NC House – Deep Budget Cuts in Health and Human Services

This morning the NC House Appropriations Subcommittee for Health and Human Services passed out its proposed list of budget cuts. Just a few examples – NC children’s health insurance program closed to new kids; over $1.2 billion in unspecified cuts must be made in Medicaid; medical provider rates reduced by 4%; reduce mental health services by $165 million etc. Full official budget cut document posted below: [Note – at 4.20pm today we corrected this link to display the entire budget cut document. Before the PDF of the document only contained every other page.]

House Budget Cuts – Health and Human Services (PDF)


  1. Marsha V. Hammond, PhD

    May 28, 2009 at 3:11 pm

    Trimming the fat?—or cutting off your nose to spite your face somewhere down the road?

    These are short-sited cuts. A better strategy would have been to go after more taxes from the corporations. HEY! YOU COULD START W/ BCBSNC! Naw, won’t happen because Capstrat, headed by Eudy, former NC Dem Party Chairman, now creating adds for BCBSNC in order to block choice of government sponsored health insurance like Medicare, is right in the center of NC Dem Party and gee, we can’t be rude to him, can we?


    There are 158 items associated w/ suggested cuts put forward by the House Appropriations Subcommittee for Health & Human Services, 2009-2011.

    1. Lots of loss of money and positions within NC DHHS. (This will only make my psychologist job harder)

    2. LME’s are to have funding cuts and loss of positions (This will only make my job harder and make me steer away even more pointedly from the state funded clients).

    3. Non-core LME functions lose money (This means I won’t have to speak to Meridian Behavioral Health Services aka Smoky Mountain Center LME—–they were supposed to privatize, remember?—–regarding trying to steer my Medicaid client into their Recovery Education Center—-group therapy not led by particularly skillful people—-which would have meant I could not bill Medicaid for therapy)

    4. Lots of miscellaneous cuts to children and infant services. (This means that kids w/ problems will grow up to be adults with problems and then go to jail where we will pay for them there).

    5. No more new local health departments (It appears that what is in place, stays in place; local health departments are used by indigent clients).

    6. School health nurses will lose funding (This is another stop-gap measure which keeps people from getting sicker, particularly those w/o health insurance).

    7. Item 72: No more Special Olympics, a source of pride in the Waynesville community, in particular.

    8. Item 74: The Key Program, which works on housing subsidy has reductions (Does this mean that Tom McDevitt, formerly CEO of SMC LME, will get a salary reduction—-since he’s still running that SMC LME program—-even though he was fired).

    9. Item 77: reduces Weatherization Assistance Program (Its not clear to me if this means that indigent clients will get a break re: some of their heating fuel or not. If disabled clients are living in Section 8 housing, they can’t have a wood stove and they can’t have a functioning fire place. Therefore, they are stock w/ expensive heating fuel).

    10. Item 92: Big $5 million cut to the DSS Public Assistance programs. (more problems w/ Food Stamps which are already way to little. Bring on more soup kitchens, I reckon.)

    11. Eliminates 5 positions within Vocational Rehabilitation Services (as far as I can tell—and after years of working w/ Vocational Rehabilitation Services, they should just get rid of all VR Services. Other than paying me for assessments, I have seen very little benefit from VR Services over the past 10 years in either GA or NC; I cannot even say that they used my assessments in any way that profited the clients).

    12. Eliminates funding for Senior Center Outreach Program (I guess my elderly client won’t get her Meals on Wheels anymore; I don’t know what the link of Meals on Wheels is re: this, however).

    13. Item 132: Establishes a $50 co pay for non-emergency visits to the emergency room. (Now how are they going to bill Medicaid for this? It won’t happen and they will not be able to squeeze blood from the turnip of indigent clients who would not be going to the ER unless they really needed to).

    14. Item 135: Medicaid cards will be printed quarterly and not monthly.

    15. Item 136: Big $53 million saved here: Case management services will be consolidated throughout the Medicaid program.

    16. Item 138: 4% reduction in Medicaid fees across providers (that means you will have less available mental health services).

