Health care budget cuts begin this week

BATON ROUGE (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


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.