• Special Report Main Page

By Maria Tsigas
Capital News Service
Wednesday, Jan. 22, 2003

ANNAPOLIS - Gov. Robert L. Ehrlich Jr. kept his campaign promises and made health care a priority when he released his proposed budget Friday, but he also cut funding in half for both tobacco prevention and cancer control programs.

More than 100 cancer funding advocates and survivors are expected to rally at Ehrlich's office this morning asking for restoration of $23 million for cancer control and anti-tobacco programs in the 2004 budget.

Taken as a whole, however, Ehrlich's health budget for 2004 rose by $379 million, a 7 percent increase from fiscal year 2003.

The governor's budget fully funds Medicaid, with an $128 million increase in fiscal year 2004. Mental health services, an area that has suffered under a deficit and repeated cuts, will receive a $36 million boost in 2004, and gain $30 million this fiscal year. Developmental disabilities services gained $38 million.

Ehrlich made health funding a priority because "serving the people who need it the most and helping the vulnerable and underserved of Maryland," is one of the governor's goals, said James C. "Chip" DiPaula Jr., Ehrlich's budget secretary nominee.

Some health care services that have been ignored in the past are getting their due.

"Mental health services is an area that has been crying out for aid. The dismantling of our public mental health system has made services less accessible in this state," said Sen. Paula C. Hollinger, D-Baltimore County, chairwoman of the Education, Health and Environmental Committee.

"Overall, we're extremely pleased with Governor Ehrlich's budget and the funding he's providing for mental health services. Governor (Parris) Glendening was not supportive of mental health services. He chose to put money into Smart Growth and higher education and was not very responsive to the needs of mental hygiene," said Barbara Bellack, executive director of National Alliance for the Mentally Ill in Maryland.

Maryland's public mental health care is in crisis, said Linda J. Raines, executive director of the Mental Health Association of Maryland. There is no room for cuts in Medicaid or mental health, she said.

Raines also praised Ehrlich for making mental health services a priority "right out of the gate," and keeping his campaign promise to issue an executive order stopping the practice of forcing parents to relinquish custody of their special needs children in order to receive services.

Ehrlich's executive order, signed on his second full day in office, establishes a council to find ways to keep families together in such circumstances.

Cancer funding advocates were not as effusive, but said they would work with the budget given them.

Cancer control programs -- colon, prostate, breast and cervical cancer screenings, for example -- were cut from $17 million for 2003 to $8.6 million for 2004. Tobacco-use reduction programs, including anti-smoking advertisements, dropped from $30 million for 2003 to $15.2 million for 2004.

"For a short-term savings, this budget will create a long-term nightmare and burdens the state's Medicaid system," said Charles D. Leiss, American Cancer Society's chief executive officer, in a statement.

"We anticipated severe cuts because of the condition of the state's deficit," said Arlene H. Stephenson, acting secretary of the Department of Health and Mental Hygiene.

Ehrlich was forced to close an estimated $1.7 billion budget gap when he took office last week.

The Department of Budget and Management worked closely with Ehrlich's transition team. "They listened very closely," Stephenson said.

The department's Cigarette Restitution Fund took a $30 million cut. The fund was established in 1999 as result of a national tobacco settlement with the states. Maryland lawmakers allocated $800 million to the fund, with $30 million/year for 10 years going to tobacco prevention programs and $50 million a year for 10 years going to cancer control programs.

The $30 million cut meant "we would have to put off some projects for a year," Stephenson said. That could include a million-dollar contract recently granted to a Washington research firm to evaluate the state's tobacco program.

"We looked at how we could spread the cuts across various programs. We tried to spread the pain," Stephenson added.

The director of the health department's Cigarette Restitution Fund Program, Carlessia A. Hussein, said, "We are clearly able to operate at these numbers."

Media counter marketing such as anti-tobacco ads are the type of programs that will be trimmed, Hussein said.

However, Kari Appler, director of Smoke Free Maryland, said the cuts may appear minor but could have long-term consequences.

"Prevent it now or pay for it later, in the form of disease," she said. The cuts are "very disappointing," she said, adding that the 2003 funding, $30 million, was the minimum required by CDC guidelines to run tobacco prevention and cessation programs. "It will be felt at the ground-level services," said Eric Gally, a contract lobbyist for the American Cancer Society and the American Heart Association. "People screened and treated in 2003, won't be in 2004."

Copyright © 2003, 2004 University of Maryland Philip Merrill College of Journalism