BATON ROUGE, La. (AP) - Cuts to health care services begin this week for at-risk children, low-income moms and HIV patients, part of Gov. Bobby Jindal's rebalancing of the budget to close a midyear deficit.
Slated for elimination are programs that provide behavioral health services for at-risk children, offer case management visits for low-income HIV patients and pay for at-home visits by nurses who teach poor, first-time mothers how to care for their newborns.
The Medicaid program will no longer cover physical therapy and speech therapy rehabilitation services for nursing home residents. Dental benefits to pregnant women through Medicaid will be cut off. Hospitals and doctors will be paid less when they care for Medicaid patients.
The cuts begin Friday, part of a series of Jindal administration reductions announced in mid-December to close a nearly $166 midyear budget deficit for the fiscal year that ends June 30.
The Medicaid hospice program that provides at-home care for terminally ill patients who can't afford private insurance won a last-minute reprieve after the Department of Health and Hospitals identified grant dollars to continue the service and state senators voiced loud complaints about the planned closure.
The rest of the programs slated for elimination this week won't be spared, however.
Health and Hospitals Secretary Bruce Greenstein said he targeted programs that were duplicative, costly and optional under the state's participation in the state-federal Medicaid program.
Greenstein said in many instances, people can get the care they're losing through other government-funded programs. But he acknowledged that won't happen in every case, meaning some people will simply lose the services or receive reduced services.
For the 250 HIV patients whose case management program is being eliminated, Greenstein said the private managed care networks that cover Louisiana's Medicaid patients offer similar services.
He said many of the 400 people in the rehabilitation services program will be able to get their care through Medicare, which is federally-funded.
Jan Moller heads the Louisiana Budget Project, which advocates for low- to moderate-income families. Moller said he's most distressed by the cut to the Nurse-Family Partnership Program.
DHH is eliminating the portion of the program that offers at-home visits to low-income women who are pregnant with their first child. Registered nurses visit the women early in their pregnancy and until their children's second birthday, offering advice on preventive health care, diet and nutrition, smoking cessation and other child developmental issues.
Greenstein said pregnant women can receive case management and a focus on healthy births and early childhood care through Medicaid's private managed care networks and health providers.
"What the Nurse-Family Partnership does goes above and beyond what a good obstetrician does," Moller said. "It's really about teaching life-skills to at-risk moms to make them better parents and make them better able to care for their children, and it's been proven to work."
Janet Ketcham, executive director of McMains Children's Developmental Center in Baton Rouge, wrote to Jindal asking him to spare 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.
"We have first-hand knowledge of the essential services they provide because they refer children to us for speech and occupational therapies, and we refer children to them who are in need of behavioral/mental health intervention," Ketcham wrote.
Her request was unsuccessful.
Greenstein said DHH is reviewing the cases of 540 children in the program to determine whether they can receive services through nonprofit groups or, for more intensive treatment, the state's behavioral health program.