NAMPA — Families coping with health issues like autism, schizophrenia and bipolar disorder may have to make do with fewer hours of therapy as the Idaho Department of Health and Welfare takes steps to save millions of state dollars in 2009.

Medicaid payments, including those made to service providers, will be reduced by $35.2 million because of state budget cuts. Payments to Idaho hospitals, doctors and nursing homes were also affected when Health and Welfare officials revised their fiscal 2009 budget in response to a 4 percent general fund holdback ordered by Gov. Butch Otter earlier this month.

"They aren't extreme reductions," Health and Welfare spokesman Tom Shanahan said. "We do have to make reductions in these major cost drivers."

The Medicaid cuts mean a cap on therapy hours allotted to developmentally and mentally disabled individuals.

"Part of the strategy was not to eliminate any programs, but to reduce the hours so we could still maintain the programs," Shanahan said.

Families receiving the benefits have already been notified in letters that the hours of developmental disability therapy will be reduced from 30 hours per week to 22. Families who don't want to reduce weekly therapy sessions will be responsible for paying for those services out-of-pocket.

There is a safety net in place for children, Shanahan said. Some children can be pre-approved for additional hours if it is deemed medically necessary. Families should contact Medicaid for more information and must go through a screening process.

The cuts to developmentally disabled Medicaid clients will save $2.6 million in total funds and $800,00 in state general funds. In 2008, Health and Welfare spent $168 million in Medicaid for people with developmental disabilities, Shanahan said.

The number of psycho-social rehabilitation hours was also reduced from 20 hours per week to 10.

"People are pretty scared because they automatically think this will make a huge impact in their services," Barbara Hill, a family support specialist with the Idaho Federation of Families, said.

But 87 percent of people already receive 10 hours or less of psycho-social rehab services, Shanahan said, so that cut won't affect as many people.

Hill said she understood the need to cut costs but expressed concern that the most needy families in Idaho will be impacted by Medicaid reductions.

"It's always sad to see us moving backwards in a time when we should be moving forward for people," she said.

Another cap to Medicaid-provided mental health services affects partial care, similar to group therapy. Partial care hours were reduced from 36 hours to 12 hours per week.

"That will save $2.6 million of the state's general funds and $6.1 million of federal funds. That's an $8.7 million reduction out of a whole year," Shanahan said.

Seventy percent of Idaho's Medicaid program is federally funded.

In addition to the cuts, Health and Welfare officials are taking steps to control the budget by reducing hours of some temporary workers, holding off filling some jobs and eliminating others.

All department employees are being asked to take three days off without pay over the next four months. Department managers are being asked to take four days off without pay.

• The Associated Press contributed to this story.