Commissioner: HHS needs more funding

HUDSON – Barely a year on the job, Health & Human Services Commissioner Nick Toumpas said he’s already concluded the state’s largest agency cannot survive with the status quo.

Toumpas said that later this month he would recommend to Gov. John Lynch that his agency needs nearly a double-digit increase in state spending over the next two years just to tread water.

In the past, predecessors have found the rising cost of payroll, health insurance and retirement spending push even a so-called maintenance budget up 6 percent to 8 percent more a year.

“It will be on the upper end of that,” Toumpas said during an interview with The Telegraph editorial board Monday.

“I have to first deal with reality, get the governor and Legislature to see it and then agree that we can’t keep doing the status quo.”In mid-October when Toumpas suggests how much the agency should get in what’s known as a change budget, the increase will appear alarming, he continued.

“It will be a lot more than I know we will be able to get, but I feel I have to put that on the table. It’s going to be an incredible challenge for us,” Toumpas said.

New Hampshire government spends $3.2 billion in state dollars for the two-year cycle that ends June 30.

HHS consumes 45 percent of state spending and even more than that from total sources because the federal government pays nearly 60 cents for every $1 the department spends.

A public policy think tank has warned the state faces a structural deficit over the next biennium of at least $170 million and as much as $450 million.

Toumpas said the state’s declining economy has caused welfare and food stamp caseloads to climb up and the revenue supporting agency spending to come crashing downward.

A year ago, Toumpas took over the agency when Manchester Republican John Stephen stepped down to make an unsuccessful primary bid for Congress.

Lynch named Toumpas as commissioner in January.

While Toumpas faces rising costs, Lynch has directed all agency heads to propose how they would survive with 3 percent less money in 2010 than they have this year and a 2011 budget that equals and does not exceed 2009.

“Clearly, we are going to have to build a budget based on less than what we have right now,” Toumpas said.

He’s convinced three stakeholder councils to explore innovation in the three major areas of his agency – health and medical, long-term care and human services – that is the only way over time to make fundamental reform that makes the agency more efficient.

A former business executive, Toumpas would not offer much detail, as some of his ideas for systemic change are just preliminary.

One is likely to involve paring down the 12 district offers that deliver a myriad of human service benefits to citizens.

Toumpas notes an alphabet soup of state office spaces that he saw driving throughout the state.

“I’d drive by a DES (environmental services) building, then a DMV (motor vehicles) substation, then Employment Security, then DOT (transportation), a DRED (resources and economic development) and then one for Health and Human Services,” Toumpas said.

“Do you need to have all of them and can we centralize our delivery of services as a state government?”

Toumpas would like to create a “virtual front door” so that citizens who visit a city or town hall, anti-poverty agency, community health or mental-health center can at the same time apply for state benefit programs.

“Long term, this is not an optional type program,” Toumpas concluded.

“This is something we need to do.”