After the struggles last spring to balance the state budget, we are now faced with predictions of an even bigger gap this coming year. The governor is asking department heads to cut 10 percent from their funding requests for next year. With Wall Street in turmoil and a national economic slowdown in progress, it seems a safe bet that there will be no letup in the pressures that have strained Maine’s ability to provide basic public services in recent years.

As the Baldacci administration prepares the next two-year budget, we have valuable lessons to learn from recent policy decisions. Our present situation could have been even worse. The current budget contains a number of creative changes in the way the state does business that save money without creating hardship for our most vulnerable citizens.

In response to never-ending pressures to trim or cut back, all too often Maine’s budget debate has dealt with only the bottom line. By focusing instead on how we can better provide services, improving program quality while controlling costs, the budget debate can focus on positive steps that should be done in the best of times. The reforms Maine has recently embarked on in the children’s behavioral health system, as mental health services are now known, is an excellent example of creative and effective public policy

At the Maine Children’s Alliance, we believe the state has not always provided the most effective or most efficient behavioral health services. We have considerable experience in setting evidence-based standards and, as a result, have extensive knowledge about what treatments work best. As the Maine ombudsman for child welfare services, I work with the state to ensure that children who are abused or neglected receive appropriate care without exception.

In many cases, better care can also be less-expensive care. Previously, the state provided standard reimbursements without a precise standard of what care would actually be offered. Under the new system, providers must specify treatments, and those who can provide better care are rewarded accordingly.

We’ve also learned that not all standard treatments are effective. As with other kinds of health care, a relatively small number of cases represent a majority of costs. So it makes sense to examine each treatment plan for effectiveness.

For example, not all children benefit from individual counseling, so such care should not be routine. Other help may be more effective.

Similarly, the state has generally paid for recreation services for foster care. Some kids who receive these services say they’d prefer recreational opportunities just like other kids.

These changes may sound simple, but they have resulted in major shifts in the relationship between the state and providers, most of them small, nonprofit agencies. Providers have had to change quickly, and this has placed new and unfamiliar burdens on them. While these changes have proved effective, the state must be careful that its expectations do not exceed caregivers’ ability to adapt.

We have moved from a cost-based system, including widely varying hourly fees, to a standardized schedule, as we did much earlier for providers such as dentists and primary care physicians.

It has not been easy, yet the changes are worth the effort. By emphasizing outcomes for each child and better care management, we can provide a much sharper focus for choosing services and measuring their effect.

In the early years, savings from behavioral health changes have been relatively modest, but they should become substantial over time. These changes will benefit the state as well as the thousands of families who depend on these services now and the families who will need them in the future.

Earlier budget policies were not fiscally sustainable, and these strains will only increase without strategic reform. No one likes cutting services to vulnerable young citizens, but what we have learned is that there is a better, smarter way to do what’s needed.

Applying consistent guidelines and equalizing provider rates will help us live within our means and still meet the needs of children. By replacing a cost-based system with one that emphasizes quality care, we help children while creating the accountability that legislators rightly demand.

By revamping its core programs, Maine can invest the resultant savings in the future well-being of kids. Assuring that our children can grow into healthy adults is as important to economic development as traditional initiatives for infrastructure, research and development and higher education. By taking care of our kids, we end up improving the future for all Mainers.

Dean Crocker is the state’s ombudsman for children’s services. He is also vice president for programs at the Maine Children’s Alliance.