Virginia's powerful House Appropriations Committee today adopted in principle a tight $3.25 billion human services budget that does little to soften the blow of federal budget cuts.
But on Medicaid, which has become one of the state's most pressing financial problems, the panel indicated it will seek key concessions from the Robb administration to restore health aid to an estimated 3,000 medically needy children and to win some control over the impact of the cuts on hospitals and nursing homes.
The Appropriations Committee, now entering the final stages of its budget process, had little room this year to make wholesale changes in the human resources budget left to it by former Gov. John N. Dalton.
The state's new Democratic governor, Charles S. Robb, gave the panel a clear message last week that he does not intend to seek a general tax increase, and that message was not lost on the subcommittee that prepared today's report. "This assignment you've given us this year is certainly one of the stickiest anybody's ever been left with," said subcommittee chairman Dorothy S. McDiarmid (D-Fairfax), as she turned in a report that could only rearrange priorities set in Dalton's budget document.
The full committee accepted McDiarmid's report by a consensus agreement and with little discussion. It included recommendations to accept a Robb package that would save the state an estimated $45 million in Medicaid funds over the next two years, including proposals to:
* Continue medically needy coverage to approximately 24,500 aged, blind and disabled Virginians who Dalton had proposed purging from the state's welfare rolls;
* Continue Medicaid funding for nursing home patients regardless of their monthly incomes. Dalton had proposed denying Medicaid to patients whose incomes exceeded $500 a month. Public outcry later had forced him to soften that proposal with a recommended income cap of $875 monthly;
* Discontinue coverage for medically needy and categorically needy individuals ages 18 to 21, at a savings of $4 million over the next two years;
* Institute a system whereby medically needy people would pay for a portion of their state-supported medical treatment, at a state savings of $1.9 million over the next two years; and
* Discontinue all medical coverage for parents of medically needy dependent children except for prenatal and delivery services, at a state savings of $12 million over the next two years.
But the subcommittee report rejected Robb's recommendation that hospital services for medically needy children be discontinued. It also balked at a Robb proposal urging that the governor alone should be charged with the responsibility of revising reimbursement systems for hospitals and nursing homes, an area in which committee members hope to make up some $77 million of an expected $122 million Medicaid shortfall.
"We didn't want to exactly give him a carte blanche on that," said Del. Arthur R. (Pete) Giesen Jr. (R-Augusta). "That was our biggest reservation."
It is not known exactly how the subcommittee arrived at its decisions on the Robb Medicaid proposals. Subcommittee members, who met briefly to hear a report on the matter by Human Resources Secretary Joseph L. Fisher late Sunday afternoon, convened again in a private session later that night in a secluded photocopying room in a corner of the maze-like General Assembly building.
It was there, with only the subcommittee members and one aide present, that the final recommendations were hammered out. "It was a work session, and in that respect there was a desire to do things on a quiet basis," said Giesen. "We weren't trying to be devious."
The human services budget will not be considered until the committee begins work on the entire $13.15 billion bi-annual budget, but committee aides said they expect to see few changes in it.