health and family Services

Beshear proposes more money for child protection and substance abuse treatment

Additional $21 million proposed

bmusgrave@herald-leader.comJanuary 18, 2012 

FRANKFORT — Gov. Steve Beshear proposed Tuesday spending an additional $21 million to decrease case loads for frontline social workers and asked for additional money for substance abuse treatment for adults and adolescents.

Beshear's two-year, $19.4 billion budget proposal also spares several social services programs from cuts, including Medicaid, the state's community mental health centers, behavioral health, child protection and other keys areas of the Cabinet for Health and Family Services.

However, most other programs in the cabinet — public health departments, nursing home inspectors and a commission that oversees treatment for children with chronic health care needs — will receive an 8.4 percent cut, Beshear said Tuesday. The Department of Aging and Independent Services, which runs programs for seniors, would be cut 6.4 percent.

It's not clear how the cabinet will implement those cuts and what services will be affected. Those details are likely to be released when Beshear's budget bill is filed in the next few days.

Sheila Schuster, who advocates for the mentally ill and on other health-related issues in Frankfort, said Tuesday that all the publicly supported social service agencies — public health clinics, domestic violence shelters, rape crisis hot lines and services for the disabled — are hanging on by a thread. Those that have not been cut have not received any additional money in years, although need for services has only increased.

"The bottom line is the safety net providers are in shreds," Schuster said. "There really is no safety net."

Kentucky AARP members were dismayed Tuesday that the Department of Aging and Independent Services would be cut. There are 19,000 people on a waiting list for in-home services for seniors, including more than 8,200 waiting for meal services such as Meals on Wheels.

"I'm astonished that he again — for the fifth time in his administration — wants to reduce food and services for older Kentuckians and persons with disabilities. It's time to take the needs of seniors and persons with disabilities seriously," said James Kimbrough, the president of the Kentucky AARP. "It's simple math. Home- and community-based services cost taxpayers less and serve seniors better. We hope House and Senate leaders will see the value of saving Medicaid costs."

Rep. Jimmy Lee, D-Elizabethtown, chairs a key House budget subcommittee that oversees the cabinet's budget. Lee said he has not been fully briefed on how the cabinet will make the 8.4 percent cuts but he has concerns about how those reductions will be administered.

"I have to look at each one of those and see how those are impacted," Lee said, of the budget reductions. "I am pleased that we're going to put money in family support and in frontline social workers."

Lee said it's his understanding that the $21 million proposed by Beshear to decrease caseloads for child-protection workers would hire about 300 additional workers. Some of the money will come from Medicaid and the rest will be General Fund dollars, he said.

Terry Brooks, the executive director of Kentucky Youth Advocates, cheered Beshear's proposal to beef up the state's child-protection system. On Saturday, the Louisville-based child advocacy group held a summit on improving the state's child protection system in light of recent news reports about problems within the child protection system, including increasing caseloads.

"Protecting funding and increasing frontline workers are absolute cornerstones if we are serious about Kentucky children's safety," Brooks said. "If coupled with tangible steps toward more transparency and accountability in the child welfare system, then those budget decisions can begin to turn the tide for our most vulnerable children. It is literally a life and death investment. "

Adding additional social workers would lower the average caseload from about 20 cases per social worker to 18, Beshear said Tuesday. The national standard is 17.

Beshear also included money in the state's Medicaid program, a state-federal health care program for the poor and disabled, to fund outpatient substance abuse treatment. Over the two years, he is asking for $7.8 million that would be used to treat 5,800 adults and adolescents. He is also asking for additional money to treat people with severe mental illness and mental disabilities in community settings.

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