Monday, February 22, 2010

Nevada's governor backs off some cuts to programs for people with disabilities, senior citizens

From the Las Vegas Sun:

After state officials were bombarded by complaints that Gov. Jim Gibbons' proposed budget cuts of programs for seniors and other vulnerable Nevadans were too draconian, Gibbons announced Feb. 19 that he was rescinding some of those measures.

Gibbons said he was able to make these adjustments thanks to a reduction in how much the state must pay the federal government for prescription drugs Nevadans receive that are paid for by Medicare, but were previously funded by the state’s Medicaid program. This change will save the state $16.3 million.

The governor that his plan to balance the state budget will protect medically fragile Nevadans, the mentally ill and developmentally disabled, while still responsibly cutting state spending.

Among the changes, Gibbons decided to reinstate adult day health care coverage in Medicaid. He also decided to continue covering adult dentures, which were originally proposed for elimination.

“I was simply not comfortable eliminating adult day health care because of the tremendous impact it would have on the 388 families that rely on this service,” Gibbons said. “We were only able to identify alternative services for about half of these people, and leaving them with nowhere to turn was not an acceptable option.”

Continuing adult day health care will also likely prevent many of these individuals from ending up in nursing homes, which ultimately would have cost the state more money.

Nevada Adult Day Healthcare Centers, which operates three facilities in Las Vegas, was among the service providers that had received a Feb. 12 letter indicating that Medicaid reimbursement for those services would end on March 16, pending final approval at a public hearing. The letters were sent by Charles Duarte, administrator of the state Division of Health Care Financing and Policy.

This morning, prior to the governor's announcement that the program would be spared, some clients and family members affiliated with Nevada Adult Day Healthcare Centers expressed their disappointment with Gibbons and the disruption to their lives that they were facing.

At those centers, they receive physical therapy and medication and have their vital signs checked regularly, services that would be difficult for them to receive if they stayed at home.

Among the distraught clients was Josephine Leu, a 60-year-old stroke victim who uses a wheelchair.

"I'd ask the governor if he wants to be the governor of the only state that forgets about its elderly and disabled," she said. "I've visited nursing homes and I don't want to be in one."

Ruth Green, 86, said she would be sitting at home with nothing to do if the Medicaid benefit took away her ability to attend the healthcare center five days a week.

A diabetic who uses a walker, Green said: "What I like about this place is that they see after me. If I was at home, I would just be sitting down, maybe laying in bed. I would not feel good."

Green's daughter, Deloris Brooks, said that she probably would have had to quit her job as an office manager and care for her mother full time had the Medicaid benefit been eliminated.

"That would be a hardship because my husband and I are upside down on our mortgage and we're trying to do a loan modification," Brooks said. "Adult day care has given my mother a new life. I don't know what I would do without it."

The governor also said he came to the realization that the decision to continue coverage of dentures made sense.

“Proper nutrition is essential for seniors to continue living independently, and without dentures its likely people’s health would deteriorate rapidly,” Gibbons said.

Among the other major changes to the governor’s budget proposal was re-establishing some housing assistance for Nevadans with developmental disabilities and those suffering from mental illness. Under Gibbons’ revised proposal, the state Division of Mental Health and Developmental Services will be able to maintain existing housing supports for the developmentally disabled while adding 120 placements in Southern Nevada and 64 placements in Northern Nevada.

On the mental health side, the change will allow the division to add 85 residential support placements in southern Nevada, which is the area of greatest need.

“These were recommendations made by the Department of Health and Human Services to reach a budget cut target,” Gibbons said. “Unfortunately to meet that target, we had to look at cutting services to those who are most vulnerable. We need to maintain these services.”

Other changes include reinstating funds for transitional rehabilitation services for people with brain injuries and community corrections services for juveniles that keep them out of institutions.