Legislators Take A Swing At, Pass On State Health Department Budget Cuts For Now
It’s a small part of Arkansas's overall budget, but Gov. Asa Hutchinson's proposed $400 million dollar appropriation for the Department of Health next year got a strong review and a rebuke today by legislators at the capital.
"There are not enough votes to cut" the budget, complained state Rep. Doug House (R-North Little Rock), "therefore, I’m going to vote for the ER [executive recommendation], in which case the budget gets drafted, and we’ll fight this battle another day."
"Amen, brother," said Sen. Larry Teague (D-Nashville), Joint Budget Committee co-chairman, after roughly an hour's worth of motions, discussion, voice votes and roll calls.
At roughly $400 million, the department's budget is a slender slice of the governor's overall $5.63 billion budget. The budgets for the departments of Education and Human Services, at $2.19 billion and $1.67 billion, respectively, gobble up more than two-thirds of the state's entire budget.
What's more, the proposed budget typically overshoots actual spending, since it's easier to absorb an amount that's unused than to expend an amount greater than what has been approved.
"They’re saying, 'Last year we spent X. This year we want permission for X+Y,'" House paraphrased, loudly. "We are saying, 'No, if you get some extra money, you don’t get to spend it on what you want to. We will decide as a body where that money will be spent.'"
The committee hearing did nothing to change the proposed budget for the department, but even if it did, the whole 2018-19 state budget comes up for hearings and amendments next month at the start of the biannual fiscal session. Only then can a formal and finalized budget be put forward for the governor's signature.
The Joint Budget Committee is composed of more than 50 legislators who questioned Health Department executives for more than an hour then took another hour just to vote. The sticking point appeared to be the relatively small $14.3 million appropriation for the department’s tobacco cessation efforts.
Arkansas, according to statistics from the Centers for Disease Control and Prevention, has one of the nation's top five highest rates of tobacco use. State spending on the matter ranks 11th — not per capita but in total dollars, putting it on a par with the entire state of Texas, according to officials.
"We’re spending an extreme amount of money, and I’m wondering what are we doing differently to address this issue?" asked Rep. Mark Lowery (R-Maumelle). "We’re spending close to the same amount of money that the entire state of Texas is spending on tobacco cessation. What is it we’ve decided we’re going to do different that’s going to work?"
"Great question," department head Dr. Nate Smith said. The state's focus has been on youth "initiation" rates, and through the health department's efforts, "Our youth smoking rates decreased by half over the last 10-15 years.]
State Republican Reps. DeAnn Vaught of Horatio and Jim Dotson of Bentonville both made motions to cut the health department’s budget at this line item, but none got through, and not strictly along party lines, either.
"I don’t know how many people in here have actually talked to your county health office and know them," state Rep. Charlotte Douglas (R-Alma) said, "but as you heard Sen. Hester say a while ago, their budget has been stagnant for 10 years, and when I talk to people in my county [health department] they have one person doing two jobs."
"They are under extreme overwork, and they can’t keep people. I don’t know what consequences this would have, down to that level, on those workers, if you take these appropriations away."
She pointed out that, not only does the state maintain a high rate of tobacco use nationally, its 1st in heart attack deaths per capita, according to officials.
Last year, about 10,000 Arkansans tried the telephone quit line overseen by the department, and officials said between 1,000 and 2,000 quit because of it, prompting this rebuke from House.
"You ask how many people quit smoking. 'Oh, 1,000 or 2,000.' Wait a minute, 1,000 or 2,000? Which one is it. They don’t know. They don't know if it's effective or not."
House likened this part of the budget to the recently maligned General Improvement Fund, a budgetary spillover used by legislators to appropriate money in their districts with little or no real oversight — "a big pot of money" legislators pick beneficiaries for, he said.
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