    17. Item 142: all providers must file Medicaid claims electronically (its the easiest billing I’ve ever done, for sure, via EDS that interfaces w/ NC Medicaid)

    18. Item 143: reduces dental services within Medicaid (There are very few dentists that will take Medicaid as it is; therefore, people will just continue to lose their teeth and the dentists that create dentures will make more money).

    19. Item 144: reduces funding for Hospice services (I know that Hospice is already cutting out things like physicians, using instead nurse practitioners; I assume that Hospice is fairly dependent on donations and as we know, there are fewer of those these days. ).

    20. Item 154: Positions eliminated within Department of Health Service Regulations (this is the agency within NC DHHS that is SUPPOSED to regulate Family Care Homes; I have a one inch plus file of letters from them indicating that they never could find a basis for any of my 10+ paper complaints associated w/ WNC Homes and so hey! we can save paper too; I turned the case over to Congressman Shuler’s office; I bet HE won’t get downsized).

    21. Increase of licensing fees (I guess that certainly means I will not be able to rejoin American Psychological Association for its whopping $500+/ year).

    One piece of good news: Federal judge ruled that Broughton Hospital should not have had its accreditation revoked in 2007 which means that $8 million goes back into the pot from the Feds re: monies that were kept when Medicaid/ Medicare clients were in Broughton.

  2. Alicia

    May 29, 2009 at 4:43 am

    Senior citizens are taking the hit that no one talks about during the recession. Senior citizens, as their numbers increase exponentially, are increasingly taking to short term loans to keep afloat. As more people are laid off, there is less tax revenue coming in, and that is how Social Security and Medicare are funded. The Medicare expense out of every paycheck goes to the Medicare fund, and part of the Medicare woe is that not only is the fund running out faster than it can be replenished, but health care costs are going up. Medicare will be bankrupt in 8 years or less, which means we need debt relief to be able to care for our senior citizens.

  3. National Priorities Project

    May 29, 2009 at 5:27 am

    When its guns vs. butter, who do you think gets the goodies? On April 9, 2009, the Obama administration requested, in a final emergency supplemental, an additional $ 77.1 billion in war spending. Estimates are that approximately $52.7 billion of that will be for Iraq and the remaining $24.4 billion for Afghanistan

  4. Steve Jackson

    May 29, 2009 at 12:11 pm

    As bad as the cuts are in education – and they are bad – the HHS cuts are worse. The poor, the defenseless and those with nowhere else to turn get the shaft. And for what? The House is too nervous to do a little taxation reform?

  5. Cindy

    June 3, 2009 at 12:58 pm

    The cuts proposed by DHHS are targeting the young, old and helpless, our most vulnerable citizens. I work in foster care and know first hand that as we eliminate services for children, they will remain in homes that aren’t able to access needed services like child care, medical treatment and therapy which in turn will result in more abuse and neglect. Why is it that we as a society refuse to protect the vulnerable until after abuse, neglect, medical harm or some other crisis occurs. At that point persons have been severly impacted and the original problems are much worse than if we supported them properly to begin with.

  6. Ryan

    June 3, 2009 at 2:55 pm

    Isn’t this a peculiar posistion that the state is inviting in the door?

    I work for a large NFP, covering the whole state of NC. We offer a veriety of programs, including those where the largest cuts are proposed. These cuts are very short-sighted.

    There are many smaller providers that will have to close their doors. The larger providers may survive it.
    Think of the infrastructure that will be lost!
    This will not be the only year for budget cuts. Next year will be worse.

    NC’s medicaid program is among the most complex in the nation. After including the general operational costs of doing business and the numerous hoops that providers have to jump through (cost reports/accreditation/licensing/authorizations), I believe the state will see an extrordinary drop in the number of good providers willing to offer services in NC.

