CARSON CITY -- Poor people eligible for free Medicaid health care no longer would receive eyeglasses, dentures, hearing aids or as many adult diapers under the $109 million in social service spending reductions proposed by Gov. Jim Gibbons.
"We are down to the ugly list of options of where we can cut," Department of Health and Human Services Director Mike Willden told members of the Legislature's Interim Finance Committee on Tuesday.
"These things are beyond ugly," replied Assembly Speaker Barbara Buckley, D-Las Vegas.
Buckley warned the committee that even more disturbing cuts might be ahead for Willden's agency because so far, the governor has proposed reductions that total less than half of the $881 million in cuts the state must make to balance its budget.
"There is no magical solution to this," said Senate Majority Leader Steven Horsford, D-Las Vegas.
So far, legislators know only that Gibbons will ask them to approve 10 percent cuts for most state agencies, including Health and Human Services, when the Legislature starts its special legislative session Feb. 23. The governor's proposals cannot go into effect without the Legislature's support.
Horsford said legislators will develop their own budget adjustment plan for the special session.
The state would save $829,304 by reducing the number of adult diapers that incontinent disabled and elderly people would receive. The reduction was mentioned repeatedly Tuesday as the most horrendous example of a budget cut.
Eligible people now receive 300 diapers per month; that would be cut to 186, which, according to the Health and Human Services agency, is in line with national standards.
But Washoe Legal Services lobbyist Jon Sasser predicted that elderly people will be spending hours per day "with poop in their diapers."
"It is abhorrent to be discussing this," Buckley said. "Are we really going to tell the elderly we are cutting them off dentures and hearing aids and diapers? I don't know how we can look the elderly in the eye."
When questioned about the proposal, Gibbons' communication director, Daniel Burns, said the state simply does not have the money. If legislators do not want to take the limit off diapers, the governor will support them if they find something else to cut, he said.
"The state can't pay for everything," Burns said. "The governor realizes some adults have to wear diapers. This is a serious (recession)."
Burns mentioned that the Ritz-Carlton hotel at Lake Las Vegas announced Monday that it will close, with 340 people losing their jobs there.
Willden said he is prepared to make additional cuts in social service programs if requested by the administration. In most cases, when the state reduces its funding for a social services program, support from the federal government for the program is reduced by a similar amount, he added.
Gibbons' cut list also includes closing the Summit View Correctional Center in North Las Vegas, saving the state $3.7 million. The 48 youths would be transferred to youth centers in Elko or Caliente.
The state would reduce the capacity of the Rawson-Neal Psychiatric Hospital in Las Vegas by 22 beds and cut what it pays hospitals for treating Medicaid patients by 5 percent.
Bill Welch, Nevada Hospital Association president, said Nevada hospitals lost $1 billion last year treating indigent patients, and he expects that figure to increase 13 percent in 2010.
"As unemployment grows, our uninsured population grows," Welch said. "Those patients will continue to find their ways into our hospitals and nursing homes."
Nancy McClain, director of social services in Clark County, predicted that the social services cuts will lead to poor people going to the counties for help. She said there is a federal requirement that hospitals provide care for people in emergency rooms.
The Health and Human Services budget is being reduced when its client caseload has grown to record levels because more people are seeking help in a recession.
The number of people on Medicaid has risen to a record 238,891, 18,000 more than for what was budgeted for the program. The number of recipients is expected to reach 277,124 by June 2011.
The number of people receiving food stamps is 254,376, which is 35,000 more than projections, and it might reach 486,224 by June 2011, Willden said.
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