Rising caseloads, end of stimulus slams human services budgets

Lawmakers were told Wednesday that caseload increases and loss of stimulus funding will force the state to pump more than $400 million into Medicaid and other entitlement program budgets.

Health and Human Services Director Mike Willden told the legislative committee reviewing Gov. Brian Sandoval's proposed budget that caseload growth alone in the Medicaid, welfare and food stamp programs will cost an additional $244 million this coming biennium.

In addition, the more than $216 million Medicaid received in stimulus money won't be renewed. The percentage of Medicaid paid by the federal government will drop back from 64 percent to 55 percent in fiscal 2012 and 58 percent in fiscal 2013.

But the law bars the state from changing eligibility to reduce the number of people who qualify for those entitlement programs. As a result, he said Nevada must put an additional $460 million into those budgets for the coming biennium, pushing the state's share to more than $1.5 billion.

Because of the recession, Willden said the Medicaid caseload jumped 22 percent in 2010. Welfare's caseload increased 29 percent, and 45 percent more people qualified for food stamps. He told the committee that halfway through this fiscal year, those caseloads are still increasing.

He said, however, Sandoval put about $119 million back into his budget to protect critical services. About half that total is to pay for personal care attendants who help severely disable citizens remain in their homes instead of becoming institutionalized - a cost savings in the long run.

He said efforts are also being made to protect the Office of Consumer Health Assistance and the 211 telephone help system for people seeking health and other public services, which Willden called "one of the most important services we have."