TribBlog: HHSC Making The Cut

The Texas Health and Human Services Commission has released its best bets for how to meet the 5 percent budget reduction requested by Gov. Rick Perry and other state leaders. The possible reductions, distributed in an email Wednesday morning, come in an advance of an HHSC public hearing on Thursday.

In order to make a 5-percent reduction across its five agencies, HHSC will have to cut about $205 million from the agencies' biennial budget — plus reduce the rates paid to providers for many state health programs (a savings of another $100 million). The recommendations call for:

—A 1-percent provider rate reduction for most Medicaid programs, including acute care, dental services nursing facilities and family planning.

—A 2-percent provider rate reduction for Medicaid long-term care, for residential and acute care adults, and for nursing and hospice.

Other possibilities:

—Almost all health agencies could institute a hiring freeze.

—The Department of Family and Protective Services could eliminate an in-home pilot program to enhance family preservation.

—The Department of Assistive and Rehabilitative Services could reduce independent living programs for the blind and those needing rehabilitation — and try to make up the difference with stimulus dollars.

—The Department of State Health Services could eliminate dozens of beds in both the Rusk, North Texas, San Antonio and Terrell mental hospitals. The agency could also reduce services for children with special health care needs, cut administrative costs at state hospitals, reduce available trauma funds for trauma centers and reduce funding for regional offices which also serve as local health departments.

—The Department of Aging and Disability Services could reduce travel costs and curb cases where in-home care services exceed state limits.

—The Health and Human Services Commission could delay implementation of a Medicaid buy-in for children.

In a letter sent to state agencies last month by Perry, Lt. Gov. David Dewhurst and House Speaker Joe Straus, the leaders directed the agencies under HHSC to present a unified plan like this one.

"Reducing direct services should be your last option," the letter notes. "Specifically, there should be no reductions to benefits or client eligibility levels in the Medicaid entitlement, Children's Health Insurance Program and foster care programs, and no reductions to eligibility staffing."