Rules for moneysaving cuts in services for disabled and elderly Nevadans, children from low-income families and others were approved today despite emotional protests from people who depend on those services.
Charles Duarte, head of the state Division of Health Care Financing and Policy, said the cuts were required because of Nevada's projected $1 billion-plus revenue shortfall in the current budget cycle, which closes in mid-2009.
Duarte noted state legislators already endorsed the service reductions as part of their review of Gov. Jim Gibbons' cutbacks throughout state government. The first-term Republican governor is trying to deal with the revenue shortfall without seeking any new or higher taxes.
Several people, some of them in tears, others angry or confused, said the disabled-service reductions could force them, or people they care for, out of their homes and into institutions.
"What am I supposed to do?" wheelchair-bound Candy Roper of Carson City said in describing how she could be forced to give up her full-time job and even her home if her personal-care assistance services provided by the state are cut in half.
"We just keep losing ground, losing ground," said Paul Gowins of Reno, also in a wheelchair. Gowins, a longtime advocate for the disabled, added that the state must make sure that it doesn't lose track of the many people losing services in developing future budgets.
Robert Desruisseaux, representing the Nevada Aging and Resource Disabilities Council, warned that the reduction in help for some 4,500 recipients opens the state up to possible litigation, and is likely to result in more people being forced from their homes into institutions.
Barry Gold of AARP Nevada said he was concerned about the removal of eyeglass services for adults under Nevada Medicaid, adding that someone living at home could be forced into a nursing home if unable to replace lost or broken glasses.
Jon Sasser of Washoe Legal Services pressed for details on anticipated cost-savings and for explanations of the thinking that went into the decisions to cut the various programs. He also said he realized the division delayed the cuts as long as possible and "I'm not here to bash you guys."
Duarte said the cutbacks would save million dollars in state general funds. He also said the steps being taken now help deal with the shortfall in the current fiscal year, and more shortfalls are expected in the coming budget cycle.
"The options, should we not adopt regulations that reduce spending, are even a little more scary than what we're having to do today " and those include basically just discontinuing things for all services at some at the end of this fiscal year," he said.
In adopting the regulations, Duarte directed staffers to work with some of the people who testified about their concerns. He said some type of exception criteria should be developed based on service recipients' needs.
The new rules reduce the time allotted for personal care services for people who need such assistance, and also eliminate exercise as a covered service.
In the Nevada Check Up program, coverage for vision services was eliminated and dental services were limited to just $600 worth of care a year.
Nevada Checkup serves about 25,000 children. An estimated 85,000 children in Nevada lack health insurance, officials have said.
Nevada Checkup provides low-cost health insurance to children who are uninsured, come from low-income families and don't qualify for Medicaid. Medicaid is the federal insurance program for the poor.
In the Nevada Medicaid program, eyeglass services for adults were eliminated although other services such as glaucoma screenings and cataract surgery remained in place.
Also, the rules bring the state into line with a cut in federal funding for transporting some Medicaid-eligible students to and from school.