Budget Trends Reveal Uncertain Future for Health and Human Services

May 18, 2011..Columbia, Maryland…Howard County Human Services agencies will be facing a crisis point in the very near future if current trends of flat or cut funding, reductions in staffing and programs, and increased service demands continue.

These are the conclusions drawn from findings in a new report   Budget Trends in Howard County Health and Human Services FY2008-FY2011.  The report was prepared by the Policy Analysis Center for the Association of Community Services (ACS).

The report is a record of how health and human service provider organizations in Howard County have fared during the recession.  As Howard County citizens have lost jobs, faced foreclosures, and sustained significant losses in their retirement savings, the demand for public assistance has increased.  Most of the health and human service agencies in the County have been affected, directly or indirectly by the increase in need. People that had never before received public assistance are seeking services ranging from temporary cash assistance, to home energy bill payments and food assistance.  The number of people enrolling in Medicaid has increased and many organizations report that there has also been an increased demand for mental health services

According to Budget Trends, the organizations highlighted in the report are have risen  to the challenge by using stopgap funding from the County and from the American Recovery and Reinvestment Act (AARA) and by adjusting their operations and personnel.  It cautions this is only a temporary solution and that the future looks extremely uncertain.

According to Viviana Simon, Director of the Policy Analysis Center, the information revealed in this study demonstrates a pattern of cuts and coping strategies within Howard County’s human services non-profit and governmental agencies. Simon stated “This simply is not sustainable without serious deterioration in the services offered, the people served, and the quality of the services that has always distinguished Howard County.”

Simon also noted that the report shows that Howard County government has been very responsive to human services, working to maintain funding in the face of reduced revenues and state cuts. But local governments are likely to face some tough choices in the face of looming federal and state cuts to key programs that may ultimately impact services.

Added ACS Executive Director Anne Towne, “Human Service providers are part of the basic county infrastructure, much like roads and bridges are to the community. Budget Trends shows that in the last few years several organizations have been operating under strained conditions, patching holes in funding and services as much as possible.  Long-term, these patches are a threat to their institutional viability. You can keep fixing potholes, but if you don’t allocate adequate funds to repair the whole road, ultimately traffic will come to a halt.  This report is a warning that we can’t afford to just repair potholes without damaging our community.”

Among the report highlights:

• Budgets have remained flat, but demand for services has dramatically increased.   Applications for Supplementary Nutrition Assistance (food stamps) has increased 80%, requests for temporary cash assistance is up 27%, and for home energy assistance up 125%.  Calls to Grassroots for financial assistance for example, increased 300% between 2008 and 2009.

• Nonprofit and public  agencies serving Howard County’s at risk populations are seeing growing gaps in services, affecting children and youth, persons with mental illness, vulnerable persons with complex medical needs, transit dependent populations  and persons who cannot afford housing.

• Healthcare services have been particularly hard hit as a result of reductions in the State’s Core Funding Program, which has been reduced 43% between FY08 and FY11.  Specifically:  family planning funding decreased 50%, Maternal and Child Health decreased 66%, and wellness funds went down 20%. Public health resources in the Health Department are stretched extremely thin.

• Organizations are seeing more and different clients:  the “new poor,” people who had jobs but lost them, have lost their savings, and whose unemployment benefits have run out. These individuals are unfamiliar with public assistance and eligibility issues, leading not only to client crises, but increased tensions.

• Howard County service providers are facing state-mandated tightened eligibility and reduced program flexibility as a result of trends to more centralized, rule driven service models.

• Increasing reporting demands, coupled with decreasing capacity are straining staffs and services. Staff have taken a large brunt of the budget constraints as agencies work to maintain services, many of them mandated at the state or federal level.  Agencies are not filling vacant positions, are reducing staff benefits and pay. Staff have to assume multiple responsibilities, diluting their ability to focus on clients. For example, at the beginning of 2011, the Department of Citizen Services had 12-13 vacant staff positions which are not going to be filled this year.

Budget Trends in Howard County Health and Human Services FY2008-FY2011 included interviews with several county agencies, and a review of state, county and federal reports. Budget Trends author James Macgill, Jr. looked at the populations they are serving, how they have coped with increased demand and the overall decrease in funding,. The study also looked at the impact of federal stimulus funding on current and future program support.  A copy of the Executive Summary is attached to this release. Copies of the complete report can be beginning the afternoon of May 18 at http://www.policyanalysiscenter.org/policy-studies/budget-trends-ho... 

About the Policy Analysis Center.  The Center was established in 2007 and is a joint partnership between the Association of Community Services (ACS) of Howard County and the Horizon Foundation. This unique collaboration was designed to provide a new capability to develop useful research information in the areas of health and human services. 

The Policy Analysis Center is under the direction of Viviana Simon and guided by a Steering Committee co-chaired by Rich Krieg, President of the Horizon Foundation and Anne Towne, Executive Director of the Association of Community Services. Current Steering Committee members include Roy Appletree, Shirley Collier, Jacqueline Eng, Glenn Falcao, Harry Schwarz and James Truby.

Budget Trends: Howard County Health and Human Services FY2008 – FY2011

Executive Summary

Between FY 2008 and FY 2011 Howard County health and human service agencies have struggled to maintain services for vulnerable populations as need increased. Funding for most County health and human service agencies was basically flat, while the number of citizens needing help grew significantly.

Key trends during this period included:

• The number of County residents applying for services and benefits grew dramatically.  Applications for Supplemental Nutrition Assistance (Food Stamps) rose by almost 80% while the number of persons receiving Energy Assistance more than doubled.
• American Recovery and Reinvestment Act (ARRA) funds helped support County residents, but grants funded by ARRA have now ended or are being phased out, creating uncertainty for some agencies.
• Most public and nonprofit agencies in the County have had level funding or even reduction in their staffing budgets over the past few years. Agencies report that they are experiencing strains on capacity, as employees work harder to maintain operations. In particular, administrative staff is under increasing pressure.
• The County Health Department’s public health functions have suffered significant State cuts.
• Changes in State funding appear to be accelerating a trend away from programs with local flexibility toward more centralized, rule driven service models.
• The United Way, which in the past provided on-going support for some agencies, no longer plays that role.
• Nonprofit and public  agencies serving Howard County’s at risk populations are seeing growing gaps in services, affecting children and youth, persons with mental illness, vulnerable persons with complex medical needs, transit dependent populations,  and persons who cannot afford housing.

 Throughout this difficult period, Howard County Government has been particularly responsive and supportive of health and human service agencies on the front lines, and has stepped in to fill gaps that have been created by funding cuts and increases in service populations.  Over the next few years, however, there is likely to be more pressure on local government and the nonprofit sector, as efforts are made to reduce Federal and State expenditures. County decision makers may have to make difficult choices in allocating resources for health and human services in the near future.