Budget cuts hit health care services

The start of February brings an end to programs that care for some of the most vulnerable citizens of the state, those in the final days of their lives and children at risk for mental health problems, the latest casualties of Louisiana’s budget woes.

Gov. Bobby Jindal made the cuts in mid-December to help close a nearly $166 million deficit in the current fiscal year.

And the cuts are only likely to get worse. The governor and lawmakers will have to deal with another $1.2 billion budget gap for the fiscal year that begins July 1, in a poverty-troubled state where so many people look to the state for assistance.

Jindal has had to close mid-year budget deficits for five consecutive years – each of his years in office.

Among the reductions announced in December, doctors and hospitals that care for the poor, disabled and elderly in the Medicaid program will be paid less. Dental benefits to pregnant women through Medicaid will be cut off. Additional cuts are falling on the LSU hospitals that care for the poor and uninsured in north Louisiana. Dollars for juvenile justice treatment programs are shrinking.

The deepest cuts to services were made in the health and social services departments.

The biggest complaint from lawmakers was over elimination of at-home, end-of-life care through the Medicaid hospice program for people who can’t afford private insurance.

“We’re not going to assist them with services for people who are on their death beds?” Sen. Dan Claitor, R-Baton Rouge, asked Jindal’s chief financial adviser, Commissioner of Administration Kristy Nichols, as she outlined the cuts.

Senate Finance Committee Chairman Jack Donahue, R-Mandeville, asked the Jindal administration to find another way to trim spending, rather than end the hospice assistance. Three weeks later, Donahue said he hasn’t heard from anyone at the health department about his request.

“I would like them to acknowledge that the Legislature would like them to move in some other direction and come up with a different idea. I would hope they will consider other options,” Donahue said Thursday.

That’s not happening. A spokesman for the Department of Health and Hospitals said the hospice program will be shut down on Feb. 1.

Health and Hospitals Secretary Bruce Greenstein didn’t respond to a request to discuss the cuts to hospice services and a separate mental health program for children. Instead, his office emailed a statement from DHH Undersecretary Jerry Phillips defending the reductions and offering no indication they’d be reconsidered.

Phillips said the hospice cut doesn’t affect anyone currently receiving services, and he said people could seek those services through Medicare and through clergy and nonprofit groups. He said Medicaid recipients still will have access to medication to relieve pain, through the pharmacy program.

“When we make reductions through Medicaid, we can only eliminate optional benefits, of which we have very few in our state,” he said in the statement.

Also closing next month is the Early Childhood Supports and Services program, which provides community-based services to children from low-income families who are considered at risk for mental health conditions.

“In light of the recent massacres that occurred in Connecticut, it would seem that these services are more critical than ever, and we know that the earlier we can intervene, the more effective the outcome for all involved,” Janet Ketcham, executive director of McMains Children’s Developmental Center in Baton Rouge, wrote to the governor. She was referring to the shootings at Sandy Hook Elementary School in Newtown, Conn., last month.

Phillips said DHH is reviewing the cases of 540 children currently in the early support program to determine whether they can receive services through nonprofit groups or, for more intensive treatment, the state’s behavioral health program.

In both the hospice and early childhood programs, some people may find care elsewhere. Others may simply fall through the cracks. With more budget problems and cuts on the horizon, the cracks seem likely to grow even bigger.

EDITOR’S NOTE: Melinda Deslatte covers the Louisiana Capitol for The Associated Press.