LBB recommendations

We’re still waiting on the Pitts “You’re gonna get it good and hard” budget, but until then the Legislative Budget Board has released a list of recommendations for savings, which you can see here, that’s worth reviewing. There’s some good stuff here, so let me go over a few highlights.

Things I like:

—  Require electronic banking for state business. Replace paper checks with direct deposit for all state employees and others who receive regular payments from the state.

—  Strengthen regulation to improve food safety. Coordinate food safety regulation between the four main agencies involved to cut down on the six million cases of food poisoning reported each year in Texas.

—  Tie the August sales tax holiday to budget conditions. This would save $111.8 million by canceling the sales tax holiday in August 2011 and 2012 and by then conditioning it on the health of the state budget. If the state has a surplus in 2013, there would be a holiday, and if available revenue for the 2014-15 budget — the one that’ll be written in two years — is greater than available revenue now, then they can have the holiday then, too.

—  Repeal restrictions on Sunday liquor sales. Getting rid of the state’s ban would increase revenue from state alcohol and sales taxes by $7.4 million. Texas is one of 14 states that don’t allow hard liquor sales on Sundays.

—   Lose the exemption on hotel taxes for permanent residents. Hotels don’t charge occupancy taxes on people who stay for 30 days or more. If they did, the state would bring in another $16.1 million in taxes every two years.

—   Reform how health care is delivered and paid for to reduce costs. The LBB suggests legislation that encourages Texas health care providers to try out new payment and delivery models, and to consider using bundled payments in the Texas Medicaid program. The LBB recommendations also seem to suggest lifting — at least in part — the ban on the corporate practice of medicine, or hospitals hiring doctors.

—   Expand Medicaid managed care into South Texas. The LBB suggests lifting the ban on Medicaid managed care in the Rio Grande Valley, which has been offered by the Health and Human Services Commission as a potential cost-saver.

—   Reduce Medicaid patients’ reliance on emergency rooms. The LBB says redirecting patients with non-emergency conditions from the ER to a clinic could save $184.2 million a year. They suggest physician incentive programs, making urgent care centers Medicaid clinics, and encouraging Medicaid managed care to put tougher restrictions in place.

—   Continue and expand the Medicaid Women’s Health Program. Expanding a program that uses preventative screenings to avoid pregnancy-related Medicaid costs would save $3.8 million in the next biennium, the LBB says.

—   Allow advanced practice nurses to prescribe certain drugs. The LBB says advanced practice nurses are poised to ease Texas’ physician shortage, if the state allows them to diagnose and prescribe in some capacity. The cost to patients would be less too, LBB argues.

—   Establish a supervised re-entry program to reduce costs and improve efficiency. The LBB is recommending that lawmakers consider closing one or more prison units. That’s a big deal, because tough-on-crime Texas has never closed a prison. The board says the state could save up to $33 million in the next biennium if the Texas Department of Criminal Justice does a better job of helping released prisoners stay out of the big house, reducing prison population.

—   Eliminate statutory barriers to contain costs in correctional managed healthcare. The LBB says the state could save about $1.2 million in the next biennium by improving health care processes in prisons, like prescription drug distribution and dialysis treatments, and by allowing more really sick and really old prisoners out under the Medically Recommended Intensive Supervision Program. The LBB says in fiscal year 2009, 74 offenders died while awaiting review for medical parole.

— Implement a fuel inefficiency surcharge. In 2010, Texans bought nearly 566,000 cars with less-than-efficient fuel ratings. The LBB says adding a $100 surcharge to the purchase of new vehicles with poor fuel efficiency could raise $115.3 million over the next biennium.

That last one may be my favorite of them all. My only objection is that the surcharge should be higher – I’d plump for $1000, which in the context of buying a bigass truck or SUV isn’t that big a piece of the sticker price. And I say this as someone whose last automotive purchase would undoubtedly have been subject to this. (But not my next one!) Beyond that, lots of other worthy suggestions, all of which I hope receive support in the Lege.

Things I don’t like, or at least am dubious about:

—  Consolidate the state’s poison control centers. There are six now; merging them into one would save $2.6 million annually.

—  Raise prices for storing documents for local governments. The state’s archives aren’t covering their costs with current pricing, and doing so would cut $1.6 million from state spending.

—  Charge state employees for parking in state garages. The state could bring in $5.5 million every two years, the LBB estimates, if it charged state employees as it now charges visitors who don’t work for the state.

—  Cut state contribution to state employee insurance plans. This would save the state $298.1 million in the next biennium by shifting health insurance costs to employees or by keeping those contributions level and lowering benefits under those plans.

—   Charge state retirees extra to keep current health benefit levels. The state could save $95.5 million if it charged retirees to pay part of their insurance premiums based on their years of service, and if it lowered the state’s subsidies for those retirees’ dependents to 40 percent of their premiums (it’s 50 percent now).

—  Increase the state traffic fine to improve traffic safety. Texas could gain about $53 million in general revenue and another $31.7 million in dedicated general revenue over the biennium by increasing the state traffic fine. Already, Texans found guilty of a traffic violation pay a $30 traffic fine to the state in addition to whatever the cost of the citation is. The LBB recommends ramping that fine up to $45.

—  Improve traffic safety by banning the use of wireless communication devices while driving. This ought to make state Rep. Jose Menendez, D-San Antonio, happy, since he’s tried session after session to ban cell phone use while driving. The LBB says Texas could save lives and generate about $2.3 million by making it illegal to use your mobile device while driving, and also making it an offense under the much-maligned Driver Responsibility Program.

The poison control merger may be all right, but given recent history, I’m highly distrustful of such things. I would oppose anything that increases costs on local governments without strong assurance that other budget actions will not simply transfer state expenses to localities and call them “savings”. I think more work needs to be done on revamping the Driver Responsibility Program before any fines should be increased; while I don’t oppose a texting-while-driving ban, adding anything to the DRP is something to be very skeptical of. I realize that the insurance items are big tickets, but imposing them on top of furloughs is putting a lot of the burden on state employees; charging them for parking is just insult to injury.

Things I think are hilarious:

—  Steer veterans to benefits that aren’t state-funded. Use national public assistance databases to make sure veterans in Texas aren’t using Medicaid — which costs the state money — for benefits that are available from veterans programs that don’t use state money.

—  Maximize the federal funds Texas receives for transportation. Texas could get more than $223 million from federal transportation dollars if lawmakers changed some laws to improve the transportation planning process and the coordination among transportation-related agencies, according to the LBB.

We hate the fascistic, freedom-killing federal government and its evil, filthy money, except when they help pull our budgetary fat out of the fire. Then we can’t get enough.

Those are my off-the-top-of-my-head thoughts. What do you think?

Related Posts:

• Here’s the official budget forecast
• Bill filing deadline has passed
• What will the excuse for austerity be now?