Child abuse prevention and at-home care for seniors are latest services at risk due to shrinking state government (Capitol Update)

Steve Lewis served as Speaker of the Oklahoma House of Representatives from 1989-1991. He currently practices law in Tulsa and represents clients at the Capitol.

Even with the legislature adjourned, there seems to be no dearth of activity emanating from Oklahoma City. The State Supreme Court has set oral arguments on the constitutional challenge to the cigarette “fee” for August 8, to be heard by the entire court. I haven’t seen the pleadings in the case, but oral arguments are usually among the last things to happen before an appellate court makes its decision. This must mean the Court decided to assume original jurisdiction and rule on the case quickly. Given the importance of the funding to the recently-passed budget and the havoc that would be created if the fee were implemented, then held unconstitutional, it’s a good thing to get the ruling before the fee is set to go into effect on August 25th.

Meanwhile, health care and social service agencies have been reacting to the budget cuts and shortfalls of funding that they received for next year, even WITH the funding that would be generated by the new $1.50 per pack cigarette fee. Department of Human Services (DHS) Director Ed Lake has said DHS is considering freezing admissions to the ADvantage Program. That means that as the elderly and frail go off the program — for whatever reason — their slots will remain vacant, thus saving the cost of providing services to new clients. The problem is if these folks do not receive the help they need to stay at home, they will likely either die sooner or end up in a nursing facility that is three times as expensive. Also, this will soon put out of business the private provider infrastructure that cares for these people outside nursing homes. This is not smart, and Mr. Lake would probably be the first to acknowledge so, but it likely puts in context how bad all other options are.

The State Department of Health (OSDH) is considering cuts to the Federally Qualified Health Centers that provide primary care to the uninsured and to Child Abuse Prevention Programs. The child abuse prevention programs, sometimes referred to as home visitation programs, are there to help get parents and newborns off to the right start in providing proper care and nutrition to the babies. With Oklahoma’s child abuse and neglect rate, it’s painfully obvious that just because a couple has figured out how to produce a child doesn’t necessarily mean they know how to care for it. The right start can make all the difference in the child’s life for the decades ahead and for those in the community who live with the child.

Among other things, the Oklahoma Health Care Authority (OHCA) has postponed the implementation of the managed care proposal that was supposed to more efficiently provide services to the blind, aged and disabled. Some had questioned from the beginning whether the program would save money, but the fact remains that the legislature directed OHCA to begin developing the coordinated care plan three years ago, and the agency has spent a lot of time, effort and resources to follow that direction. Now, because of lack of funding and possible Medicaid changes at the federal level, much of that work may become outdated. Moreover, If the cigarette fee is held unconstitutional because of the way it was passed by the Legislature, which seems likely, it will compound these already existing funding problems for DHS, OSDH, OHCA, and the Department of Mental Health and Substance Abuse Services.

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Steve Lewis served as Speaker of the Oklahoma House of Representatives from 1989-1990. He currently practices law in Tulsa and represents clients at the Capitol.

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