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Few government department heads come better prepared to handle the often contentious battles over state spending and budget cuts than Steven M. Costantino, entering his second year as secretary of the Rhode Island Executive Office of Health and Human Services.
The former chairman of the House Finance Committee recently told Providence Business News he views his new role as leading the transformation of government agencies to “break down the silos and firewalls that interfere with the development of a seamless system of care for the individuals that we serve.”
The five agencies that he oversees – the Department of Children, Youth and Families, the Department of Elderly Affairs, the Department of Human Services (which oversees Medicaid programs in Rhode Island), the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, and the Department of Health – have often been at the center of the annual budget debate.
Disabled Rhode Islanders and their caregivers have protested $24 million in cuts to programs serving those with developmental disabilities. Efforts to pursue “rate reform” – to pay nursing homes one rate for services, based on price, not cost – have met with angry words from critics such Leading Age RI, the advocacy group for nonprofit nursing homes. DCYF, despite efforts to streamline its services, has already overspent its fiscal 2012 budget by a projected $7.8 million, leading to a testy exchange between current House Finance Chairman Helio M. Melo, D-East Providence, and Administration Director Richard Licht at a Jan. 16 hearing.
In the coming months, as the fiscal 2013 state budget is debated, there are certain to be more flash points – such as the proposal by the Department of Human Services under Costantino to eliminate dental services for adults on Medicaid, a budget cut that would save $2.6 million.