    The DHHS budget cust alone will deepen the effects of the economic recession; causing thousands of additional jobs to be lost. That will lead to:

    1> Increased unemployment claims
    2> More foreclosures
    3> Less income tax revenue
    4> An increasing number of individuals in need of Medicaid services – where none will be offered.
    5> Increased costs for surviving providers to offer remaining (funded) services

    Folks, these outcomes just scratch the surface. HHS services are crutial to the well-being of our communities. The services offered by providers’ oganizations are a vital to meeting the ever-increasing demand – espeically in community supports and MH/DD/SA. Without these services, the state is placing many lives and jobs in danger!

    Help save lives!! Help save NC jobs!! Call you’re congress preson today!! I’m not typically one for increasing taxation, but it is a viable solution. Take a couple extra bucks out of my paycheck, but don’t cut these services!!!!

  7. TJ

    June 4, 2009 at 5:10 pm

    i cant believe they would cut services for these children but give out free phone to people who already have them. They can give
    at & t money to move here for two hundred jobs. how many jobs will be lost with this cut. they will put people who pay taxes and for their own insurance on food stamps and medicaid. These children will end up in emergency rooms and mental hospitals. How is that saving any money, seems to me that would double the bill. where are these peoples brains. Who do they work for?
    Are they taking a big pay cut themselves. I bet they are not.

  8. Kristine

    June 7, 2009 at 4:10 pm

    These cuts will also eliminate outpatient speech, occupational and physical therapy. Not only will infants and children go without needed therapy but thousands of therapists will be without a job. The state will actually loose money because when these therapists loose their jobs they will either leave the state (taking millions in state income tax with them) or file for unemployment. NC will loose more than it saves! NC is a cutting edge state for the services it offers in my field of audiology. When we diagnose a baby with hearing loss early we can begin intervention and are ahead of the game. Without speech therapy, our children will be delayed. These children in need of ST, OT and PT will hit the already strapped public school system at age three having received no services. How crazy is that? Why can they nor make moderate spending cuts and increase revenue (cigarette tax) to solve the budget crisis?

  9. Sue

    June 9, 2009 at 8:13 pm

    Vocational Rehabiliation is a good prgram and does help many people with disabilities return to work. I would imagine they will be overwhelmed with people that are losing other needed services and benefits. People with disabilties will need to go to work now more than ever.

  10. john

    June 11, 2009 at 2:08 pm

    What angers me the most is that mental health providers across the entire state have had to spend all of our time jumping through all of the hoops that the state and feds have required us to jump through with mental health reform for the past six years. We’ve also spent out hundreds of thousands of dollars in payback money for the most inane reasons and have been chided and audited repeatedly by people who don’t work directly with the mentally ill (some of whom are CPA’s that the state chose). We’ve been to countless trainings and have been told that we need to change this and that and how all of these changes are going to benefit the people we serve (both sides knowing that it’s all about money) and how it’s going to make serving the mentally ill easier (it hasn’t). Now were essentially being told that we’re apparently going back to many of the things we were doing before but with even less people and money than before. When do the mentally ill get some slack for being mentally ill. They can no more help that they’re mentally ill than a diabetic can help having diabetes. You can usually only treat it.

    It just seems as though so many people would rather cut benfits from people who really need them the most and if you keep cutting from these people, as per always, we’re (society) going to end up paying more than the government is trying to cut. When do the cuts get to come from the top and from programs like sports programs. When do we actually do this the smart way.

    It’s been said before and I’ll say it again, it costs more to hospitalize someone who’s mentally ill than it does to provide day services and medication services. When will people in power actually listen to those of us who actually work with the mentally ill. We really do know what we’re talking about and we could probably save you much more money than you’re trying to cut.

