by Mike Smith The Shumlin administration announced this past week that absent corrective action by the Legislature the state’s expanded Medicaid program will have a $38 million budget deficit.Enrollments into the program are occurring at a faster rate than estimated. One out of every three Vermonters is enrolled in the taxpayer-funded program. And this challenge is just part of the projected general fund budget gap quietly approaching $100 million.
No doubt the overall cost of providing social services to Vermonters and the network of programs and staff these systems require will be a large part of this year’s budgetary discussion — it always is.
The costs of providing these services will skyrocket if the Legislature continues to examine these problems through the same lens. Both need and success are currently measured by what is going into the system — the number of people we’re enrolling into our social services programs — and not by the number of Vermonters we’re transitioning from dependence on the system to economic independence.
There is no doubt Vermonters are generous and compassionate people. That’s why we create, maintain and expand programs for low-income Vermonters. The state employees who deliver those services do good, compassionate work and should be applauded.
But as with anything of this nature, our success at building these programs and seeking out Vermonters to access them also highlights our biggest social service failure.
Vermont has failed to create a robust system with the necessary requirements for moving Vermonters through the system in a way that empowers them to transition to a life of independence.
Compassion cannot be measured solely by the commitment to provide services, or how many people we enroll; it also must be measured by how many people we help achieve success in their own right. Building this type of social services infrastructure allows those who seek help to get the services, training, support, counseling, and nourishment they will need for a life of success and independence. It requires more thought, extensive cooperation between departments and agencies at all levels — and frankly, tremendous effort and accountability.
It may require partnerships that aren’t often seriously considered: for example, doubling down on job training, placing social workers in schools or requiring the higher education community to partner with the Department for Children and Families to help clients obtain a college education. Such a system must be well coordinated; parts cannot be incongruent with one another.
We know that children whose parents have job training or a college education are far more likely to be successful themselves. And we know that parents with a good job or enrolled in classes are modeling good behavior for their children. This is only one example of how we can come together as Vermonters to break down the silos. We must think outside the existing program structure and change the lives of the people who need us most.
It is necessary to keep in mind that this transition is not possible for all Vermonters. There are some who for various reasons, often mental and developmental health challenges, will require and rightly deserve the state’s continuous support. We all have a responsibility to ensure those in need are safe and able to live up to their potential.
Obviously, reforming a system that currently defines success with measurements of input rather than concentrating and transforming to one where success is measured by output (how many Vermonters we successfully transition from dependence on the system to economic independence) can’t be done overnight. It certainly can’t be implemented in time to solve the Legislature’s 2016 and 2017 budget problems. It will take time, but the work must begin now.
The state has proven that it is capable of major change in social services: It redesigned its entire Medicaid funding system; it implemented a waiver with greater flexibility of federal funds to allow seniors the option of staying at home instead of being mandated to go to more expensive nursing homes; and it enhanced services for foster children.
We simply cannot sustain our current system from a financial standpoint. It’s massive, complex and extremely expensive. Social service programs are growing faster than our ability to keep up.
We also owe it to Vermonters who need help to have a system that is sustainable and dependable. Cutting services for low-income and vulnerable Vermonters because we failed to examine alternatives — that may in fact prove more beneficial to them than the current system — amounts to a broken promise.
Getting Vermonters into programs and services they qualify for is only the first step on their journey. We have to break down the barriers of generational poverty, addiction and abuse, just to name a few, in order to provide these Vermonters a plan for independence and success in their lives. That’s what a functioning social services system should look like.
Therefore, we must rethink our current social service delivery system and how we define success. In some ways, the current system fails the very people we are trying to help.
Mike Smith was the secretary of administration and secretary of human services under former Gov. Jim Douglas. He is the host of the radio program “Open Mike with Mike Smith,” on WDEV. He is also a political analyst for WCAX-TV and WVMT radio and is a regular contributor to the Times Argus, Rutland Herald and Vermont Business Magazine.