Don Greever doesn't know what to do next year for his stepdaughter Amber Pepperdine.

That's because as of January, Medicaid will no longer pay for the service coordinator from TESH, Inc. that secures assistance for the 18-year-old autistic girl.

"She's Amber's voice," the Sagle father said.

It was the service coordinator who interceded when Social Security threatened to cut Amber's payments, Greever said. The coordinator found the best programs for Amber's condition, and ensured her high school developed an academic plan just for her. The coordinator even helped Amber obtain better medication.

"All the special places you can find all these services, (the coordinator) knows where they're at. We the parents have no clue," Greever said. "Without that, it's going to be a nightmare."

A number of Kootenai County families are facing similar problems, says Terri Johnson of TESH, the Coeur d'Alene nonprofit with programs for disabled and disadvantaged individuals.

Idaho Health and Welfare is cutting Medicaid coverage for some services for developmentally disabled children and adults, which Johnson said will affect all TESH clients.

Taking effect on Jan. 1, 2011, the coverage changes will deprive those on the Aged and Disabled Waiver of a service coordinator, who represents disabled clients and connects them with needed services.

"When they have struggles with something going on in their life, they might need help with school or medical equipment. And now they won't have someone who knows how to get that for them," Johnson said. "Some of our clients don't have family, so this is their person."

Also cut will be coverage for supportive counseling, provided for children and adults.

"Obviously they'll be losing their ability to talk with someone," Johnson said. "Some of our clients are court ordered to get these services, so they will lose that."

Anna Mae Padgitt of Coeur d'Alene is a developmentally disabled adult who will lose coverage for counseling.

Padgitt, who has been in counseling for a year at TESH, needs the sessions to help with anger issues that affected her at her previous job, she said.

"When I have it (counseling), I'm happy," Padgitt said on Tuesday. "It helps me not get upset."

Johnson added that Padgitt would like to work again, and the counseling was helping her work toward that.

Johnson estimated that about 19 clients will lose coverage for their supportive counseling, and 17 for their service coordinators.

The scrapped coverage is part of across-the-board cuts the Department of Health and Welfare had to make to balance its budget, said IDHW spokesperson Tom Shanahan.

Even with all the changes - about $160,000 was saved with the cuts to developmentally disabled coverage - the agency still needs to ask for a supplemental $10 million from the state this fiscal year.

"We knew we were going to be short. That's why we were working with providers to fill the gap from the very beginning," he said. "This was actually one of the smallest cuts we made, out of all our services. (Developmental disabilities) is less than 1 percent of the total budget we spend."

All the cuts were recommended by consulted providers, he added.

Shanahan explained that supportive counseling coverage was cut because it duplicates psychosocial therapy that is also provided.

But Johnson disagreed. The psychosocial therapy doesn't offer developmental therapy clients can get with supportive counseling, she said.

Developmental therapy is crucial for teaching independent living skills, she added.

"Currently if a client has developmental disabilities and they want to receive developmental therapy, there is no other option as far as counseling," she said.

The Idaho Association of Developmental Disabilities Agencies will give a presentation on these and other Medicaid changes from 5:30 to 7:30 p.m. on Tuesday at Northstar, 180 W. Clayton Avenue.

The new cuts only last until next July, Shanahan said, when this fiscal year ends.

But at that point even bigger cuts will need to be made, he said. Developmentally disabled services are just as vulnerable to slashing as any others.

"The 2012 deficit dwarfs the year we're in right now. It really does," Shanahan said.