Cuts would dramatically shrink Nevada safety net

AP Photo/Scott Sady

Gov. Jim Gibbons, center, stands with Dan Burns, his communications director, left, and a camera operator for the state as he prepares to give his State of the State speech upstairs in the Capitol building in Carson City on Monday, Feb. 8, 2010.

By David McGrath Schwartz (contact)

Tuesday, Feb. 9, 2010 | 2 a.m.

State of the State

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Gov. Jim Gibbons gave an emergency State of the State address at 6 p.m. Monday, Feb. 8. Video is courtesy KVBC Channel 3.

State of the State Address

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Carson City — During Gov. Jim Gibbons’ State of the State speech Monday, he told Nevadans to prepare for a smaller state government. Although the list of what he wants to jettison is not finalized, and some of these cuts need legislative approval, lawmakers privately have signaled that many will go through.

The cuts would run from the dramatic — allowing more mentally ill to become homeless — to the mundane — eliminating vacant positions.

The state would save $1 million by reducing janitorial services in buildings from five or six times a week to three days a week. At the Gaming Control Board, 27 investigators and auditors would be laid off.

Still, the cuts represent just a fraction of the $881 million hole Gibbons and the Legislature must close. Operations cuts total $162 million, slicing into health and human services, prisons, public safety and general government. The governor and lawmakers are considering $166 million in K-12 reductions and another $100 million in higher education cutbacks, reflecting about a 10 percent reduction of state allocations.

Although Gibbons rejected some proposed cuts, such as eliminating a health insurance program that covers 22,000 children of the working poor, he proposed curtailing enrollment in programs that serve the mentally ill, mentally disabled and seniors.

“It will be very, very difficult for someone to get into a service if they’re not already in it,” Health and Human Services spokesman Ben Kieckhefer said.

The Legislature will hold hearings beginning today on cuts, based on a document that will be given to lawmakers, proposed for the Health and Human Services Department, such as:

• Increase premiums of Nevada Check Up, which provides health care to children of the working poor. Quarterly premiums will go from $25 to $75 for some, and $75 to $180 for others ($1 million in cuts).

• Eliminate coverage for eye glasses for 6,300 people on Medicaid ($716,000).

• Eliminate hearing aids and hearing tests for those on Medicaid ($131,000).

• Stop paying for 4,400 Nevadans’ dentures ($2.5 million).

• Reduce the number of incontinence products, such as adult diapers and bed pads, that Medicaid will pay for ($830,000).

• End adult day care for 367 people. It’s typically used to care for an adult while the spouse or family member works ($2.1 million).

• Cut state reimbursement for nursing homes ($3 million).

• Not hire 77 staff workers to process welfare cases, slowing benefits for clients and falling further behind federal standards, according to the department ($1.4 million).

• Not provide housing assistance to the mentally disabled not currently enrolled in the state program. The department estimates about 300 fewer people will receive housing throughout the state ($6 million).

• Not provide housing assistance for the mentally ill. “This cut will increase the number of mentally ill homeless individuals in the community and put additional stress on community emergency rooms,” according to a department summary ($4 million).

• Eliminate the problem gambling program, which provides grants for treatment and prevention ($1.8 million).

• Reduce enrollment in the Community Services Options Program for the Elderly, which works to keep seniors in their homes ($1.2 million).

• Reduce Medicaid reimbursement for anesthesiologists ($2.5 million).

• Put certain anti-psychotic, anti-organ rejection and anti-convulsion drugs on preferred drug lists. Drugs not on the preferred list would require approval from the state before it pays for them ($767,000).

• Reduce payments for personal care attendants for the elderly and disabled by $1.50 an hour, to $15.50 per hour ($3 million).

• Reduce hospital reimbursement rates by 5 percent ($5.3 million).

• Reduce reimbursement rates to psychiatric facilities serving youth ($900,000).

• Reduce psychiatric visits in rural counties ($291,000).

• Reduce by 22 beds the capacity at Southern Nevada’s psychiatric hospital ($1.5 million).

• Freeze vacant positions at the state’s institution for the criminally insane, which, “may undermine the facility’s ability to maintain patient and staff safety” ($1.3 million).

• Close the Southern Nevada youth prison, Summit View Correction Center. Some youths would be transferred to lower-security facilities in Elko and Caliente, while others would be released into the community ($3.7 million).

• Cut by 10 percent Washoe and Clark counties’ child welfare and child protective services. Clark County has not addressed this possibility ($6.1 million).

• Eliminate tobacco cessation programs ($2.8 million).

• Put $40 million from the state’s tobacco settlement fund into the state general fund ($40 million).

• Cut funding for autism treatment ($1.5 million).