Nevada officials on Tuesday outlined drastic cuts to the state's Medicaid program that include plans to ration adult diapers, eliminate denture and hearing-aid programs, and force personal care assistants to buy their own disposable gloves.
State lawmakers learned of the cuts at a committee hearing in which health officials said adult day care programs, vision services and outpatient programs for people with brain trauma would also be cut to slash $109 million from Medicaid costs.
The grim proposals brought criticism and rebuke from lawmakers of both parties over Gov. Jim Gibbons' comments that Nevada can no longer pay for "bloated government services."
To close Nevada's $881 million budget deficit, Gibbons has proposed eliminating public school mandates for class size and full-day kindergarten, and suspending collective bargaining for teachers. Public schools would lose $166 million, and administrators say hundreds if not thousands of teachers could lose their jobs.
Proposal to close prison
The governor also has proposed closing the 140-year-old Nevada State Prison in Carson City, a juvenile corrections facility in Las Vegas, and said 234 state workers would be laid off. More across-the-board salary reductions might be necessary, Gibbons said.
In his special State of the State speech Monday night, the first-term Republican governor who faces a June 8 primary blamed legislators for the state's budget crisis, saying "they gambled on new taxes and we all lost." He has told state agencies to plan for their budgets to be cut by 10 percent.
"The Legislature didn't cause this problem," Senate Minority Leader Bill Raggio, R-Reno, said during Tuesday's hearing before the Legislature's Interim Finance Committee. "We were able last session to delay some of this impact on the lives of a lot of Nevadans who really need some services."
He said it's a severe problem when legislators are "talking about reducing the number of diapers that incontinents will be able to get."
Assembly Speaker Barbara Buckley, D-Las Vegas, said lawmakers raised revenue last session to avoid such cuts.
"Cutting them off of dentures, hearing-aid services and diapers ... I don't know how we look the elderly in the eye," she said.
Most of the tax and fee increases approved in 2009 are scheduled to sunset at the end of the year.
‘They raised spending’
Gibbons' spokesman Daniel Burns said in response that legislators "raised taxes and they raised spending."
The governor in his speech "was merely reviewing the facts that got Nevada's budget where it is today," he said. "But that is history."
Burns said the governor, legislators and citizens "must work together to keep Nevada afloat."
In Las Vegas, several hundred university students boycotted classes Tuesday to rally against plans for deep cuts to funding for Nevada colleges. Higher education officials have said the proposed cuts of $147 million could force them to close colleges and campuses, lay off staff and increase tuition.
Many boarded buses and carpooled to the Grant Sawyer State Office Building, where they chanted "no more cuts" while the Finance Committee met inside.
Lawmakers are holding hearings before a special legislative session Feb. 23, when they will try to reconcile with Gibbons on how to balance the state's budget.
Mike Willden, state health and human services director, said the 10 percent cuts the governor is calling for would have totaled $132 million, but some measure were considered too onerous, so the administration reduced the agency's target reduction to $109 million.
‘Best of the worst choices’
Reducing the number of incontinence products that Medicaid will pay for to 186 from 300 per month will save $829,000 a year, the agency said. Eliminating reimbursements for disposable gloves can save $834,000.
About 4,400 people received dentures or had their dentures relined in 2009. Eliminating that benefit is projected to save $2.5 million. Ending adult day care, used by 367 Medicaid recipients last year, will save about $2.1 million.
Cutting reimbursement rates for personal care services by $1.50 per hour to $15.50 would save nearly $3 million, and reducing hospital reimbursement rates by 5 percent would save $5.3 million.
Willden said there are no easy answers.
"I'm giving you the best of the worst choices," he said.
He conceded that with proposed cuts so far totaling only half the state deficit, deeper cuts may be necessary.