Health and human service agencies on the Vineyard are already feeling the effects of severe state budget cuts made last week by Gov. Deval Patrick and are bracing for more in the months ahead.

State funding to Family Planning of Martha’s Vineyard and Martha’s Vineyard Community Services was slashed in the cuts, while directors at the Island Health Care Rural Clinic in Edgartown and the Martha’s Vineyard Hospital were busy this week preparing for spending and hiring freezes.

The cuts were the first made by Gov. Patrick in an attempt to close a projected $1.4 billion deficit in the state budget.

“It’s big. It’s huge,” said Patty Begley, director of family planning, the Vineyard Haven clinic which provides reproductive health and family services on a sliding-fee scale. Family planning operates as part of Health Care of Southeastern Massachusetts, a nonprofit health and human service organization which runs nine similar clinics throughout the Cape and the Islands. The organization lost 11 per cent of its state funding — nearly $100,000 — in the cuts.

“We have not really made any firm decisions about how we will manage it other than we are in meetings constantly to try and figure out the best ways to minimize stress to our clients and staff,” said Health Care of Southeastern Massachusetts development director Bev Wright. “Without a doubt, across the state, people in need of social services will be impacted by this in a negative way,” she continued. “Service needs will increase and provider ability to provide those services will decline.”

“We will try to minimize the cuts to the patients and try to keep hours and staff the same,” Ms. Begley said. Past funding cuts have resulted in decreased services and increased fees for patients and no pay raises for staff, Ms. Begley said. Following particularly severe budget cuts in 2003, Health Care of Southeastern Massachusetts was forced to close two of its clinics, one in Falmouth and one in Quincy. “We do not see the clinic closing as a result of this, although we do see more budget cuts on the horizon,” Ms. Wright said.

The Community Services Daybreak program, a drop-in center that provides vocational and social rehabilitation services to people with mental illness, lost 5.2 per cent of its funding, said community services director Julia Burgess this week. The cut amounts to a loss of $10,200, the equivalent of a partial staff position.

Mrs. Burgess said the organization also lost a small amount of funding for substance abuse programs. Funding for domestic violence and sexual assault programs remain intact. “So far, we were not affected as badly as we feared,” Mrs. Burgess said. “We were expecting to close our doors, practically, but I think we can make it through the winter, of course.” To offset funding decreases, Mrs. Burgess said Community Services may possibly reduce operating hours and cut printing costs and travel expenses. “So that we can keep up the best level of services, we are making sure that we are as efficient as possible about doing our work,” she said. The funding cuts come just one month after the organization unveiled an ambitious five-year strategic plan. Mrs. Burgess said the plan itself will not suffer, but the timing of certain initiatives could be delayed.

She said the biggest impact to Community Services will be felt indirectly. The organization often refers patients to health centers and practitioners on the Cape for services not offered on the Island. Some of these agencies fared much worse than Island agencies in this first round of cuts.

Massachusetts residents enrolled with MassHealth, the state insurance program, will also feel the impact of the budget cuts. Timothy Walsh, president and chief executive officer of the Martha’s Vineyard Hospital, said the MassHealth insurance program stands to lose $45 million in funding from state budget cuts. Drug co-payments will rise and travel reimbursements will decrease for those covered by MassHealth. Providers who care for MassHealth patients could see a decrease in reimbursements for services. Family planning, Community Services, Island Health Care and the hospital all accept MassHealth. Sarah Kuh, director of Health Care Access, said about 1,000 Island residents are enrolled in MassHealth. She worries that the cuts to providers will impact the level of service for MassHealth patients. “If a provider gets paid less, there is less of an incentive to provide care,” she said.

Mr. Walsh said eight per cent of hospital patients have MassHealth. “It could be a little bit of a hit to us,” he said. He said 75 per cent of patients at the Windemere nursing and rehabilitation center use MassHealth. “Right now, they’re not making rate cuts, but they may freeze them going forward, which would be tough for us,” Mr. Walsh said. The hospital will continue to provide core services, Mr. Walsh said, but will aim to tighten spending. He said no staff cuts are planned at this time and there will be no impact on the $46 million construction project underway. But he did say the numbers in general at the hospital are down. “Our volume was a little less than last year and we’ve been trying to figure it out,” Mr. Walsh said.

“I don’t know yet how our MassHealth payments are going to be affected beyond just freezing levels,” said Cynthia Mitchell of Island Health Care. The first rural health clinic in the state, Island Health sees roughly 6,000 patient visits a year. It serves as a primary care provider for roughly 3,000 patients, about 120 of whom are covered by MassHealth. Mrs. Mitchell said the clinic was fortunate in this round of cuts. “We last year had close to $200,000 in grant funding from various state programs. We were very concerned that the same money for this year was going to be cut. Fortunately, none of it was,” she said. “The governor made it a goal to protect vulnerable populations. He obviously sees the community health center clientele as a vulnerable population and he’s correct.” But she said the long-term outlook remains uncertain. “I don’t believe the state budget is out of the woods yet. I won’t say there won’t be cuts farther down the road,” she said.

The funding cuts come just two years after a statewide mandate for universal health care. According to a survey recently released by The Boston Globe and the Blue Cross Blue Shield of Massachusetts Foundation, 97 per cent of Massachusetts adults have some sort of health insurance. Yet the study reports that in the past year, 13 per cent of insured residents were unable to pay for some health services. The same number chose not to fill prescriptions because of the high costs. “This ends up hitting people with very few resources,” said Ms. Wright of Health Care of Southeastern Massachusetts. “We need to come together and see that the residents of the commonwealth get their social services met, their mental health services met.”