Kentuckians with intellectual and developmental disabilities and their caregivers crowded Frankfort committee rooms Wednesday as they urged lawmakers to reverse massive funding cuts to the Lee Speciality Clinic in Louisville.
The clinic, which provides comprehensive medical, dental and behavioral care to the highly vulnerable population, is set to sharply curtail its outpatient care in July, eliminating services for more than 1,000 disabled Kentuckians.
Parents, family members and those with disabilities overflowed the Medicaid Oversight and Advisory Board meeting to beg lawmakers and Democratic Gov. Andy Beshear’s administration to not treat them as a “pawn in this political game between the executive and the legislature.”
“Why are we, this community, being punished with the loss of the only specialized care facility that we have in Kentucky?” asked Bill Kenealy, board chair of the Council on Developmental Disabilities.
Beshear hinted in a video Tuesday evening that a fix may be imminent, implying an announcement may be made at his regular press briefing Thursday.
Many parents told lawmakers how their child struggled in standard medical settings, but how, at the specialty clinic, they were finally able to get their child stabilized. Many explained how their child would likely end up in a series of emergency rooms and intensive care units if not for the Lee Clinic, costing the state more and putting their child in danger.
Kim Thompson described struggling to find the proper diagnosis for her child. One month ago, thanks to the Lee Clinic, her son Forest got the genetic testing he needed and is now in the correct treatment.
“The multidisciplinary medical treatment that my son receives is just top notch,” Thompson said. “These employees are unicorns. They are different. This is not like a regular medical facility that you could just walk into. Everyone is highly specialized with an adult intellectual developmental disability population, and they are working day and night to treat this population.”
Beshear’s administration blamed shortfalls in the state budget for cuts, saying funding allocations for the Cabinet for Health and Family Services were not enough to cover ever-expanding costs. At the Wednesday hearing, Health Secretary Steven Stack defended the decision, saying the budget is forcing difficult choices, but that Beshear will soon offer a “band-aid” to help the clinic through the next year.
“The budget that was passed did not contain enough resources to do all the things the cabinet does. I don't want to argue with the legislature in this venue. That is where we stand,” Stack said. “I have to be able to have the dollars to pay the bills, and I'm engaged in dialogue, and look forward to ongoing dialogue with the legislature.”
The executive branch budget bill passed by the legislature this year included a specific line item for the Lee Specialty Clinic, appropriating $720,000 from the General Fund in the fiscal year that begins July 1 and $697,500 in the following fiscal year. That’s a roughly 5% cut from the previous budget, but not close to the multi-million-dollar cut coming the way of the clinic in July.
The Department for Behavioral Health, Developmental and Intellectual Disabilities receives an increase of roughly $16 million in each of the next two years in the new budget compared to current funding levels. However, the annual allotment is roughly $12 million less than what Beshear recommended in his budget proposal.
Louisville GOP Rep. Ken Fleming, who co-chairs the Medicaid advisory board, told the sea of supporters that he understood their plight. He said he expects the Beshear administration to present a plan for how to provide these services moving forward.
“The operating contract for Lee Specialty Clinic to provide services has been eliminated by the administration,” Fleming said. “The services are still required, covered benefits under the Kentucky Medicaid program, and the General Assembly increased funding of these Medicaid benefits in the budget. What we have not heard [is] if there is a plan to continue to provide access to these services from the administration.”
In a statement, the Kentucky Democratic Party Chair Colmon Elridge again blamed the cuts on Republicans in the U.S. Congress and state General Assembly.
“This November, Kentuckians will elect Democratic lawmakers who know how to balance a budget without ripping care from foster children, seniors and the disabled,” Elridge said.
Two former Republican state representatives also spoke in support of the Lee Clinic, asking the legislature to ensure the program doesn’t go under. Former state Rep. Scott Brinkman told lawmakers that his 42-year-old son David relies on the clinic. He described the relentless pursuit for providers who could serve his son in Louisville, saying it’s likely even more difficult in less populous counties.
“These are healthcare providers who are willing to tend to their healthcare needs — their medical needs, oftentimes very complex medical needs, their dental needs, their behavior issues, and others,” Brinkman said. “In fact, it will wreak significant hardship on these 1,300 individuals and families, individuals and families who already suffer enough hardship and don't deserve to experience further hardship, certainly under circumstances which are completely avoidable.”
Several parents and advocates were especially afraid that, should the reductions go into effect, it would take years to get the clinic back to where it is now as specialized staff are already forced to look for jobs elsewhere.
There were several tense moments in the hearing, especially toward the end when Fleming initially cut off Stack, telling him he would not be allowed to address the room after hearing several pleas for help. When members of the audience yelled that he should be given the chance to speak, Fleming relented.
A friend of Corey Nett, a Kentuckian with cerebral palsy, read aloud his statement as Nett sat at the table beside her. In his statement, Nett called the two-year budget “morally bankrupt” and said it will cost the state more in the long run by forcing people with disabilities out of their homes and into intensive care.
“The staff at Lee is exemplary, and they are like an extended family to these patients, going above and beyond with their care and compassion, and from experience I know that no other place will give this population the respect that every human being deserves,” Nett said via his proxy. “If only 14 patients were to go into [Intermediate Care Facilities], that would equal Lee's yearly budget, and for those who don't go into ICFs, their primary care will probably be the emergency room, and people will die.”
The Lee Speciality Clinic already has a lengthy waitlist, both for its medical and dental services. Many supporters called on lawmakers not only to ensure the clinic’s continuation, but to invest in its expansion.
“I pray night and day that not only will the Lee clinic be saved, but that there will be a Lee Clinic in every county in Kentucky,” said Dr. Paula Robinson, the clinic’s director of medical services.
