OKLAHOMA CITY — Panic is mounting as the state budget crisis drags on into its eighth week and cuts to health care, mental health and social services programs are now just days away.
And some lawmakers warned that even deeper cuts to state agencies are on the horizon a day after House lawmakers killed a proposed tax increase on cigarettes, gasoline, beer and oil and gas producers.
Proponents argued the measure would have gone a long way toward bridging the state’s lingering $215 million shortfall that has health care, mental health and social service programs on life support. It would have also paid for $3,000 raises for teachers and $1,000 raises for public employees.
Meanwhile, as lawmakers continued to bicker Thursday over how to fill the state’s lingering $215 million shortfall, the state’s Health Care Authority reluctantly approved 9 percent cuts to the Medicaid reimbursement rates it pays medical providers. Observers say the rate cuts will likely make it more difficult for many of the more than 800,000 enrollees to access care.
Also, a Wynnewood nursing home announced it couldn’t afford to remain open, displacing the 25 elderly residents who lived there.
And the situation will likely worsen without action, advocates warned.
Come Dec. 1, the funding for a number of programs, including Medicaid, outpatient mental health treatment, and the Medicaid ADvantage Waiver program — which provides in-home care to lower-income Oklahomans — dries up. The programs were supposed to be paid for by lawmakers’ unconstitutional cigarette tax.
“Cuts to mental health and other services will be much more severe,” said Senate President Mike Schulz, R-Altus, in a statement after Wednesday’s failed House budget vote. “The cuts will be deep and spread out across the government. … If we spend everything we have now, there won’t be any money left over for other emergencies that could arise.”
House Speaker Charles McCall, R-Atoka, meanwhile, urged the Senate to use existing cash savings to fill the budget hole.
Gov. Mary Fallin said Wednesday that she’ll keep lawmakers working until Christmas if that’s what it takes. She said she’ll veto any budget that uses one-time money, all available savings and makes “draconian cuts.”
“I’m losing hope. They don’t seem to be on the same page,” said Brett Coble, board president of the Oklahoma Association of Health Care Providers. “Meanwhile, the clock is ticking, every day we find ourselves closer to Dec. 1. I’m just afraid of what may happen that cannot be undone even if our Legislature finds the will to do something in December or January.”
Nursing homes are bracing for a 4 percent reduction in their Medicaid reimbursement rates starting Dec. 1 if lawmakers do nothing, Coble said. That would leave about a third — or 100 — of the state’s nursing homes insolvent, he said.
“There is a lot of panic around a reduction in our Medicaid rate because many facilities struggle day-to-day under the current reimbursement structure, and any reduction could render their facility insolvent,” said Coble, who operates six nursing homes and one assisted living facility in southern Oklahoma. “We understand that (the Health Care Authority is) not taking that action by choice. It’s the position the Legislature has put them in.”
Significant cuts are also coming for mental health providers, said Michael Brose, CEO of Mental Health Association Oklahoma, which provides advocacy and education services.
The state’s mental health department has said it will need to eliminate all outpatient treatment.
“It’s hard for me to believe it,” he said. “I’m in some kind of denial. Numb. The cuts are inevitable at this point. It will affect lives, jobs, people who need these services, medications, therapy, outreach.”
Even though lawmakers pushed through a bipartisan measure to take more than $23 million from the state’s savings account to pay for mental health services, it’s not nearly enough to fill the agency’s $75 million shortfall, Brose said.
“That’s sticking a finger in the hole in the dike,” he said. “The hole is a lot bigger than the finger.”
Department of Human Services officials had hoped the Legislature would advance a plan to fill their $69 million gap before Nov. 1, said Sheree Powell, a spokeswoman for the Department of Human Services.
The agency will be short funding Dec. 1 — when it was supposed to start collecting on the cigarette tax. It now plans to eliminate care for seniors and adults with disabilities, the ADvantage Waiver Program, child care subsidies and other programs for vulnerable Oklahomans.
“We are hearing from our clients every single day,” Powell said. “They are worried. They’re upset. Some are frantic. It is frightening for everyone. I know that everyone here at DHS is just sickened at the thought of what our clients are going through.”
Powell said lawmakers have promised they won’t let the programs fail. If they can come up with a way to fully fund the agency by Dec. 1, the cuts can be avoided, she said.
“All of us here at DHS are just watching this every single day, and just hoping, hoping a resolution will come,” she said.