Agency of Human Services budget largely maintains current services while adding substance-use pilots and shelter annualization

Secretary, Agency of Human Services outlined a 5.81% budget increase for the agency and said 5.34% of the state's general fund would support current services at a legislative budget briefing. The presentation said the agency employs 3,835 people and that overall staffing rose by 0.2% (about six positions).

The budget, the Secretary said, is primarily a current-services package that converts multiple one-time federal and state investments into ongoing funding, preserves shelter expansions initiated with one-time dollars, and directs modest new funding toward gaps in the substance-use continuum of care and primary care. The Secretary summarized the choice facing the agency as addressing structural issues in provider networks rather than immediately increasing rates across the board: "we chose to move forward with working to address structural issues rather than pull back services," the Secretary said.

Key fiscal and program details included a $51,000,000 gross Medicaid consensus increase driven by utilization; a reported 0.2% net growth in agency positions (about six positions); and the movement of several programs from one-time to base funding. The briefing cited a favorable Federal Medical Assistance Percentage (FMAP) adjustment that reduces general fund need by about $16,200,000. The Secretary also said the state has put more than $212,000,000 into provider rate increases in the last two to three years.

Substance-use investments: The administration identified the substance-use continuum as a priority and proposed both base and one-time investments. A $1,300,000 investment is intended to create a 15-bed recovery campus model that pairs recovery housing with intensive outpatient services and wraparound supports so people can live and receive treatment in a single setting. The administration also proposed a short-term pilot to convert part of a correctional facility into residential-level treatment, funded with one-time dollars for planning and a single quarter of implementation. The Secretary said medication-assisted treatment (MAT) is widely used in correctional facilities and that MAT remains voluntary: "It's always voluntary," the Secretary said, describing MAT as a stabilization tool that should be paired with treatment.

Shelter and homelessness: The briefing confirmed that last year's temporary shelter expansions, funded with one-time dollars and run by community organizations, are being moved into the base to remain year-round. Committee members noted and welcomed a $3,300,000 annualization line for shelter expansion; the Secretary said the Department for Children and Families will provide location-level details in its department presentation.

Primary care and other gaps: The presentation flagged a near-term primary-care funding shortfall as the state loses several one-time funding streams and payments from ACOs, Medicare programs and pilots. The administration proposed $10,800,000 to help fill part of that gap, preserve the SASH program in the gap year, and sustain mental-health integrations in primary care initiated under earlier pilots.

Other items: The budget moves mental-health urgent-care alternatives to emergency departments from one-time to base funding, continues PCB testing funded through the Department of Health, and expands a pretrial supervision pilot into an additional county for further evaluation. The Secretary described efforts to work with financially stressed community providers through an extraordinary financial relief process that includes book reviews, sustainability plans and targeted funding; that work uncovered structural issues such as duplicated administrative functions, workforce shortages and facility costs that the administration wants to address alongside targeted rate or methodology changes.

Committee exchange and next steps: Representative Bartlett pressed why designated agencies and home- and community-based services were not included in broader rate increases; Representative Bartlett asked, "how can that not include things like designated agencies, home and community based services?" The Secretary replied that mandated rate increases required by statute or federal regulation are being implemented, while other provider funding will be addressed through structural interventions and targeted adjustments. The Department for Children and Families was scheduled to follow with more detailed, location-specific information on shelters and program annualization. The committee indicated it will continue department-level review in subsequent sessions.