An already bleak budget outlook for the state got even worse Wednesday as Gov. Jay Nixon announced that February tax receipts dropped 14.6 percent, compared with February 2009.
As legislators attempt to plug what could be a $300 million shortfall in revenues, social service providers across the region are scrambling to deal with $60 million in cuts proposed in February by the Missouri House Appropriations Committee for Health, Mental Health and Social Services. Although the cuts are not official until the budget process is completed in mid-May, few in Jefferson City are optimistic that the money will be restored.
District 68 Rep. David Sater, R-Cassville, the chairman of the appropriations committee, said the cuts — $10 million from senior services, $15 million from mental health, and $35 million from social services — were “difficult, but necessary” in order to deliver a balanced budget. Federal mandates require funding for certain programs the committee pays for with Medicaid dollars, Sater said, which meant cuts had to come from other areas of the budget.
“There are a lot of programs that are mandated through Medicaid — we have to pay for these services unless we want to drop out of the program entirely. Once you take those programs off the books, what you have left are a lot of good programs we would like to keep funding, but the cuts have to be made somewhere,” Sater said. “You can vote with your heart, but you also have to vote with your financial mind, too.”
Sater said declining revenues made restoring funding unlikely.
“January was down 12 percent. February isn’t looking any better. We are in better shape in Missouri than some other states, but every month those numbers are bad makes it less likely we will be able to fund everything we want. As bad as this year is, next year could be even worse,” Sater said.
District 118 Rep. Stanley Cox, a Sedalia Republican, said Nixon and various members of the General Assembly had taken cuts to K-12 and higher education off the table and that there was consensus in Jefferson City that tax increases were not the answer to a balanced budget.
“Sometimes what appear to be savings aren’t really savings, it is just a shift in the costs. There is no doubt about that. Everybody makes the same argument. The bottom line is if you never cut anything, you never get a balanced budget. You have to be smart about those things,” Cox said.
Cox said he would “do what he could” to help find funding for social services but had “told the folks at (Katy Trail Community Health) — if you look at the prospect for state funding, it is bad this year and even more desperate next year.”
“If I was on the board, I would be trying right now to make the difficult decisions,” Cox said.
Domestic and sexual violence shelters
Advocates for domestic abuse shelters say services are already under-funded and struggle for resources to operate. The 80 shelters that operate in Missouri served 50,000 women and children in 2009, but were forced to turn away 14,000 people seeking assistance due to a lack of space, staff and funding.
Colleen Coble, the chief executive officer of the Missouri Coalition Against Domestic and Sexual Violence, a group that lobbies on behalf of shelters and support programs, said she understands the state’s budget situation but believes the “safety of women and children should certainly qualify as an essential public safety issue,” and fears even greater numbers will have to be turned away.
Stress from the economy spills over into more instances of domestic violence, Coble said, so shelters are now being asked to stretch fewer resources to serve even more people.
“I am encouraged by the response of some in Jefferson City, but these are sobering and difficult times. We need the support of all the legislators when it comes down to making these really crucial decisions,” Coble said.
Citizens Against Spousal Abuse, or CASA, provides food, shelter, counseling and legal support to victims of domestic and sexual violence in Pettis County.
Amber Scott, the shelter’s executive director, said an average of between 17 and 20 women and children are housed at the group’s Sedalia facility on any given night. About three-quarters of CASA’s $400,000 annual operations budget comes from contracts with state and federal agencies, while the remaining 25 percent comes from the United Way and individual donors and donations. Scott said the shelter stands to lose $30,000, or nearly 10 percent of it’s budget, due to the proposed cuts.
“There is no way for it not to affect our ability to provide services. That could mean one entire job eliminated. That means we have to stretch our resources even further and we may have to cut some services,” Scott said. “Putting a roof over someone’s head is just a small part of what we do. Our real work involves helping them figure out how to recover from their abuse and move on with their lives. These cuts really complicate our ability to help some of the most vulnerable members of the community.”
Scott’s concerns were echoed by her Johnson County counterpart, Kathy Kay, executive director of Survival Adult Abuse Center in Warrensburg. Kay said the center was looking at losing between $45,000 and $50,000 in revenue. She said the matter was complicated because some dollars come attached with specific mandates for how the money is to be used.
“Some of the funds cut come from a grant that deals only with our operating expenses. That means essential services are all I can bill for on that grant. We are talking about water for the fire system, electricity for the alarm system, food. It is what you use to operate. We aren’t talking fluff. I don’t know what we will do,” Kay said.
Kay said she had met with the center’s board of directors but that no decisions had been made regarding the hole created in their budget by the cuts.
“We are going to see what actually happens before we start panicking. Right now, no one wants to comprehend it — it is such a crippling blow,” Kay said.
Kay and Scott agreed that cuts from the state would mean the shelters would have to seek more assistance from local communities, religious organizations and charities.
“The depth of cuts is just really staggering. I am sure everyone else feels the same way and feels their program shouldn’t be cut. I just don’t know how you can cut support for victims. It takes a lot for a person to decide to leave an abusive relationship. If they finally make that decision and we have to tell them that we can’t take them, then they just end up going back and the cycle of violence continues and escalates,” Kay said.
Katy Trail Community Health
The appropriations committee also voted to eliminate all state funding for county community health services.
Chris Stewart, executive director of Katy Trail Community Health, which provided low-cost medical and dental services to 7,750 low-income families in Pettis and Benton counties in 2009 said Katy Trail lost $330,000, or 12 percent of its annual budget.
“It will have an impact and will mean a reduction of services. We haven’t decided exactly how to respond. We are still hopeful that it will be reinstated or a portion reinstated,” Stewart said.
The health center completed its 2010 budget in December. Though the center had been preparing for some reduction in funding from the state, “we were not anticipating a complete elimination,” Stewart said.
“This came as a complete surprise to all of us,” Stewart said.
With fewer resources, Stewart said some low-income and uninsured people in the area would have to seek medical services elsewhere at a greater cost to the community as a whole.
“I know they think they have a savings, but it is going to cost taxpayers more in the end. We have been able to provide primary care services very efficiently. We want to prevent people from using emergency rooms ... and have that uncompensated care passed on to taxpayers. If we can have them serviced at our health center (it is) much more cost-effective for the state,” Stewart said.
Pathways Community Behavioral Healthcare
Cuts to mental health services also have left mental health care providers trying to come up with ways to stretch remaining dollars.
Pathways Community Behavioral Healthcare operates 34 offices in mid-Missouri, including facilities in Sedalia and Warsaw, and provides services to about 28,000 people annually.
Pathways’ chief executive officer, Mel Fetter, said they lost $5.5 million due to budget cuts. He said about 80 percent of Pathways’ operating budget comes through the Missouri Department of Mental Health and that the loss in revenue would mean “reductions in access to care for people in need of mental health treatment.”
“The system as a whole is becoming much more Medicaid driven. We are directing those resources to specific target groups. Our fear is that those dollars for treating people in crisis will be totally gone and we will only be able to provide services to those that are Medicaid enrolled,” Fetter said.
Fetter said Pathways had been dealing with declining revenues over the past two years, and had already adopted a number of austere budget measures in the hopes of not having to cut staff or services, including all 900 of its employees foregoing salary increases last year.
“We have been in budget reduction mode for the last couple of years. Our promise to staff was to keep everyone employed. We did no salary increases this year. Whether we can keep that promise going into this fiscal year is impossible to say. There is probably little chance we will see money put back into the budget. We will be looking at further reductions.”