  11. Jim

    June 13, 2009 at 1:03 pm

    One thing to remember about Medicaid in this state is that for every $1 the state spends it gets $3 back in federal funding. This is a money maker for the state it does not make since to cut. Why do the lawmakers not understand that? If the current budget passes tens of thousands of patients across the state will go without the proper care not to mention the job losses in our industries. They will keep cutting us unless we can organize as a group and fight. The NC Council is a joke and does nothing more than offer training they are suppose to be advocates for both providers and patients but they remain silent at this point and I feel they are out of touch with reality. They will not see another dime of my money. I know I’m not the only provider that feels this way! I urge everyone to contact their representatives in the house and senate and let them know the true cost of these cuts. We can not sit idle and let the out of touch policy makers completely destroy what little mental health we have left in this state. We still have time the senate has to reach an agreement with the house before it moves to the governor’s desk

  12. Sean

    July 24, 2009 at 10:02 pm

    I think the cuts to the HHS field are not good and will end up costing the the state in taxes in the long run. I am a provider and I know that my job allows people to work while i assist with there children or teach there children good social skills. These cut backs will distroy many two income homes. I know for a fact that I in a since allow for at least $100,000 of taxible income to flow through the state. This is me alone rember that and that I know some that cause more than that to flow. So i do beleave that when that is taken into consideration the budgets are actually cutting Millions of dollars to flow through the state. I wonder if the Govener took that into consideration. My job also keeps individuals out of jail through the use of skill building teaching individuals to act this way and use calming skills instead of blowing up. This is very important when talking to a judge i do beleave. So i do hope that the governer does not mind paying more in law inforcement now whith these budget cuts. I mean in a since there taking out of one hand and putting 2+ in another. The biggest problem is when you gave to the one hand it was through educating and teaching and allowing a person to make better choices. Now, you putting 2+ into a hand that will lock up and investagate does this really work. Not that I think i am better than law enforcement but i do believe that where just as important in a way. Of course I will never save a life on the streat or catch a criminal, but i do keep people from ending there lives (or is that saving a life). I do assist folks in making better decisions that can keep thenselves out of Jail or from doing some criminal acts. I think that we all need to see whats important for the lives of all thoes that were not given the correct guidance in there youth or from there parents. Community supports really feels in the gaps of homes that are broken or have to live on two+ incomes if one parent has to work a second job to make ends meet. Community Supports Works for many many people and there are a few that do slip through the cracks but for the most part there would be a much higher crime rate if CSWs did not exist. untile Taxes are lowered and you can live off 7.55 an hr there is a need for CSWs. Untile there is a “takes in every thing a child or adult with any mental or substance problem” book put out there is a need for CSW’s. there was a time when people that had mental problems were locked in small rooms and druged I would hate to see that happen again. the whole ideal of history is to learn from are mistakes and by eliminating Community supports and cutting CAP/MR servises this is what will happen all over again. As a worker in the human servises fiel we hold titles like Teacher, Councler, medical advisor, Legal advisor, ect. we help all people learn bettewr ways to live and proform this is very important.

  13. Raymond Sanders

    June 22, 2010 at 10:06 am

    We understand the need to cut the state’s budget, but at what cost to the people being served. We hear alot about the smaller minority MR/MI/CAP providers that are not complying with DHHS rule. All the recouping of money, which put alot of us in tax trouble. But what about those companies that are doing what is ask of them and complying with all the rules. We as a small provider who has put everything we own into our business will soon lose everything we own because DHHS decided instead of helping those companies that are in good standing with them to invent this new thing called CAHBA to close down all the smaller minority MR/MI/CAP providers. The National Accreditation couldn’t get enough of the minority providers to just give up and quit, so they continue to spend money on getting us out and less money on the people who need the services.
    Governer Perdue was in LaGrange about two weeks ago to promote small business, she was about twenty mile from our office. While promoting small business in one town, not concern about small businesses being closed in Kinston. Some voices speak louder that others as a minority I understand that. So like alot of people I know who have or had a small business, we will try in another state once we get straight with the IRS. North Carolina not for minority who want to be in business. Thank you for reading this. This is not a complaint, We just understand the mind set we are dealing with.

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