Calif. budget cuts will hit adult day care centers, prison health care; Texas and Kansas weigh Medicaid cuts

The Los Angeles Times, on adult day care centers in California: "Under the most recent cost-saving budget proposals, 327 adult day healthcare centers throughout California would be eliminated. Cuts could save the state $135 million in fiscal 2011, state projections show. But advocates and center operators said care for many of the 37,000 low-income participants -- who suffer from diabetes, brain injuries, dementia and other chronic conditions -- would cost the state even more money if the centers close. More than 40% of participants would end up in nursing homes, said Lydia Missaelides, executive director of the California Assn. for Adult Day Services. Others would be hospitalized" (Gorman, 2/11). 

The Los Angeles Times, in a separate story: "Democratic state senators pushed the first budget cuts of 2010 through a key committee Wednesday, slicing government payroll costs by 5% and cutting $811 million from the prisons' healthcare budget. ... It remains to be seen how much of what the lawmakers cut from prisons will materialize; $811 million is more than 40% of the medical budget. The panel did not offer many specifics on how the reductions would be made. And the corrections system has been plagued by cost overruns for years as inmate healthcare has been overtaken by federal courts, which have ordered improvements. Still, the sizable cut is politically popular -- there has been public outrage over what some have called 'gold-plated' prison healthcare" (Goldmacher, 2/11).

The Dallas Morning News: "Doctors, dentists and hospitals would see their Medicaid fees trimmed by at least 1 percent under possible budget reductions offered Wednesday by state Health and Human Services Commissioner Tom Suehs. When treating adults, the caregivers would take a 2 percent hit, as would nursing homes, group homes for the mentally disabled and NorthSTAR, which provides mental-health services to about 400,000 low-income residents of Dallas and six nearby counties. ... Other suggested cuts include closing 50 beds for psychiatric patients at the Terrell State Hospital, withholding 10 percent of hospitals' trauma money from the Driver Responsibility Program, delaying help for families with very sick or disabled children and postponing hires of new food safety inspectors" (Garrett, 2/11).

The Wichita (Kan.) Eagle: "State budget cuts could affect some of Sedgwick County's most vulnerable residents, including those with developmental disabilities and mental illnesses and the elderly, concerning commissioners who don't want to raise taxes but want to continue services to such groups. The county could lose about $8 million in state funds, commissioners were told at their annual planning retreat Tuesday. Most of the cuts are part of the state's budget for fiscal year 2011, which starts July 1. Comcare, the county's mental health agency, would take the biggest hit, losing about $4.5 million" (Gruver, 2/11).

Health News Florida: "After opposing expansion of 'Medicaid Reform' for three years, Gov. Charlie Crist said Tuesday he's 'open' to seeing it grow beyond its current five Florida counties. Crist said the program, which requires most Medicaid recipients in the five pilot counties to enroll in managed care plans, gives the state 'the ability to exercise options' in its Medicaid program. But the governor said he probably would not support a proposal that would limit expansion to HMOs. Other kinds of networks - led by hospitals or minority-physician groups - are active in Medicaid Reform now. ... The governor's remarks come as legislative budget committees are wrangling with a revenue shortfall of as much as $3 billion. Medicaid -- a $19-billion state and federal program that pays the health care costs of the poor, elderly and disabled -- is being scrutinized by not only the budget panels of the House and Senate, but also a strategic and economic planning committee" (Sexton, 2/10).

The (New Orleans) Times-Picayune: "Faced with a looming loss of federal health care dollars, Gov. Bobby Jindal plans to propose a significant shift of state resources from institutional care to private and community-based options when he presents his 2010-11 budget to the Legislature on Friday. Health and Hospitals Secretary Alan Levine said the shift will affect services for the developmentally disabled and acute-care hospitals. But the biggest changes will affect mental health services, where the administration will propose closing 100 inpatient beds while pumping new money into less-expensive outpatient services designed to keep people out of psychiatric hospitals. ... But the Louisiana State University-run charity hospital system, which was looking at potentially having to close several small hospitals because of  budget pressure, will get a one-year reprieve while a 'transitional plan' is developed that will plot the future of the charity system. ... The proposals come in a year when Louisiana stands to lose up to $650 million in federal support for health care, most of which is because of a reduction in federal Medicaid payments" (Moller, 2/10).

The Chicago Tribune: "The state is seeking private health insurance industry partners to provide better coordinated and more cost-effective medical care for some elderly and disabled Medicaid patients in Illinois. The Illinois Department of Healthcare and Family Services, which runs the state Medicaid program for the poor, has issued a request for proposals by managed-care plans to provide medical care services to 40,000 seniors and adults with disabilities in suburban Cook, DuPage, Kane, Kankakee, Lake and Will counties. The Medicaid patients will have to enroll in one of two health plans" (Japsen, 2/10).