Tuesday, February 23, 2010

Bring Our Kids Home - Maybe Not

Here's a part of a story I found sticking out somewhere. That's to say, parts of the story were visible and parts still aren't.  I'm going to write about it, but take this as a 'present fiction.' Sort of like historical fiction, present fiction is based on bits and pieces of 'truth' but the rest of the 'truth' isn't known. What I'm going to do here is take some the fragments of 'truth' I found and try to make sense out of them. I'll try to let you know what is 'real' and what I'm sketching on my own.

I know a little about budget processes in government. Agencies in the executive branch have programs they want funded by the legislative branch. So each agency makes a list of their programs and how much each is going to cost. If they do it really well, they can link the money they are requesting with the outputs that money will 'buy.' 

"This $400,000 will buy one public transit buse that will carry 500 passengers a day, taking 40 cars off the road and emptying 40 parking spaces, and carrying 300 people who can't afford a car to work, who otherwise would be unemployed."  Of course, we can't know the outcomes so precisely, but it gives you the idea.     

[double click to enlarge photos]

First these budgets are (or should be) scrutinized inside of the executive branch. Then those programs that survive that process are sent to the legislature for approval. The legislators' job is to review these and find inefficient, ineffective, or unnecessary programs and cut them out. Legislators look good when they axe wasteful programs. Assuming, of course, that anyone notices and knows enough to understand what they have done.

Earlier, when I first got here, I started reading the budget documents for Health and Social Services. Some are written reasonably well with clear descriptions of outcomes. But it's pretty hard for outsiders to understand a program from pieces of paper. The programs that tend to get funded are the ones that have the best advocates - their descriptions get written well and/or people speaking for them are convincing to the funders. Selling programs isn't the same as operating them. The sales people could be much better than the programs they sell. And good programs may not have great salespersons.

The Bring the Kids Home program, it seems does not have good salespeople. This is a program, as I understand it - and I'm getting on shaky ground here - that is intended to set up networks around the state to provide community services for kids who have been institutionalized Outside (of Alaska, for non-Alaskan readers). The agencies that got money to implement this last year have been busy putting together programs and requests for proposals (RFP's) for agencies and businesses outside of government to run these programs. Apparently they are just about at the implementation stage and the money has been committed to the organizations that won various contracts to provide services.

The FY11 DHSS Budget (That's Fiscal Year 2011 Department of Health and Social Services) page 103 [I have a hard copy, couldn't find a matching link on line] has a section that mentions Bring the Kids Home:
Funding will assist in establishing serious emotional disturbance (SED) children's services in rural areas.  Almost 40% of youth experiencing SED in Residential Psychiatric Treatment Centers (RPTCs) out of state are Alaska Native.  This funding will develop services and strategies specific to tribal systems and improve funding mechanisms, such as Medicaid at 100% FMAP.  The funding will support tribes to expand health service delivery, as reommended by Senate Bill 61 (Ch 10, SLA 2007) (Medicaid Reform report).  Funding may support technical assistance and training from state staff or from contractors and/or adding additional staff functions to DHSS tribabl programs. . .
Another project in the budget (p. 105) includes:
...funding expands multiple grants to community behavioral health centers, to enhance outpatient services with innovative programs/training so as to reduce the need for residental level services for youth experiencing serious emotional disturbance (SED).  It will also emphasize special populations, such as Fetal Alchohol Syndrome, birth to six years, etc.  This increase in outpatient care assists in treating youth at the home and community-based level, and aoids utilizing costly residenatal care...

So, this is where the legislators and the sales pitches collide. Apparently, members of the House Finance Health and Social Services subcommittee, the committee that looks at the HSS budget, have found money that was allocated last year (or the year before) that hasn't been spent yet. This probably deserves them some kudos for looking closely enough to find these funds. Or perhaps there were people in the agency that tipped them off. I have no idea. I'm just listing possible ways this kind of thing could happen. And so, fulfilling their role as vigilant legislators cutting the fat out of the budget, so I'm told, consideration is being given to cutting that unspent money out of the budget. Not an insignificant amount I've been told. I've heard different numbers but one figure was about $750,000.

But, finding such unspent money is one thing. Understanding why it is there is another.  From what was explained to me, the money is unspent at the moment because of the planning and grant requesting and awarding process which has now taken place.  So the kinds of things outlined in those two quotes from the budget above, which were approved of last year and budgeted, have been worked on and the money has been promised to various contractors to provide services to keep kids with mental health issues in their communities where their family can visit them.  It just hasn't been spent yet.

So, because it hasn't actually been spent, it looks to people combing the budget for extra funds like an unnecessary expenditure.

At least that is the scenario that I understood.  The people who explained to to me might not recognize this version, so don't get too worked up.  The reason I'm not waiting until tomorrow to pass it by them is because at 8:00 am, there is a committee meeting where all this will be hashed out. 

We have reality television that is REAL and the stories directly affect our lives.  It's called Gavel to Gavel and you can see it live an unedited.  This post is the backstory for tomorrow's show.

Gavel to Gavel comes to you in different ways.  Try this link.
.  But these pages keep changing.  The live audio link won't be there until tomorrow and then this page will change.  But try it and see what you can find.

Here's the main Gavel to Gavel page.   Right now it says the House Finance - Health and Social Services Subcommittee will be live audio streamed tomorrow. But this page changes all the time as time passes. 

Here's the page that tells you where you can watch on television in your area.

Here's where you can get live feeds of the broadcasts on your computer.

I've given you one version of what may be happening with the Bring Home the Kids budget. 

I'm told there could be real drama at this meeting tomorrow as the Department of Health and Social Services works to get the committee members to understand that this is not unused money.  That this money is still there because it takes a certain amount of time to spend it well.  (And I'm not saying they are or are not going to spend it well because I can't judge that.  I can only convey what others have told me.) 

You can watch or listen to it live at 8am or you can listen to the archived audio after the meeting.  I've found they are usually pretty quick about getting that up. 

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