By Barbara Hollingsworth, Topeka capital-Journal, January 07, 2010
Medicaid recipients across the state this week are getting their first peek at what a 10 percent cut in services feels like.
Caregivers like Michael Carter, who cares for a man who has cerebral palsy and is a quadriplegic, is seeing his wages decline 10 percent.
Ann Duffy worries about the cutback in services for her daughter Latisha, 30, who has developmental disabilities, as well as the caregiver who has become like a member of her family — someone she knows would make sure Latisha wasn't alone if something happened to Duffy.
"It's wrong to not take care of people who can't take care of themselves," Duffy said. "I'm lucky. I can do it. I can keep her. There are some parents that can't."
As big cuts hit Medicaid-funded programs — including agencies serving adults with developmental disabilities, physicians serving Kansans in poverty, and nursing homes caring for the frail and elderly — Kansas lawmakers on Monday will converge on the Capitol for the 2010 legislative session. Even with the drastic cuts aimed at balancing the budget, the Legislature faces a budget shortfall of between $300 and $400 million.
"There are serious questions that even if there was a legislative desire or willingness to reverse those cuts, where would they get the money?" asked Jerry Slaughter, executive director of the Kansas Medical Association. "The state can't print money like the federal government. If you don't have the money, you don't have the money."
The 10 percent cut in Medicaid reimbursement rates was part of $258.9 million in budget adjustments announced in November, although the Medicaid reduction didn't go into effect until this month. In all, the 10 percent cut is aimed at saving the state about $22 million through the end of the fiscal year. However, the loss to Medicaid providers will amount to about $66 million because the program relies heavily on federal matching funds, said Peter Hancock a spokesman for the Kansas Health Policy Authority.
It wasn't a decision that was made lightly, said state budget director Duane Goossen.
"The results from doing this are not positive things," he told the Senate Ways and Means Committee last month. "They are almost entirely negative things."
Slaughter said medical providers are having to reconsider if they will continue to accept new Medicaid patients or if they will stop serving Medicaid patients entirely. If the cuts last longer than a few months, he said he anticipates some practices may begin making decisions about cutbacks this summer. As is, he said, many physicians barely break even when serving Medicaid patients.
"We've gone too far," Rep. Ann Mah, D-Topeka, said of cuts to Medicaid and education. "We are at the edge of not providing a quality education and treating people with less than respect."
The cuts come as needs continue to rise. Applications for assistance this year to the Kansas Health Policy Authority were up more than 1,000 each month. In November, more than 317,000 Kansans received coverage through Medicaid and other similar programs, including the Children's Health Insurance Program.
Waiting lists for people with developmental disabilities in need of additional assistance — programs primarily funded by Medicaid dollars — have risen to 4,265 statewide and 380 in Shawnee County. Even when the state had more money to spend, waiting lists continued to grow, said Tom Laing, executive director of Interhab.
"It blows our minds the extent to which the Legislature and governors have turned their backs to this," he said. "We think (Gov. Mark) Parkinson has a better feel for the extent of our challenges, but by the time he got the job, the money was gone."
Mitzie Tyree, director of the self determination division at TARC, said pay cuts and reduced hours hurt caregivers who were already poorly compensated. In general in this area, she said they will go from making $9 to $9.50 an hour to $7.75 to $8.50 per hour.
Carter said that will make it difficult to attract quality caregivers.
"These people deserve people who are trained and know what they are doing," he said.
After 20 years working with the same man, Carter said he won't quit caring for someone who he said has become like a brother, but finances are going to be tight.
"This has happened to us for years," he said. "We've never got a leg up. These cuts, it will be hard to ever get them back. When they make cuts they stay cut, and people like myself don't get a raise very often, that's for sure."
Barbara Hollingsworth can be reached at (785) 233-7470 or barbara.hollingsworth@cjonline.com and tweets at twitter.com/capj_barb.