Senate Budget Writers Fund Medicaid But Not Childcare

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Committee Chair Sen. Gary Daniels, R-Milford


CONCORD — The Senate Finance Committee decided to use tens of millions of dollars in Health and Human Services money that will not be spent this year to increase funding for the Medicaid managed care program in the next biennium.

The committee also decided to use additional lapsed money to provide $8 million in transitional housing in the next two fiscal years, but voted down additional funding for childcare, increasing reimbursements to homeless shelters and money for family planning.

The committee discussed what to do about the Sununu Youth Services Center in Manchester and agreed it should be closed but not before the biennium ends and will reduce funding from current levels but will finalize its plan Wednesday.

The committee also discussed how to address unemployment compensation for employees of nonprofits after July 1 and also whether to move forward with a consultant proposed plan to move out-of-state placed developmentally disabled individuals to in-state facilities.

In budget deliberations Monday, the committee decided to increase funding for homeless programs by $3 million dollars but not a $20 million request that would increase youth outreach, rapid rehousing, eviction prevention and additional money for shelters.

State Sen. Cindy Rosenwald, D-Nashua, said homeless in the state increased 21 percent — including more than 300 school aged children in Nashua — before the pandemic hit and that has exacerbated the problem.

She said some shelters have struggled as the state reimburses them $7 dollars a day when it costs $47 a day to provide services.

Chris Santaniello, division director, said the proposal would increase rates to $27 a day, and began a program to help 18- to 24-year-olds obtain and maintain housing so they are not homeless.

The committee approved the $3 million increase on a 7-0 vote but voted down the larger proposal on a 4-3 vote.

“While I am happy to see the partial expansion of these programs,” Rosenwald said, “I am disappointed that my Republican colleagues’ support did not extend to increased funding for youth street outreach, rapid re-housing, and eviction prevention.”

Child Care

The committee also voted down adding $3 million for childcare under the protection and prevention program to help families that are under the division’s supervision or at risk of that.

Santaniello said the money would provide childcare to at-risk families or those under the division’s involvement whose plans require the child to be in a licensed child-care facility.

“Now more than ever, struggling families and children who are at risk for abuse and neglect need reliable support services,” Rosenwald said, “and we should be doing everything we can to keep these children safe.”

The money was voted down on a 5-2 vote, but the committee did approve a budget footnote that would continue a program begun during the pandemic that reimburses child-care facilities based on the number of children enrolled not on daily attendance. 

That would provide the facilities some financial stabilization, Rosenwald said.

Committee Chair Sen. Gary Daniels, R-Milford, noted salaries are going up as businesses search for people to work, and wondered how much help families would need with child-care costs.

In the past, low-income families have needed subsidized child-care, but with more and more people earning $15 an hour because of the labor market, they are more able to take care of their own childcare, he said.

Rosenwald said in Nashua to have a child in a licensed child-care facility costs about $15,000 a year, which is really expensive even if you are paid $15 an hour.

Sununu Center

The committee grappled with how to handle closing the Sununu detention center for delinquent youths and what level of funding would be necessary to keep it open for the biennium.

The House budget included the funding to operate the center for just the 2022 fiscal year, and some money to send residents to other programs while closing the facility beginning with the 2023 fiscal year.

Senate President Chuck Morse, R-Salem, said he believes the center should close but does not believe that will be possible in just one more year.

The current building environment would prevent having a new facility completed in a year, he said, and he supports a commission to study how best to proceed.

But Morse noted that currently the center costs about $1 million a year per detainee to operate.

He proposed about $11 million for the first year of the biennium and then a little less in the second year.

Daniels wondered if the program could be done by the private sector.

Joseph Ribsam, director of the Division for Children, Youth and Families, said the cost in the private sector is about $1,700 a day per child, which would not save much money.

He was concerned if the state contracted with one private facility and that did not work out, there would be no other options for the residents. That would not be a good policy, he said.

Vermont had a contract approved recently to house some of its young people at the Sununu center until their own facility is ready.

Rosenwald said the center’s budget has grown every year while the population has gone down. “At $13 million and 10 kids, we can find a better way to spend the money,” she said, noting “some of the same kids keep coming back.”

She was reluctant to move the closing date beyond the end of the next biennium. “If we don’t force the closure,” she said, “it will just keep going.”

Ribsam said part of the challenge is hiring and retaining youth counselors, noting there are not enough to cover all the shifts.

He said the average daily census is between eight and 18 and probably averages in the low teens.

The change in the continuum of care has slowly lowered the number of residents, he noted, and will continue that trend but warned against having no other options. He noted all the residents are required to be in a secure facility.

Several members of the committee will work on a proposal for the committee’s Wednesday meeting.

Managed Care

The committee agreed to a proposal to address a projected deficit of more than $20 million in general funds for the Medicaid managed care program during the next biennium.

The plan developed by Morse and committee member Sen. Erin Hennessey, R-Littleton, would use money the department appropriated but would lapse at the end of the biennium to make up the shortfall in that program and several others.

The change significantly reduced the amount of state general fund money needed to cover the increase in the Medicaid managed care program.

A similar use of lapsed money results in a plan for an additional $8 million for transitional housing.

The committee meets again Tuesday and expects to finish work on its budget proposal Wednesday.

Family Planning 

The committee voted down party lines, 5-2, to appropriate $400,000 next fiscal year to fund family planning contracts until federal funding is restored.

Garry Rayno may be reached at

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