Health & Medicine

Health services budget woes outlined

FRANKFORT — More than $1 million in grants to grandparents raising their grandkids and $1.5 million to local health departments would be slashed to make up for a state government shortfall under a proposal unveiled Thursday.

Other programs that could be in jeopardy include Homeplace, which connects elderly and poor residents with health and social services, funding for a statewide poison control center and a mobile health clinic in Central Kentucky.

If the state does not find additional revenue soon, the safety net Kentuckians depend on in tough times will have gaping holes, Janie Miller, secretary for the Cabinet for Health and Family services, said Thursday.

Miller was the latest state agency head to detail how a proposed 4 percent budget cut would affect day-to-day operations. Gov. Steve Beshear last week asked most state agencies to make 4 percent cuts in an attempt to make up for a projected $456 million shortfall. The cabinet for Health and Family Services has to trim $18.6 million from its budget.

"We've already done all the belt tightening," Miller said. "We're now cutting services."

The state gives eligible grandparents $700 in vouchers to help with health care, school supplies and other essentials if they are raising their grandchildren. The state-funded program would be discontinued in 2009 if the General Assembly approves the cuts.

Concerning proposed cuts to local health departments, Miller said it's difficult to say how the departments will be able to manage the loss in funding. Health departments also receive county and other government funding.

The cabinet is also looking at eliminating security at a Louisville cabinet office, closing some neighborhood cabinet offices in Louisville and consolidating a Hopkinsville clinic for special-needs children with other clinics.

Saved from the proposed cuts were the community mental health system, mental retardation and Medicaid funding. Miller said the cabinet opted not to cut any staff. It's already down 700 employees to about 7,300.

It is still filling critical positions such as front-line social workers, because there is more work that needs to be done.

"More and more people are coming in the door," Miller said. For example, the number of people applying for food stamps increased by 42,000 this October, compared to October 2007.

But if the legislature does not pass an increase in the cigarette tax or find another revenue source, Miller said, she might have to lay off social workers, cut or reduce Medicaid services and close units in state-run facilities for the mentally disabled.

Bart Baldwin, president of the Children's Alliance, which represents private child care providers, said how the state will cut reimbursements to the agencies is still being worked out.

"I know they're trying to limit the negative impacts," Baldwin said. But any reductions in payments for private foster care placements will at best result in reduction of services to children. At worst, some agencies will have to close, Baldwin said. "We take care of 3,000 of the 7,000 kids in state custody," Baldwin said. "It's just a no-brainer to me that these kids should be a priority."

The cabinet also faces other monetary problems, including a more than $183 million shortfall in Medicaid, a state and federal health care program for the poor and the elderly. That $183 million is not included in the $496 million shortfall.