs all over the state in other fields. We also have, to my knowledge, the lowest employment rate of able-bodied adults between 18 and 65. A lot of those individuals that are not employed could potentially be employed, and they’re also on the Medicaid rolls,” Reeves said.
Speaker of the House Philip Gunn concurred with Reeves: “I would agree with the lieutenant governor’s assessment. It’s more about people working. … If more people worked they wouldn’t qualify.”
Not all members of the legislative budget working group felt that an unwillingness to work among some state residents was driving Medicaid’s high enrollment numbers. Sen. Brice Wiggins, R-Pascagoula, pointed out that many available jobs don’t come with benefits such as insurance.
“In order to be covered and off the Medicaid rolls, they have to have jobs that have insurance connected to them,” Wiggins said. “So there may be jobs out there, and I’m not disagreeing with anything the speaker or lieutenant governor said, but the jobs out there may not have insurance connected to them, so (employees in these jobs) cannot be covered outside Medicaid.”
Wiggins also honed in on the salary of Medicaid’s employees, asking Dzielak why an analyst who sits behind a computer in a Jackson office would earn more than a case worker in one of Medicaid’s regional offices, who deals directly with the Medicaid beneficiaries.
“It seems like the focus should be on people who are there for our citizens, as opposed to, say, and I’m not minimizing anyone’s role, but a systems analyst,” Wiggins said.
Dzielak explained that salaries are set by the State Personnel Board and consistent with other state departments. But Dzielak said the department would be open to reevaluating them with the State Personnel Board.