Ashley Howard takes her 5-year-old daughter Gabby to see Oak Island pediatrician Jugta Kahai at least every other week.
It can be as often as every week depending on Gabby, who has the extremely rare, genetic disorder primary ciliary dyskinesia that gives her constant ear, sinus and respiratory infections.
More than three years ago, it was Kahai who finally helped diagnose Gabby, who had coughed since a baby but had befuddled other doctors and specialists in the state.
“We can come here instead of going to Chapel Hill. Nobody else knows what to do with her,” said Howard, who lives in Oak Island.
Because Gabby qualifies as disabled, Medicaid helps the Howards pay for the costly equipment and medicines that the family’s insurance does not cover and that help keep her alive.
Howard has a vested interest in Kahai keeping the doors to her private practice open.
But for Kahai and other doctors throughout the region, that could become more difficult under drastic cuts that have been proposed in Raleigh as state House members try to balance a budget whacked by the economy.
The House is expected to vote this week on its version of a $17.8 billion spending plan for the state. House members also could approve a package of tax increases to raise an additional $815 million and intended to shrink the size of the some of the cuts to education, health and other programs that have been proposed.
House Democrats said they have a $4 billion hole to address for the upcoming budget year, though Republican leaders argued Tuesday that estimate was over-inflated to push support for the tax increases because it did not take federal stimulus money properly into account.
Local doctors and administrators for mental health services said they expected to see a decline in state funding this year as slowing tax collections affected how much money the state has to spend on programs.
But many said they were shocked at the size of recommended cuts that came from the House committee over the Health and Human Services budget.
The proposal that would most affect area physicians and hospitals was a 5.5 percent drop — followed next year by another 6 percent drop — in how much the state reimburses providers for Medicaid, the health coverage program for low-income and disabled people that is split between state and federal funding.
For doctors like Kahai, one of a dwindling number of physicians even willing to take new Medicaid patients, that change would cut deep if it were approved.
“We go check to check now,” said Kahai, who said more than two-thirds of her patients are on Medicaid. “I can’t even imagine how many other physicians are going to close their doors. They’re (patients) going to lose their primary doctors, and they’re going to go to the ER. How does that save the state any money?”
She said the proposed cut is a knock on doctors committed to treat underserved populations.
Local mental health officials also were taken aback by the House committee’s funding recommendations.
“It certainly is more than expected,” said Foster Norman, area director for Southeastern Center for Mental Health, Developmental Disabilities and Substance Abuse Services. “Most people would say that these cuts were more than what we had ever anticipated.”
For agencies like Southeastern that coordinate state money for local providers, there would be $50 million less in the coming budget year for direct services to people statewide, under the proposal.
Other proposed cuts would affect Southeastern’s payrolls and other services.
Another recommendation was to essentially phase out community support services that are funded through Medicaid and help those with mental health or substance abuse problems skills live in the community and pay for case management.
The committee’s recommendations would result in $3 billion in cuts to the N.C. Department of Health and Services, according to the Mental Health Association in North Carolina Inc, an advocacy group.
All of these proposals could change as the budget debate continues, especially if House Democratic leaders are able to gain enough support for the tax increase package. But that is expected to be difficult since some members already have spoken out against additional taxes while people are already struggling with the economy.
Any budget plan the House ends up approving still has to be worked out with the Senate.
“We have no idea what that might look like,” Norman said, who discussed budget concerns while meeting with members of the local legislative delegation last week. “It’s tough, and it’s going to be tough on everyone. At least the folks I talked to would like to find ways not to cut Health and Human Services so much.”
Vicky Eckenrode: 343-2339
On Twitter.com: @vickyeckenrode
Copyright © 2009 StarNewsOnline.com — All rights reserved.