Attendees lament services lost

Marina Valdez wanted to preserve 40 minutes a day for her mentally retarded daughter.

Laurie Brown, community liaison for A Caring Hand Home Health Care, didn't want in-home care providers to feel rushed when providing services to the disabled and the elderly.

Neither got what they were after Tuesday as the state's Division of Health Care Financing and Policy went ahead with regulation changes that will eliminate or consolidate services covered under Medicaid.

"Our voices weren't being heard,'' said Brown, who pointed out the Legislature's Interim Finance Committee already had approved the cuts Aug. 14. "The decision had already been made.''

Because of federal and state budget woes, the state Department of Health and Human Services has lost $124 million of its budget, said Chuck Duarte, administrator for the division. About $57 million of that is state funding.

To meet the state budget demands this fiscal year, Duarte said, the division has made three rounds of cuts to Medicaid and Nevada Check Up programs in the past eight months.

Valdez and Brown, and about 50 other attendees at Tuesday's meeting in the Sawyer Building, were upset about cuts that eliminate Medicaid payments for certain personal assistant services such as exercise.

The personal services help disabled children and adults with daily activities, including bathing, eating and grooming.

Duarte said some services are not being eliminated. He said bathing, grooming and dressing are being consolidated into other services, which will save $4.3 million.

"The options, should we not adopt regulations that reduce spending, are even a little more scarier,'' he said. "Those basically include just discontinuing things for all services at some point at the end of this fiscal year.''

According to letters being sent to the 4,500 Medicaid recipients affected by the change, the maximum time allowed for bathing, grooming and dressing is now 60 minutes. Before, the time was more than two hours.

"You can't do bathing, dressing and grooming in one hour. It takes me more than an hour to get ready in the morning. We're working with people who are handicapped,'' Brown said. "We have to check them for bedsores and tears in the skin. If we're being rushed, it is going to be hard for us to do our jobs.''

Brown said the state should take into consideration each individual and their needs before cutting services.

Valdez made similar comments.

Her daughter, Samantha, is losing 40 minutes a day in in-home services because of the Medicaid cuts.

Samantha, 20, attends the special-needs Helen J. Stewart School from 7 a.m. to 2 p.m. Between 2:30 and 6 p.m., she is with her personal care assistant at home. Valdez said that if that time is reduced by 40 minutes, she will need to get off work before 5 p.m. to get home to be with her daughter.

She added that her boss has said he needs someone in the office until 5 p.m.

"Forty minutes doesn't sound like much, but it is when you're a single mom with two kids and are on a strict time schedule,'' she said.

Duarte said people concerned they are not receiving enough coverage could appeal for a reassessment of their Medicaid coverage.

Nevada Medicaid provides health care to low-income Nevadans who qualify for services based on federal and state law. Eligibility for the program is based on financial need.

Nevada Check Up, a program designed for families who do not qualify for Nevada Medicaid and whose incomes are at or below 200 percent of the federal poverty level, is being affected by the cuts too.

Officials announced Tuesday that vision and orthodontia services will be eliminated from Nevada Check Up coverage starting Sept. 1. Also, to meet budget needs, a $600 annual benefit limit will be in place for dental care for Nevada Check Up recipients.

Duarte said the elimination of orthodontia and nonmedical vision would save $250,000 in general funds.

Currently there are about 25,000 children enrolled in Nevada Check Up and 100,000 in Nevada Medicaid, Duarte said.

Under Nevada Medicaid, certain ocular services are being eliminated for adults. That means adults covered by Nevada Medicaid will have to pay out-of-pocket for glasses, frames and spectacles. Medical services such as glaucoma screenings, eye infections, and cataract surgery are still covered under a person's medical coverage.

No change is occurring in ocular services for Nevada Medicaid recipients under age 21.

Jon Sasser, representing Washoe Legal Services, said he understood cuts needed to be made to meet the state's budget. But, he said, the Division of Health Care Financing and Policy should have provided information about how many people would be affected by the cuts and about how much would be saved.

"The devil is always in the details, and I think the public is entitled to know that,'' he said. "I am disappointed the public doesn't have that information today."

Duarte said that information is public and would be provided to anyone who asked for it.

Contact reporter Annette Wells at awells@reviewjournal.com or 702-383-0283.