Steve Tembeleski’s son Alex gets medical, dental and psychological care at Louisville’s Lee Specialty Clinic, a state-owned facility that provides comprehensive care to adults with developmental and intellectual disabilities. Alex, a 31-year-old who was born with a genetic intellectual disability, is one of roughly a thousand Kentuckians who will likely lose their care team as the clinic must cut roughly two-thirds of its budget starting next month.
“The irony is there should be two or three more of them,” Tembeleski said. “Not freaking shutting it down.”
The staff at the specialty clinic learned of the cuts Thursday and were told they will go into effect July 15. A spokesperson for the Cabinet of Health and Family Services said outpatient services would be severely limited and blamed budget cuts implemented in the two-year state budget. It amounts to a $4.5 million reduction for the clinic — roughly two-thirds of the facility’s budget.
According to multiple staff members, that could result in roughly a thousand patients being removed from services, although that number isn’t finalized.
“The Governor is currently taking steps to prevent the worst, and his administration repeatedly warned the General Assembly about the painful impacts of these cuts, but the state is now forced to bear the outcome of these shortsighted decisions and the chronic defunding from the federal government,” cabinet spokesperson Elizabeth Fisher said in a statement.
Amy Roller, the clinic’s front office department head, said she was told that only 8 staff members would be retained after cuts go into effect. Its website lists more than 50 staff members, including dental residents, nurses, therapists, clinicians and specialists. Roller said it’s a hard-to-find service, even in Louisville.
“We have patients that literally will drive here, spend the night just to get up in the morning, so they can have a routine dental cleaning, because they don't have those services out in farther parts of Kentucky,” Roller said.
Roller said the waitlist for dental services is two years long and just under a year for medical and psychiatric care.
“Everybody just lost their job, and that's not even the sad part about the story, because we could find new jobs,” Roller said. “But these patients — they can't find another dentist, another primary care provider or psychiatrist that can treat them.”
Gov. Andy Beshear’s administration blames 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 — specifically for the Department for Behavioral Health, Developmental and Intellectual Disabilities.
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 in July 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.
The Beshear administration did not immediately respond to questions about the significant cuts to the clinic and how funding is being prioritized. Earlier this week, Beshear announced he would shift money from elsewhere in the budget to cover projected shortfalls in foster care, Medicaid and the Temporary Assistance for Needy Families program.
House Speaker David Osborne, a Republican from Prospect, said in a statement the Lee Clinic provides “critical services” for Kentuckians with intellectual and developmental disabilities. He pointed to the legislature’s specific line item allocation.
“While the line item was reduced by $80,000 over two years, this is just a fraction of the egregious and harmful cuts the governor reportedly intends to make. Unfortunately, this appears to be another example of the Governor choosing to make unnecessarily harmful reductions to proven, essential programs rather than identifying areas of government spending that are outdated, less effective, duplicative, or nonessential,” Osborne said. “At a time when families are relying on these services, the administration should be focused on protecting critical care and support systems, not placing them at greater risk.”
Specialty care for Medicaid patients rare across Kentucky
Fisher with the cabinet said they would provide a “one-time allocation” to extend the transition timeline for patients and staff. None of the staff members who spoke to Kentucky Public Radio had heard of such an extension — they were informed at a Thursday afternoon meeting of the cuts and given one-month notice. Fisher did not respond to additional questions. She said in a statement the clinic would continue to operate its inpatient wing, the Bingham Gardens Intermediate Care Facility.
Staff members at the clinic are speaking out about the importance of their services. Hayli Potts, a patient care specialist, said places that provide comprehensive, specialist care for people with complex special needs are few and far between, but the demand is high.
“The need for a place like this is just so great that we have that wait list,” Potts said. “To hear that not only are those people on the wait list never going to get off of it now, but the people that we already serve may no longer get our care is really heartbreaking.”
Ashlea Murphy, a medical assistant at Lee Clinic, said the ability to provide so many services under one roof is rare. The clinic offers primary care, physical therapy, ophthalmology, dietary services, endocrinology, audiology, psychiatry, behavioral analysis and dental care under one roof.
Murphy knows how valuable that is both as a staff member and as a family member — her brother is also a patient at the clinic. Many facilities or providers are unwilling to take on clients with intellectual and developmental disabilities, especially those prone to outbursts or with difficult-to-manage behaviors.
“There's not a single patient in this clinic that has not had some type of traumatic horror story from trying to be seen in a hospital or a different facility or setting,” Murphy said. “We take crisis patients that have exhausted all of their resources in the community, and they come here and, and they stay out of the hospital.”
Tembeleski, who cares for his son Alex with his wife, said services for older kids and adults with developmental disorders are few and far between. Some doctors and dentists simply won’t see adults with difficult behaviors or hard-to-control outbursts. But the staff at the Lee Clinic choose to work with patients like his son and do it better than anyone, Tembeleski said.
“Special needs kids, once they get to a certain age, they age out, and people just want to put them in the closet, just don't want to see him in public, and it's just unfortunate. But it is reality,” Tembeleski said. “Those working at the Lee Clinic know what they're doing because they choose to be there and work with adults with special needs.”
A friend of Tembeleski’s set up a website, encouraging people who want to save the clinic to contact the governor’s office. He said he’s looking into yard signs, t-shirts, posters.
“It's a matter of what can we do to get people pissed off enough,” Tembeleski said. “This is ridiculous. How can you not fund this?”
