Budget cuts fall hard on Missouri social services

JEFFERSON CITY, Mo. -- Budget cuts fell hard on Missouri's social services Tuesday as House lawmakers began the long and painful process of crafting a state spending plan amid slumping tax revenue.

If the cuts hold up, Missouri would halt funding for crisis pregnancy centers and maternity homes, eliminate its operating aid for community health care centers and cut in half the state subsidies for domestic violence shelters.

Those were just a few of the roughly $60 million in state spending cuts approved Tuesday by the House Appropriations Committee for Health, Mental Health and Social Services as it began work on the 2011 budget.

House Budget Committee chairman Allen Icet has instructed the six appropriations committees that serve as a starting point for Missouri's budget to try to trim 5 percent from the $23.9 billion operating budget proposed last month by Gov. Jay Nixon.

Tuesday's decisions show that the cuts for some specific programs could far exceed that. But the cuts embraced Tuesday still could be partially or fully reversed.

Under Missouri's budget process, the spending plans approved by House appropriations committees then go to the full House Budget Committee before moving to the House floor. The budget also must pass through the Senate before going to Nixon for his signature or vetoes.

Advocates for social services warned of potential dire consequences from the cuts.

The House committee, for example, voted to eliminate the entire $9.25 million in state grants for Federally Qualified Health Centers, the vast majority of whose patients are either uninsured or covered by the government's Medicaid program for the poor.

The health centers still would receive Medicaid payments, but if the state operating grants are eliminated, some of the 180 community health sites could be forced to close or lay off doctors and nurses, said Joseph Pierle, CEO of the Missouri Primary Care Association.

"The bottom line is this is going to reduce access to care in both urban and rural Missouri," Pierle said.

The House panel also voted to eliminate the entire amount -- nearly $2 million -- proposed for the Alternatives to Abortion program, which provides grants to not-for-profit agencies that encourage pregnant woman to give birth instead of having an abortion. The agencies provide such services as food, clothing, housing, ultrasounds and parenting skills.

"This is a program that has been funded since the mid-1990s, through Democratic and Republican administrations," said Sam Lee, of Campaign Life Missouri. If the cuts remain, "it could possibly lead to an increase in abortions, and that would be very unfortunate."

Domestic violence shelters would see a cut of nearly $2.4 million -- half of their total funding from state general revenue, although their federal funding would not be affected. That cut could prevent thousands of women and children from receiving safe temporary housing, said Colleen Coble, CEO of the Missouri Coalition Against Domestic and Sexual Violence.

Even without cuts, Missouri shelters have been forced to turn away people. About 10,500 women and children received shelter in 2008, the latest year for which statistics were available, while more than 9,000 were turned away because shelters were full.

"All of us understand it is a difficult year" for the state budget, Coble said. "But 50 percent is beyond a fair share [of the cuts], especially for women and children in danger."