Gov. Paul LePage recently unveiled his state budget proposal for fiscal years 2016 and 2017. The two-year budget is the blueprint for state government; the most important bill the Legislature will pass in a term.

From the day LePage took office, the Department of Human Services has faced monumental fiscal challenges, most of them stemming from years of decisions to expand welfare eligibility to more and more non-disabled, working-age adults. The hospitals were owed $500 million, health care providers were being shortchanged by Medicaid, and nine-figure budget shortfalls were the norm.

As a result, headlines over the years have alerted Mainers about lawmakers scrambling to fill a DHHS-induced budget shortfall.

This time around, however, they’re not.

That’s because with LePage’s leadership and Commissioner Mary Mayhew’s sound management, spending at the agency that makes up about half of state government has been reined in. As a result, the department is finally able to focus on its core mission of helping Maine’s most vulnerable elderly and disabled citizens.

From 2001 to 2011, MaineCare, the state’s Medicaid program, doubled in enrollment to a high of 354,000, which was at the time half again higher than the national average relative to our population. We’ve tightened eligibility so that today, 291,000 Mainers are enrolled, and we are finally equal to the national average for Medicaid enrollment as a share of population.

After doubling in cost in the decade before LePage took office, Medicaid spending has been held virtually flat over the past few years, and DHHS is using a new budget forecasting method to accurately predict future spending and prevent the legislative scramble to close a last-minute shortfall.

So what does this mean for the average Mainer, besides rosier headlines?

For the one-third of Mainers who rely on DHHS’s services, it means new priorities. I am very impressed with the proposal that LePage and Mayhew have put forward. It will be thoroughly reviewed by the Legislature, but this is already a fantastic set of proposals.

The budget identifies more than $100 million in spending reductions to pay for a roughly equal amount in initiatives to help the neediest Mainers who were left behind by Maine’s old welfare system, all while keeping the budget balanced.

I have been an outspoken advocate of providing home care services to elderly and severely disabled Mainers currently on waitlists. This budget proposal puts $46 million toward accomplishing that goal. We’re talking about people with brain injuries, children with severe autism, or elderly Mainers who want to age at home but just need a little help.

The proposal also increases funding to nursing homes, especially rural facilities, by $24 million. Medicaid has significantly under-reimbursed nursing homes for quite some time, leading to closures such as the one in Pittsfield last summer, which put 66 people out of work. At that home, 90 percent of the residents relied on Medicaid, the home was underwater financially because of low reimbursement rates.

The budget also maintains funding for the Health Homes initiative to move Medicaid recipients toward preventative primary care instead of costly emergency departments, and continues a heightened reimbursement rate for primary care providers seeing Medicaid recipients.

I am especially pleased to see the resources dedicated to mental health in this proposal. The budget provides $14 million in funding to provide services through a comprehensive mental health system as required under the 1990 Augusta Mental Health Institute consent decree, and adds 12 new acuity specialists at Riverview Psychiatric Recovery Center in Augusta.

Several of the savings initiatives will have my support, including restructuring General Assistance welfare reimbursement to cities and towns to provide a larger match up front and a smaller match after a threshold, instead of the other way around. This eliminates the kind of incentive that led state General Assistance spending to grow from $5 million in 2003 to $13 million last year. It saves $11 million while actually turning out to be a better deal for smaller cities and towns.

By eliminating welfare benefits for non-citizens, we save $4 million. By repurposing $20 million from the Fund for a Healthy Maine, we increase access to primary care providers and improve real health outcomes instead of watching the money disappear to an army of nonprofit advocacy groups.

In all, LePage and Mayhew have crafted not just a budget for DHHS, but a vision for the department’s future. It’s a vision that finally values fiscal responsibility while ensuring that scarce resources go to the truly needy instead of to more able-bodied adults, and it’s a vision that I share.

Rep. Deb Sanderson, R-Chelsea, is the ranking House Republican on the Maine Legislature’s Health and Human Services Committee.

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