1 day Ago By Paul Cuno-Booth
Doctor's office - NHPR file photo(NHPR)Health care providers and mental health agencies are pushing back on proposed cuts to Medicaid and other health programs in the state budget, warning they could harm some of the state’s most vulnerable residents.The budget that passed the New Hampshire House last week would cut Medicaid rates for providers by 3% across the board – for a total of $52.5 million over two years – and reduce funding for community mental health programs by tens of millions of dollars, among other cuts.
House Republicans have said deep spending cuts are necessary, given the financial pressures facing the state. The budget is now in the hands of the state Senate.Leaders of community health centers and other safety-net providers say the cuts could reduce access to primary care, mental health care, home care and other essential services.
“New Hampshire needs Medicaid rate increases, not decreases,” Greg White, the co-CEO of Lamprey Health Care, said at a news conference Friday.White said nonprofit health centers like his are the only primary care providers in some parts of the state, and nearly half their patients have Medicaid or are uninsured. He said Lamprey Health Care, which has locations in the Nashua area and Seacoast, would lose about $150,000 in the first year from a 3% cut in Medicaid rates.
That comes on top of other pressures, like the federal government’s recent decision to cancel $80 million in public health funding for New Hampshire, he said.“New Hampshire’s safety-net system is being hit from all sides right now,” White said.Medicaid rate cuts would also reduce in-home care for older adults and people with disabilities, said Amy Moore, vice president of management services at Ascentria Care Alliance, an organization that provides home care and other services.
During the last budget cycle, lawmakers approved a major increase in Medicaid rates for in-home care after years of underfunding. Moore said that allowed Ascentria to boost hiring and provide an additional 4,000 to 6,000 hours of care per month.If lawmakers cut that funding again, Moore said, most home care providers she’s talked to would have to serve fewer Medicaid patients.
Some would need to let staff go or stop taking Medicaid altogether.“Vulnerable residents will lose access to home care and be forced into hospitals and nursing homes,” she said at Friday’s news conference.The House budget would also reduce funding for community mental health programs – cutting about $18 million per year from what Gov.
Kelly Ayotte had proposed.Patricia Carty, the CEO of the Mental Health Center of Greater Manchester, said that could affect a range of programs that help keep people out of the hospital – including housing supports for people with mental illness and mobile crisis teams that respond to mental health emergencies.The state has expanded such services in recent years, as part of an effort to overhaul its mental health system and eliminate waitlists for inpatient care that have left patients languishing in emergency rooms for days.
The state is currently under a court order requiring it to stop boarding those patients in ERs.Carty worried the proposed funding cuts would reverse the state’s recent progress toward reducing wait times.“You will have more and more people in the emergency room,” she said.
The New Hampshire Department of Health and Human Services declined to comment on how the proposed cuts would impact mental health programs, citing the ongoing budget process.Another change from Ayotte’s budget concerns home and community-based services for people with developmental disabilities. The House budget took out funding to cover services for people expected to enter the system over the next two years, said Marissa Berg, the executive director of Community Support Network Inc.
, a group representing the agencies that provide those services.“Nearly 300 individuals with developmental disabilities will be leaving school over the next two years and entering adulthood,” she said. “These are individuals whose ability to participate in and contribute to their community depends on the very funding that has been eliminated” from the House’s budget proposal.
Any cuts to Medicaid could hit rural areas especially hard, Ed Shanshala, who runs Ammonoosuc Community Health Services, told reporters Monday. The nonprofit health center has five locations in Grafton and Coos counties.Medicaid covers a disproportionate share of patients in rural areas like the North Country, and is a key source of revenue for health care providers in those communities.
Shanshala said funding cuts could reduce access to primary care in areas that already have few providers.“When we don't get into primary care, people are going to present at the emergency department,” he said. “And it's really not the place to get your diabetes taken care of, or your congestive heart failure, or their well-child visit.
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