Wednesday November 28, 2012

CONCORD, N.H. -- New Hampshire’s biggest agency asked Tuesday for $321 million more from state tax sources in the two-year state budget Gov.-elect Maggie Hassan must present to lawmakers in February.

Health and Human Services Commissioner Nicholas Toumpas testified at a hearing on the request that one of the biggest increases is due to a change in how the state pays nursing homes for Medicaid care. He said the state now must pay nursing homes based on rates, not on what lawmakers budget to spend.

Toumpas is requesting a 25 percent increase in the portion of the agency’s budget that’s supported by state tax sources. It would increase the funding to $1.6 billion from the current two-year appropriation of $1.3 billion.

The agency’s current total budget is $3.7 billion, most of which from federal funds.

"The department -- like all state agencies -- is in the middle of a storm," Toumpas said.

He said people continue to seek help from the state as a result of the recession, but the numbers have leveled off in all but those needing food stamps. About 25 percent of those who apply for the federal food help are rejected, but the state must provide the staff to make the determination regardless whether they are denied, he said.

Overall, the number of caseloads has risen 15 percent since July 2009. At the same time, the number of filled jobs at his agency dropped 15 percent, he said. In addition, key members of the staff will be eligible for retirement soon, he said. That has caused stress on the staff, he said.

Toumpas said he knows the state has limited funds to provide services to everyone who is in need and promised to continue to try to find savings.

He said he included money cut from the current budget to boost payments to hospitals caring for the poorest residents. Ten hospitals sued over the budget cut in a case still pending in federal court.

Toumpas said a managed care program for Medicaid that was supposed to save $15 million in the current budget still is not operating due to slow negotiations between contractors and the health care providers needed to build a network.

On Monday, Hassan opened the budget hearings with a caution that agency requests are unrealistic. Agencies requested $3.3 billion in spending from state tax sources -- a 26 percent increase over the current budget -- and $11.9 billion from all funding sources or a 19 percent increase.