Community health center officials said yesterday they fear lengthy hospitalizations and an increase in emergency room visits for Medicaid patients if a proposed $150 million in Medicaid cuts is made over the next two years.

"It’s going to be an unmitigated social disaster if this happens," said Matthew Na­gato, spokes­man for the Hawaii Primary Care Association, at a news conference with other community health center officials at the Waikiki Health Center.

May Akamine, executive director of the Wai­ma­nalo Health Center, said clients there are seen more frequently in outpatient visits that help to prevent expensive hospitalizations. "Their lives are at stake," Aka­mine said.

Her sentiments were echoed by Beth Giesting, chief executive officer of the Hawaii Primary Care Association.

"These are people who are our neighbors, people all across Hawaii who are suffering from economic hard times, whose lives may very well go into crisis with these changes," Giesting said.

Community health centers report struggling to serve 32,000 people who are uninsured. Three-fourths of their patients either use Medicaid or are uninsured, said Giesting.

Mentally ill patients, who already have limited services, are among those who will be affected, providers warned.

The Adult Mental Health Division began cutting services and programs in the latter part of 2008. In January 2009, case management hours that include counseling and accessing medication dropped to 3.5 hours per month from three hours per week. As a result of the cuts, some patients have become noticeably agitated, the health officials said.

Sheila Beckham, executive director of the Waikiki Health Center, said temporary restraining orders have been filed against patients who have threatened staff or damaged property by punching walls and shattering windows.

Beckham said she foresees more reductions in patient support if further cuts force the layoff of about 25 people. Public safety also will be at risk, as patients will take out their frustrations elsewhere, she said.

In a written statement, Pat Mc­Man­a­man, director of the state Department of Human Services, said, "This is a difficult task because we have an acute sense of the impact these cuts will have on vulnerable families as well as elderly and disabled patients who depend on Medicaid coverage."

"We’re trying to minimize the impact, but none of the options are very attractive from the perspective of the Department or the clients we serve," she said.