While a few members of the House and Senate are behind closed doors choosing budget cuts on our behalf, or bickering about construction projects, we want to make sure that Kentuckians know what’s on the table.

We’ve looked at some of the problems—the debt, the embarrassing shell games, and the painful cuts to education—with the budget proposals, problems that persist because our legislators aren’t choosing to pass real revenue reforms.  This post focuses on how the budget impacts services that help keep Kentuckians healthy.  Many of these have been chronically underfunded, and in the Senate's budget proposal, most face 5% cuts over the next two years.

Here are just a few examples of cuts, needs, and impacts:

•  Medicaid.  The Senate budget cuts Medicaid by $26 million, but the loss works out to be much more.  The federal government will pay 80% of the total cost of Kentucky’s Medicaid program next year.  This mean that for every 20 cents that Kentucky spends on Medicaid, we get the buying power of $1.00.  If the Senate’s proposal to cut Medicaid funding by $26 million passes, it actually means that Kentucky will lose the buying power of $104 million.  This, in turn, means that there are fewer resources going to struggling families.  

• Mental Health Services. Kentucky is asking mental health to pay its 2010 bills, and meet 2010 needs, with its 1996 income. Community mental health centers have had flat-lined funding for about 14 years, despite the growing demand.  And mental health is further impacted by those cuts to Medicaid.  Several states' Medicaid plans (Georgia and South Carolina, for example) cover "recovery-oriented" services--services that help people reclaim their lives after being affected by mental illness.  Ultimately, these services save money because they help people stay well.  But Kentucky doesn't even have the Medicaid funds to get such programs off the ground.  Instead, cuts to Medicaid will mean that fewer doctors and therapists are available to help people recover, even while several mental health centers already have waiting lists of five weeks, sometimes longer.

• Farms to Food Banks.  This program, which buys seconds crops from farmers and  distributes the fresh fruits and vegetables to food banks across the state, was eliminated.  For $400,000 a year, Farms to Food Banks was supporting Kentucky’s farmers, and offering struggling Kentuckians access to fresh food.  When Kentucky has some of the highest obesity rates—more than 1 out of every 3 children is obese,  and almost 3 out of every 4 adults—some of the highest rates of heart disease, and some of the highest rates of poverty in the nation, along with overstretched food banks…This program is among the many that we should be able to support.

• Rape crisis centers.
• HIV/AIDS services.  The Kentucky AIDS Drug Assistance Program (KADAP), for example, was promised an increase in state funding in 2007.  Not only was this increase never funded, but all state funding for KADAP was eliminated.  The current budget negotiations don't include a restoration of that funding.  About 160 Kentuckians with HIV are on KADAP's waiting list.
  

• Disability services.  Throughout the session, hundreds of people came to participate in the 874K Lobby Days for funding for disability services.  Over and over, they heard legislators say that they'd been heard and listened to.  But we're not seeing the evidence of those commitments in this budget.
• Food inspections.  Ever eat out?  Cuts to public health mean fewer restaurant inspections. Yum!
  
• Disease prevention.
• Immunizations.
• Programs for pregnant women's health.
• Programs to help take care of the elderly. These include Meals on Wheels, helping people live in their own homes, and inspecting nursing homes.
  
• Programs to help take care of children.  These include working with child care centers, foster care homes, adoption centers, and child protective services. Child abuse has skyrocketed in Kentucky.  Last year, 41 children died from abuse and neglect--the highest rate in the nation.  But social workers are reporting abuse and neglect only about half as often as they did nine years ago, according to reports by the Cabinet for Health and Family Services.  (More info in this C-J article.) Why are the reports of child abuse and neglect going down while the deaths from child abuse and neglect are going up?  Since 2008, our lawmakers have cut $51 million from human-service programs, including child protection. Social workers involved with AFSCME, the state workers' union, recently explained the impact of budget cuts on their work:  "Because I have to speed up investigations and make decisions fast, rather than efficiently, it leads to unfair results for families."  "We keep doing our jobs with less and less support from Frankfort.  Caseloads and the needs of Kentucky's families are continuing to rise.  We are stretched too thin. Something has to give."  "We often have to cut visits short to ensure that someone is in the office to take incoming calls."  They also point out the lack of resources for drug treatment.  Clearly, lawmakers' decisions are not working to take care of Kentucky's children.
• Nutrition programs.
• Drug treatment and substance abuse and prevention. In some Kentucky counties, drug abuse treatment means showing up to church. 
  

These are just a few examples of what lawmakers are choosing to cut when they refuse to pass revenue reforms.  It doesn't even touch the impact that repeated cuts to environmental protection have on our health, or the health impacts from continuing to prop up the coal industry (at a net loss of $115 million a year, according to MACED). KFTC will continue tracking the budget implications as they are seen and felt across Kentucky, and building support for reforms and solutions to move Kentucky forward.