Diabetes advocates bristle at loss of line-item appropriation for prevention in budget, but officials say money exists in base funding

04/24/2016 03:03 PM

Two former chairmen of the American Diabetes Association say Gov. Matt Bevin and legislative leaders erred in keeping a $5.2 million line-item appropriation out of the budget, but an official in Bevin’s administration says funds are included in the base appropriation to public health for diabetes prevention.

The dust-up emerged Friday after Stewart Perry and Larry Smith, both of whom also serve on the National Diabetes Volunteer Leadership Council, penned an editorial criticizing the budget’s apparent lack of funding for a diabetes services.

The $5.2 million line-item first appeared in the 2015-16 budget, Perry said in a phone interview with Pure Politics Friday.

“It is counter-intuitive to save huge amounts for the future and fail to spend a tiny sum on programs that can make those funds available for other needs,” they wrote in the editorial. “Failing to fund diabetes prevention simply means that more of those rainy day funds will be needed to pay future health care costs that might have been avoided.”

But Andrew McNeill, Bevin’s senior advisor, said money for diabetes prevention is included in the Department for Public Health’s base budget, which includes prevention programs for diabetes, colon cancer, heart disease, stroke and other illnesses.

“It looks like they decided for whatever reason not to put the language in there, but the money’s there in the Department for Public Health,” McNeill told Pure Politics Friday. “… That’s not uncommon for them to not list everything that is in the base.”

The General Assembly appropriated $10.2 million in state, federal and agency funds each year of the upcoming biennium for the department’s Prevention and Quality Improvement Program, which covers its disease prevention programs. That’s down from $11.7 million per year in the current budget as part of Bevin’s call for 9 percent budget reductions across many state agencies.

Funding for licensed diabetes educators increased in the upcoming budget, from $1,000 per year currently to $26,800 annually in the $21.5 billion two-year spending plan that takes effect July 1.

Lawmakers did not explicitly say how Bevin should spend those dollars in terms of diabetes prevention in the upcoming budget.

Jena Scott, a spokeswoman for Senate GOP leadership, said the $2.6-million-per-year line item for diabetes services was never discussed in the budget conference committee, and Rep. Rick Rand, a Bedford Democrat who chairs the House Appropriations and Revenue Committee, pointed to the $10.2 million annual appropriation for the Department for Public Health’s disease prevention program.

“We kept this as the governor proposed, and we hope the governor and his administration will continue to fund this important program,” Rand said in a statement to Pure Politics.

However, Stewart and Smith aren’t convinced that $5.2 million will go toward diabetes prevention in the upcoming two-year spending cycle as it had in the current budget.

Smith called the move to eliminate the line-item appropriation “a penny wise and pound foolish,” and he and other advocates plan to push for its inclusion in the next budget-writing session of 2018. Kentucky was the first state to enact a diabetes action plan in 2011, and others have followed the state’s lead on that front, he said.

“Getting it in the first time is usually harder than keeping it in, but now we’re back to square one and we have to fight to get it back in again,” Smith said in a phone interview Friday. “Most of the legislators that I’ve talked to are sympathetic to the cause. They understand the cost associated with diabetes and the chunk it takes out of the state budget, and so they understand that this makes sense. Prevention is easier than trying to find a cure.”

Stewart, who suffers from diabetes, worried that Kentucky would regress in its efforts to address the complications of and prevent diabetes if funding dropped. The state had the 12th-highest diabetes mortality rate in the country in 2013, according to data from the U.S. Centers for Disease Control.

He said he was shocked that the line-item appropriation did not appear in any iteration of the budget as it moved through the General Assembly.

“Diabetes is such a bad problem in the Commonwealth of Kentucky that I’m at a complete loss to understand how we go backwards with what we’re doing,” Stewart told Pure Politics.

“I’m a businessman, so I understand budgets, I understand tight wallets, I understand tight belts, I understand that we have a pension problem, but we also have a problem in Medicaid, we have a problem in the entire commonwealth with diabetes,” he continued. “It is over a $5 billion problem based on estimates that I’ve seen, and not spending money on a $5 billion problem is just foolish.”


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