Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
Associated Press - December 17, 2008
Jim Davenport
Health care advocates and providers said some people would be left without care and get sicker, which could lead to more expensive emergency room visits or worse.
"My God," said Sue Berkowitz, executive director of the low-income advocacy group South Carolina Appleseed Legal Justice Center, after reviewing a list of cuts.
One saves $40,000 by no longer enrolling HIV patients. "People are going to die. Denying drugs for HIV?" Berkowitz asked.
"These are lifesaving medications," said Carmen Julious, executive director of Palmetto AIDS Life Support Services in Columbia. "Compared to people's lives, that ($40,000) doesn't seem like a good balance to me."
People who are dying also lose state Medicaid money: The state is ending hospice care for Medicaid-only patients.
"Hospice is the only program proposed to be completely eliminated in this round," said Tamra West, who runs the Carolina Center for Hospice and End of Life Care.
While that will initially save $70,000, West says the full-year savings will be $6 million when federal matches are included.
They're all on the list of cuts the Department of Health and Human services released Wednesday to comply with a round of 7 percent, across-the-board cuts ordered last week by the state's financial oversight board. The state's Medicaid program has lost $137 million since July as state spending has been cut by $1 billion in the face of sagging tax collections and a faltering economy.
"We're not happy about having to do any of these," Health and Human Services spokesman Jeff Stensland said.
The agency is using $25.7 million from a reserve fund to cover a chunk of the shortfall. And it has plans to save more than $11 million with hospitals and nursing homes.
Most of the reductions elsewhere begin Feb. 1, including plans to halve the number of meals delivered to seven a week.
"They're going to be eating once a day, that's what we're really talking about," Berkowitz said.
The state's low-income elderly also lose help with prescription drugs. The state will save $2 million as it reduces payments that cover a gap in Medicare Part D's drug program. The state had covered 95 percent of the difference, but will cover 10 percent next year.
Eliminating Medicaid hospice benefits for terminally ill people and reducing home health nurse visits to 50 from 75 a year makes no sense to Jim Head, vice president at the South Carolina Hospital Association.
"Those folks are going to end up in the hospital emergency rooms most likely and at much greater expense to the Medicaid program and the state," Head said.
And the reductions come when a bad economy likely will increase demand for Medicaid, Berkowitz and Head said.
Stensland agrees.
"We think it's just around the corner and that will add even further pressure when we have more people that are eligible," and, he said, there will be "less money to pay for them."
S.C. Department of Health and Human Services: http://www.dhhs.state.sc.us/dhhsnew/index.asp
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