Prisons, mental health, Medicaid seek more money

JACKSON, Miss. (AP) — Mississippi’s prison and mental health systems and Medicaid program are seeking millions of extra dollars to get through the budget year, then more money on top of that for the coming year.

Agency leaders appeared Tuesday before the Joint Legislative Budget Committee to request money for fiscal year 2014, which ends June 30, and for fiscal 2015, which begins July 1.

State revenue has increased roughly 5 percent a year for each of the past two years, and the state-funded portion of the current budget is about $5.8 billion. Lawmakers say they expect similar growth in the coming fiscal year, though some agencies are requesting increases of more than 5 percent.

The Department of Corrections started the current year with $337.9 million, and Commissioner Chris Epps is seeking an additional $22.5 million to get through June 30. The department is requesting $389.4 million for the coming fiscal year. That would be a 15.2 percent increase over the original current-year budget or an 8 percent increase over the proposed revision, which must be approved by legislators.

Medicaid, the federal-state health care program for the needy, started the current year with $840 million in state money and is facing a $77 million shortfall, said director David Dzielak (JELL-ick). It’s requesting $983 million in state money for the coming year. That would be a 17 percent increase over the original fiscal 2014 or a 7.2 percent increase over the proposed revision.

The Department of Mental Health started the current year with $237.5 million and is requesting an additional $1.7 million to get through June 30. Director Ed LeGrand said the department is requesting $243.1 million for fiscal 2015. That would be a 2.4 percent increase over the original fiscal 2014 budget or a 1.6 percent increase over the proposed revision.

Medicaid executives are trying to control costs with a managed care program that specifies which health care providers patients can use, Dzielak said. The program also helps patients manage chronic conditions, such as heart disease, by giving them reminders to take medication or go to doctors’ appointments. Dzielak said 22 percent of Medicaid recipients are in managed care now, up from 8 percent this past December. A state law allows up to 45 percent.

Lt. Gov. Tate Reeves told Dzielak that if managed care is saving money, more patients should be put in it, but if it proves more costly, it should be scaled back.

“I want to take it in the direction it costs the least amount of money,” said Reeves, a Republican.

Medicaid enrollment has been fairly steady the past couple of years after increasing rapidly when the economy faltered in 2008, Dzielak said. In late August, enrollment in the program was 644,504. Mississippi’s population is just under 3 million.

The Republican-controlled Legislature has rebuffed Democrats’ efforts to expand Medicaid, mostly with federal dollars under the federal health overhaul that President Barack Obama signed into law, to an estimated 300,000 residents who lack health insurance. During the budget hearing Tuesday, there was no talk of expansion, although there was some grumbling about the upward trajectory in Medicaid costs over the past two decades.

Dzielak said an estimated 48,000 to 72,000 Mississippians are currently eligible for Medicaid but haven’t enrolled. He said many could start enrolling as they face the federal mandate to buy health coverage. “That will be a significant impact on the state budget,” he said.

Epps said that the prison system could save money by releasing a larger number of nonviolent inmates on house arrest.

“Those in the (prison) beds — they will eat your lunch. That’s what this budget is about,” Epps said.

Sen. Terry Brown, R-Columbus, said the corrections system needs to cut costs.

“We can’t afford to keep all these people in prison, in my opinion,” Brown said.

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