SANFORD — Those who provide health care, early childhood education or services to the developmentally disabled are among a host of providers eyeing proposed cuts in the Department of Health and Human Services supplemental budget.
And while more details are expected to emerge in the next few days, some agencies are trying to figure out how their clients ”“ and how many of them ”“ will feel the impact if the proposal is passed in its current form.
Gov. Paul LePage, citing a DHHS shortfall of $120 million next year, and $110 million in 2013, is proposing a series of changes in a number of MaineCare (Medicaid) programs, including restructuring eligibility for some programs, redesigning benefits and moving MaineCare (Medicaid) benefits closer to the national average.
In York County, an estimated 250 of the 2,000 clients who receive health care at the Community Health Center operated by York County Community Action will lose coverage, along with 125 patients who receive dental services under the oral health subsidy of the Fund for Healthy Maine program, said YCCA Executive Director Barbara Crider.
As well, about 30 families will be removed from the Head Start program that serves about 270 families, she said.
Those figures are an “educated guess” right now, as Crider and others, like Waban Projects Executive Director Neal Meltzer, wait for more details to emerge. Public hearings on the proposal begin Wednesday. In the meantime, Meltzer said it appears there may be cuts in some adult case management services, but the language of the proposal is vague. About 3,000 developmentally disabled adults statewide receive community case management services, he estimated.
“Clearly, the governor is doing what he has said all along ”“ what he felt we need to be doing to be aligned with federal services,” said Meltzer. “Let’s be candid, there’s a big hole in the budget.
“These are tough times,” Meltzer said, “and those on the lower end of the socio-economic scale tend to get impacted more ”¦ but isn’t that when people need (services) most?”
Crider said the numbers she cited are related only to the programs YCCA runs directly.
“The harmful impact will be felt by thousands of our clients ”“ especially elders, who are already hard pressed to pay for heat and buy their medicine,” she said.
The proposal, as it currently stands, repeals coverage for about 19,000 childless adults, about 7,000 19- and 20-year-olds, 30,000 parents of children on MaineCare, and restructures eligibility for some elderly citizens in private non-medical residential settings. Vision, chiropractic, dental, occupational therapy, podiatry and prescription drugs for the elderly, adult family care, smoking cessation and a host of other benefits would be redesigned. The plan reduces payments for some crisis services and hospitals, among other payment reforms.
LePage, citing a 78 percent increase in MaineCare enrollments since 2002, said the number of Mainers receiving taxpayer funded healthcare is 35 percent higher than the national average and figures prepared by DHHS show that federal reimbursement has decreased from about $3 for every $1 Maine spends to about $1.67.
In a news release issued Monday, LePage said that current money is being borrowed from fourth quarter allocations (the state operates on a fiscal year) to pay for services within the Medicaid program today.
“We will be out of money on April 1st if we do not address this once and for all,” said LePage. “Federal funds have dried up. We are no longer receiving hundreds of millions of dollars of federal stimulus money to cover the expanded Medicaid program.”
Sen. Jon Courtney, R-Sanford, said he finds the situation “frankly, frustrating.”
“You budget and make assumptions and assumptions in DHHS always seem to be off,” said Courtney in a telephone interview last week. “I don’t think anyone feels good about it. We’ll deal with it in a thoughtful, pragmatic process. We’ll do our best to minimize the pain.”
Meltzer, of Waban, said he hopes the discussions in Augusta will go well.
“I truly hope there will be able to be non-partisan legislative discussion and vigorous debate,” he said, adding that the social service community will advocate fiercely for those they support.
— Senior Staff Writer Tammy Wells can be contacted at 324-4444 or twells@journaltribune.com.
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