Health departments across Kentucky continue to make cuts because of a dispute between the state and a managed-care company hired to help serve Medicaid patients.
The Lexington Herald-Leader reports the cuts include laying off workers, ending school health programs and decreasing clinic hours.
Kentucky Health Departments Association President Scott Lockard told the newspaper that health departments cut 53 workers last year, and another 95 have been cut this year. He said some departments are facing furloughs through July 1.
The Madison County Health Department, for example, announced the end of its school nurse program in February. Fayette County's health department ended that program last year.
"This dispute has put them in severe financial crisis," Lockard said.
The services most affected at the state's 59 health departments have been well-child visits, family planning services and school health services, he said.
For example, the Madison County health department announced the end of its school nurse program in February. Fayette County had to stop offering school nurses last year.
The problems stem from a $7.9 million debt that managed-care provider Kentucky Spirit is contesting in court. As part of the lawsuit, the company has declined to reimburse health departments for some services.
A spokesman for Centene Corp., which owns Kentucky Spirit, declined to comment due to pending litigation.
The company sued in October to end its contract with the state saying it had been provided with inaccurate information about services that Medicaid patients would receive. It pointed to state data showing an average of 390 emergency room visits per 1,000 clients, but said in the lawsuit that its experience found 942 visits per 1,000 clients.
The state is trying to find a solution, but so far has been unsuccessful.
A hearing in the case is set for Monday in Franklin Circuit Court.