Well kids, looks like we’re in for the Full Monty – the full 80 days of legislation. History in the making. Wish I could say there is a good reason for this, but quite honestly, I’m just not seeing one. What we do have is a relatively small number of bills remaining that need to be ironed out – and all deal with money. So, of course, the posturing to control not only where this money goes, but how much, is very much driven as much by politics as by need – and of course, the ever important, who will receive credit. On one bill we hear “no, we just can’t fund” this, that or the other thing because the budget alignment is seriously out of whack – and then in the next we hear from the very same sources that the money is not only there, but warranted. Bizarro world? Or, maybe less than stellar leadership…. Hmmmm.
A stunning example of this played out last Thursday morning when SB 2024, the Tobacco Control budget, came to the floor. The Tobacco Control Advisory Committee is not a particularly popular entity in Bismarck, but it was initiated by a vote of the people and must be funded. A core group of the majority wanted to send a signal of disapproval on this budget and choreographed for a narrow win – but unfortunately underestimated the vote and lost the budget by two votes. Not cool when it must be funded. That afternoon it was brought back to be reconsidered, but lost the bid for reconsideration. Ultimately, with three times being the charm, it was brought back for reconsideration Friday morning at which time it finally passed. Quite the drama to make a pointless point.
While some of these larger budget items continue to be duked out, we did find a few smaller (but no less important) bills, such as SB 2354, move forward. This one deals with the dentist loan repayment program and has a total of $180,000 appropriated for the program. Dentists are not required to accept Medicaid reimbursements, which creates a real problem in terms of getting affordable dental care to the poor and low income population. The program is structured to provide a tuition reimbursement incentive to dentists willing to serve a three year commitment providing dental care on a sliding fee schedule in either a public or non-public health setting.
There was great debate as principal, policy and need struggled against the singular wisdom of the House Appropriations that was bent to cut the funding by a third. The success of the program has ample evidence to back it up: The average starting salary of a public health dentist is at least $30,000 less than in the private sector; public health clinics see between 25 – 40% Medicaid patients; there are a total of three community health centers and two non-profit dental providers in North Dakota; there are a total of 12 dentist posts available- but are currently down by seven. The need: In 2012 a total of 31,173 services were provided in North Dakota. In the end, facts and common sense won the day and the program passed fully funded.
On another front, with all my conference committees completed, I found myself stalking several bills of particular interest as they made their way through conference committees. HB 1422 was one of these and is related to stabilizing child care in North Dakota. Lack of child care is a monumental problem that is quickly becoming catastrophic as the impacts affect families, providers and employers across the state. 1422 started in the House Human Services committee in January as a $15 million appropriation to subsidize providers and train staff… needless to say, this was a less than welcomed approach for the House – funding was slashed to $2.1 million and regulations were radically reduced. The Senate was not inclined to accept these changes… replaced the House funding with $6 million and returned most regulations.
Following the conference committee, it was clear the discourse between the House and Senate versions were heading toward a cliff as discussion and concessions found little ground. Until Friday. On this afternoon an epiphany occurred – undoubtedly with the aid of some very intelligent and creative minds in the Department of Human Services. The outcome was quite brilliant in that it included much of the key components originally hoped for, in a much more concise and accountable manner.
The new program will provide $1 million (in addition to an existing $3.1) grant funds for the retention and technical assistance of providers, $300,000 for funding early childhood services specialists (for special needs children), and $2.5 million in child care financial assistance for parents. The last is tied to federal grant money that is currently available through DHS and is a contingency appropriation in the event the federal funds are either inadequate or unavailable. The parental assistance is based on income levels, but at 85% of the state median income, should provide much needed relief to families struggling to keep up with the cost of child care, while simultaneously allowing providers the ability to create a better cash flow structure for their business. Since funding is tied to federal money, the entire package was far more palatable and passed both the House and the Senate in the same day.
The moral of the story? That in the mix of it all, there are some good things being done when politics are set aside for the good of what is needed. I think many of us wish it happened more frequently as we’d become not only more efficient, but more effective as well.
And now, off to the finish line… ‘Til next week, hoping you’ll find warmth and sunshine in the days ahead!
Representative Gail Mooney
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