Budget Summit: First Panel Discussion
Richard Licht moderates.
[9:24] Q to John Simmons of RIPEC. What’s happening in other states?
[9:24] Simmons: Rhode Island has acted much faster than other states in facing the fiscal crisis. Simmons is presenting some RIPEC “How we compare charts”…
[9:23] Simmons highlights “vendor payments” as a big RI budget driver, and that a lot of that is Medicaid.
[9:29] Interest payments on debt are also growing.
[9:30] RI’s ranking in revenues collected has dropped.
[9:32] Simmons: The major thing we have not done is make changes to the social safety net programs, particularly eligibility changes.
[9:33] Q to Lt. Governor Elizabeth Roberts: How should RI approach health and human service payments and delivery?
[9:34] LG Roberts: HHS numbers are comparible as percentage of the budget to other states.
[9:36] RI leads the country in percentage of private-sector economy in healthcare.
[9:37] We cannot only cut reimbursement rates and do nothing else, that will only shift costs.
[9:38] Constructive suggestions: 1. Continue investment in primary care services. 2. Include all Medicaid programs that involve this issue. Either 2a or 3, strengthen case management for Medicaid, improve transitions and reduce readmissions.
[9:39] Roberts: “We must save” but we shouldn’t think government is doing a worse health-care job than the private sector.
[9:40] Final point: Let’s not forget the importance of public health.
[9:42] Q to Anne Nolan, President of Crossroads RI: “Are there ways the not-for-profit sector can help us lessen the costs of the services we are providing”. “Is there a duplication of efforts?”
[9:43] Nolan: “This has been a very depressing morning”.
[9:44] There is misconception on the part of a lot of Rhode Islanders that we are a welfare-rich state.
[9:45] Our approach to social issues and people is too siloed.
[9:46] There is an opportunity now to relook at how we deliver services, including between the government and the private sector.
[9:47] My interpretation of what Nolan is saying: Rather than have different departments deliver a loosely bundled set of services to a person who needs help, government needs to look at the person as a whole and give them one point of contact, from where help can be coordinated.
[9:50] Funders have to take more responsibility, to have move effective spending of limited resources.
[9:52] Q to Ray DiPasquale, RI Commissioner of Higher Ed: Why can’t the back offices of RIC, URI, and CCRI be combined?
[9:55] DiPasquale: There is already back-office collaboration on things like purchasing, distance learning, IT.
[9:57] Presidents and vice-presidents of the institutions meet often, to discuss how they can educate all of their students, be efficient, and deal with the recent $40M in budget cuts.
[9:59] DiPasquale gives rationale for the Office of Higher Ed: It is the office that best allows RIC, URI and CCRI to work together.
[10:00] Tuition increases at this point would significantly impact access of Rhode Islanders to higher education.
[10:01] Q to Robert Flanders, Chair of the RI Board of Regents for Education: Same question as to Commissioner DiPasquale: How can cities get together to combine back office functions, as separate from educational functions?
[10:03] Same answer as DiPasquale: There’s lots of back office working-together either going on or being discussed, for example Aquidneck Island and the educational collaborative (and I can’t believe my spell checked actually recognizes “Aquidneck”).
[10:04] Plugs the idea of a statewide healthcare contract.
[10:06] We need to do a better job of keeping kids in school, and not having them turn out to be dropouts. That saves costs up the educational line.
[10:07] Better pre-school is needed, to help alleviate poverty and language problems.
[10:08] Basic math and literacy skills are needed for many of the jobs available right out of high school.
[10:09] DiPasquale: Out of every 100 RI 9th-graders, 73 will graduate. 40 of those will enter college. Only 21 will earn an associate or bachelors degree. 70% of students who enter college need one remedial course. About 50% will need two or more.
[10:13] Flanders: Effective teaching is the critical factor in raising the bar throughout the education system.
[10:14] Q from Licht to panel in general: Are there other ways we can save some money.
[10:15] Laughter then silence.
[10:16] John Simmons (addressing Anne Nolan’s concerns) argues for efficiency in the human services programs, which is different than just denying access. If we were as efficient as our neighbors, there would be tremendous savings.
[10:18] Anne Nolan: We need to think better, clearer and more effectively. And in some cases, we are going to have to spend more money, as an investment in the future.
[10:19] LG Roberts: We shouldn’t assume that managing the budget deficit will always do harm. Reforms can be implemented, to make programs more effective.
[10:20] Licht: “Government exists to serve the people of Rhode Island. It doesn’t exist to serve itself.”
[10:22] Ray DiPasquale: Extend commuter rail to URI. It will be an economic benefit for the state.
[10:23] Licht discusses the concept, possibly, of connecting to the Connecticut commuter rail system.
[10:24] DiPasquale: Get government, higher-ed, and business to work together at a high-level (the direct quote was “in a room”) to solve the state’s problems.