Poor, disabled lose state funding

ALBANY -- The $52-billion Medicaid budget approved here Thursday upends the state's health system for the poor, saving billions of dollars while handing unprecedented power to the state Health Department and moving toward malpractice insurance relief.

The most dramatic change gives Health Commissioner Nirav Shah the ability to force midyear cuts on medical providers if Medicaid spending reaches a certain level. Essentially, providers must find $640 million in savings on their own or have it imposed on them.

"That is a watershed change," said Kevin Cahill, president of the Nassau Suffolk Hospital Council.

The cuts permeate every health sector, but advocates said they slash deepest from agencies serving the disabled. The budget removes more than $180 million from such programs, limiting, for instance, how often most patients receive speech therapy.

At United Cerebral Palsy Association of Nassau, more than 750 clients receive such therapy several times a week now. "You tell someone who doesn't have feeling in their foot or leg that they should go without a podiatry appointment," said Robert McGuire, the association's executive director.

The budget cuts make Allan Suchman nervous that his mentally disabled son, Seth, 35, may lose his Bay Shore group home. "It would be the worst thing that could ever happen to my son," said Suchman, 64, of Bay Shore.

Sen. Kemp Hannon (R-Garden City), chairman of the Health Committee, said lawmakers did the best they could to restore funding. "It was the least worst result," he said.

Most of the changes came from a Medicaid panel named by Gov. Andrew M. Cuomo, a Democrat. It puts all but about 500,000 of New York's 5 million Medicaid recipients into managed care. It also creates a fund to pay medical expenses for infants injured at birth, saving hospitals an estimated $320 million a year. But hospitals and doctors felt spurned by the lack of limits on malpractice court payments.

The budget could force program closures at Stony Brook University Medical Center, which is losing millions of dollars through reductions in Medicaid, and an end to a $55 million teaching hospital subsidy, a hospital spokeswoman said.

Nassau University Medical Center will essentially break even, thanks to two budget additions of about $4.4 million, president Art Gianelli said.

The outlook for its affiliated nursing home, A. Holly Patterson, was less clear. Nearly $2 million in cuts "have called into question the ability of our nursing home to remain profitable," Gianelli said.