Budget hearings conclude with health agency

By Matt Bittle
Posted 2/25/21

DOVER — Joint Finance Committee hearings wrapped up Thursday, meaning another step in the budget process is now concluded.

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Budget hearings conclude with health agency

Posted

DOVER — Joint Finance Committee hearings wrapped up Thursday, meaning another step in the budget process is now concluded.

The full legislature has been on break for the past month, with its budget-writing committee spending much of that time reviewing Gov. John Carney’s recommended spending plan and hearing from state agencies and advocates.

The General Assembly returns to regular business March 9, while the JFC will meet again in May to make substantive changes to the budget.

The spending plan, which must be approved by July, likely won’t be finalized until late June.

Lawmakers on the budget panel spent the past three days hearing from the Department of Health and Social Services, the second-largest state agency, which accounts for about 27% of the proposed $4.71 billion spending plan.

Almost 11% of state employees work for DHSS, a percentage that more than doubles if the 15,000-plus individuals employed by school districts are not counted under the Department of Education.

Always one of the most visible state entities, DHSS has been in the spotlight more than usual over the past year. Lawmakers had plenty of questions about COVID-19, although they touched on a wide range of areas during the hearings.

“There’s not adjectives to adequately capture how difficult the past year has been,” Secretary Molly Magarik told the committee.

Sen. Dave Lawson, R-Marydel, questioned why the state is still spending money on testing, instead of putting more resources toward vaccination, also telling the agency that he has heard of some DHSS employees who were warned they could not keep working there if they do not get vaccinated. 

Agency officials promised to look into the latter, while Ms. Magarik explained that, although numbers are trending down, the virus is still spreading. Much of the money Delaware is investing in testing comes from the federal government specifically for that purpose, she said.

Elderly Delawareans have been especially impacted by COVID-19: Those 50 and older make up 34% of cases but 91% of deaths here. Officials said they are focusing many of their efforts on the elderly, ensuring that they can get vaccinated.

Going forward, they are taking a close look at social determinants of health, such as poverty, which will be even more relevant as the state’s population keeps aging.

“People want to criticize certain elements of the response, but I think the one thing no one can question is just the sheer effort (of) you and your team. ... The decisions that have been made, the effort that has been expended, has been done truly in the best interests of health and safety of Delaware residents,” said JFC co-chair Sen. Trey Paradee, D-Dover.

DHSS officials explained that about 250,000 Delawareans are currently on Medicaid, an increase of 11% from pre-coronavirus because of a temporary eligibility expansion handed down by Washington. That increase could remain through the rest of the year, Ms. Magarik said, adding, “We’re likely to not see a dramatic shift in the Medicaid numbers because, again, we’re in this stasis of people who were coming on and off (who) are not coming on and off anymore.”

Gov. Carney’s budget includes $794 million for Medicaid and related programs.

Lawmakers also expressed frustration that the budget proposal does not contain a rate hike for direct-support professionals, who provide assistance to adults with developmental disabilities. That support can include helping them find work and bathing them.

It’s a crucial job, and Delaware saves money on it by letting the private sector take the lead, but the state subsidy does not equal a living wage. That means many people working in the field are forced to take multiple jobs or leave the profession entirely, making it harder and harder to find quality caregivers.

Several speakers pleaded with lawmakers to raise pay Thursday, telling stories that backed up their requests.

“I never thought that I’d still be here begging” for an increase, said Rep. Kendra Johnson, D-Bear, a longtime advocate for people with disabilities.

In 2018, the General Assembly passed legislation calling for phasing in increases for caregivers, so that over a three-year period, the reimbursement would grow from 75% of the hourly market wage established in a 2014 study to 100%. But while supporters considered the measure’s passage a victory, the bill does not bind the General Assembly to fund the increase. Making matters worse is the fact a 2019 study revealed the need is bigger than was thought.

“It’s something that we’re going to take a long look at,” Sen. Paradee pledged.

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