$281M cut from state social programs 'devastating,' advocates say

Cutting programs for the mentally ill, disabled and poor elderly residents, the state's Department of Social and Health Services (DSHS) announced Wednesday a wide swath of reductions totaling nearly $281 million and bringing a flood of concern from advocates for the poor and vulnerable.

The 6.3 percent across-the-board cuts, some of which will begin in October, include nearly $113 million of state funding for Medicaid programs providing hospice care to the dying, and medical care for those too disabled to work, children and pregnant women, among others.

The cuts are being made in response to Gov. Chris Gregoire's directive to pare spending to help balance the state's budget, as required by the state constitution.

Gregoire's order, announced this month, followed a new state revenue forecast projecting an additional $1.4 billion drop in tax collections between now and June 2013.

Doug Porter, state Medicaid director, said he had virtually no flexibility in making the reductions.

"We are looking to the Legislature to come in and make more strategic and thoughtful cuts than these across-the-board cuts," he said.

The DSHS cuts include:

• Fewer hours of personal care — such as help with dressing, bathing, eating and medication management — for long-term-care clients;

• Elimination of 30 inpatient beds at a ward at Western State Hospital that houses people with severe psychiatric disorders who are civilly committed;

• Reductions in services for mentally ill clients in the community and at the state hospital;

• Loss of access by poor seniors not qualifying for Medicaid to services that now help keep them in private-pay homes or facilities;

• Reduced money to nursing homes.

"It will be devastating," said Amnon Shoenfeld, division director of Mental Health, Chemical Abuse and Dependency Services Division for King County.

Like leaders at various organizations, Shoenfeld on Wednesday was assessing what the cuts would mean specifically for his agency. But "it will have an enormous effect" — perhaps around $6 million for his division alone, he said.

The cuts involve programs such as voluntary and involuntary psychiatric hospitalization, crisis services, and programs that help people make the transition from jail into the community.

Nick Federici, lobbyist with the Washington Low Income Housing Alliance, said, "It's widespread carnage for low-income and vulnerable populations. ... There's a lot of blood. We're just trying to see how deep it is."

Louise Ryan, state long-term-care ombudsman with the nonprofit Multi Service Center, said the state's nursing homes already have seen cuts in food, activities and staff.

"I'm really worried that's just going to get worse," she said.

The cuts also include the elimination of 380 positions within DSHS, which have to take place by June 30. Also, beginning next month, all employees will be required to take one unpaid day off per month through June.

Medicaid cuts announced Wednesday include:

• 27,000 children losing health-care coverage through the Apple Health for Kids program;

• $8.3 million in cuts for adult dental services;

• $4.6 million in cuts for care of dying adults;

• Cuts of more than $20 million to Disability Lifeline, which provides medical care for disabled adults;

• Cuts for maternity-support services that now help one in every three women giving birth in the state.

"These cuts will have a devastating impact on our county residents, particularly our most vulnerable," said James Apa, spokesman for Public Health — Seattle & King County.

For instance, the maternity-services program effectively helps prevent low birth weight, saving the state health-care costs in the long term, he said.

"We understand the state has tough budget decisions, but we urge them to consider programs that are effective ... and protect the most vulnerable," Apa said.

Carol Ostrom: 206-464-2249 or costrom@seattletimes.com