You know... as in "fall through the cracks", what we call it when people can neither help themselves nor find help otherwise, and are lost to us.

[Full text here, until Thursday when it goes into archive, so I'm stretching "fair use" to quote large chunks]:

Missouri faces hard spending proposals

Social service programs bear the brunt under Gov. Blunt's budget proposal

By Kit Wagar

The Kansas City Star

JEFFERSON CITY — As the dust begins to settle from Gov. Matt Blunt's call to roll back social services, the breadth of the proposed cuts is becoming more evident.

The First Steps program, which helps 8,100 toddlers with Down syndrome, cerebral palsy, spina bifida and other disabilities get ready for public school, would be eliminated. Funding for personal care assistants, who help 119 persons dress and eat, would end.

Psychiatric care for 12,075 people would be reduced. Drug and alcohol treatment programs that serve another 6,311 persons would be scaled back. Early childhood education funding would be reduced.

Those service cuts come on top of a dramatic reduction in eligibility for Medicaid, which pays for health care for the poor. More than 89,000 people would lose coverage beginning July 1 and 33,511 would have their health-care benefits reduced.

All together, these and other social service changes would affect more than 155,000 people while expecting to save the state more than $700 million next year.

[snip]

[Rep. Margaret] Donnelly [a St. Louis County Democrat] and Rep. Jenee Lowe, a Kansas City Democrat, said many of the cuts made little sense because they throw away millions in federal matching funds. Estimates from the Senate Appropriations Committee show that elimination of the First Steps program saves $23.3 million. But $10 million of that comes from the federal government.

Lowe called the program an investment that saves money by reducing expenditures on special education for children when they reach school age.

Ending medical care for workers with disabilities saves $65.4 million. But $41.6 million is federal money. A habilitation center in St. Louis, one of five in the state, is slated to close. Two others — in Nevada and Marshall — would downsize. That would force 400 mentally retarded adults to find care in community-based programs.

Blunt said they would be better served outside of institutions. But community mental health programs also would be cut by $13.4 million under Blunt's plan. And three of the state's 39 independent living centers also would be shut. It has not been determined which ones would close.

In addition, $10.2 million would be cut from private contractors who treat alcohol and drug problems. Donnelly warned that such cuts in mental health programs ultimately show up as increased costs for police and local jails, which are ill-suited to handle people with mental disabilities.

I would not be a "fair-and-balanced Fox" if I didn't also include this excerpt:

Blunt acknowledged some of his proposals might have to be adjusted as the budget works its way through the House and Senate. But other programs, such as First Steps, will need to be remade, he said. He pledged that a way would be found to provide services to every disabled child in the program and every child who needs them in the future.

But those services won't necessarily be paid for by taxpayers. Some parents might have to begin picking up the cost. Parents with private insurance should be required to use that coverage to pay for the therapy and other services they receive. And Medicaid might cover many poor children in the program, he said.

The keyword is "might"... and by the way: Has anyone here looked at their private provider's annual spending caps on mental health coverage? Probably not, because you assume you'll never need it. But do so -- while realizing that the kinds of conditions now euphemized as "developmentally delayed" are lumped into that category, even for physical effects -- and imagine how little coverage your insurance would give your child.

I can hope, for the sake of those potentially affected, that Blunt is proposing the extreme now in order to be satisfied with the compromise later. Tactics like that, however, have been known to blow up in one's face. He could be stuck with exactly what he's asking for: a couple of thousand more untreated mentally ill, homeless and on the streets; a couple of hundred fewer children prevented from becoming unproductive (and probably also homeless) adults . . . but hey, he'll save even more money on Medicare when the people he throws off of it die.