Living on a fixed income and battling several ailments, Mary Lou Sailer relies on a state-created prescription drug program to get her the right medicines at prices she can afford.
But Gov. Andrew M. Cuomo's proposed budget would eliminate benefits for some of the 300,000 low- to moderate-income senior citizens now covered by the insurance plan.
"This will hurt people's well-being. It's a necessary program. It isn't anything that's extra," said Sailer, 74, of West Seneca.
Cuomo's plan would force her to rely on the federal Medicare program, which costs more and doesn't cover many of the drugs she now takes for heart, thyroid and other health issues.
As negotiators at the Capitol begin what they hope is a final march to get an on-time budget by March 31, the impact on people like Sailer remains very much up in the air.
Money for public schools and hospitals has dominated the headlines and involves far more powerful special-interest groups, but in recent weeks, advocates, including some legislators, have mounted a growing push-back on human service programs.
The governor has described cuts in some programs as unfortunate but said they result from overspending by the state, which now must close a $10 billion deficit. He has received support from fiscal conservatives who say the state's social programs have become too bloated and too generous with benefits.
"It's a difficult budget at a difficult time," Cuomo said last month in Amherst.
Everything is on the table, from money for special schools for blind and deaf students to a Cuomo plan to halt a previously approved increase of $46, to $501 per month, in public assistance benefits for a family of four. Senior citizen centers face closings, and cuts are under consideration for low-income housing programs, job training efforts and after-school programs in poor communities.
The governor's budget proposes to eliminate thousands of government-funded summer jobs for teenagers -- who get placed with local governments and not-for-profits agencies, child and elder care facilities, maintenance posts and in a variety of jobs at local parks and recreation facilities.
While the Assembly last week restored $15 million for the Summer Youth Employment Program, its fate remains unclear.
Proponents say the program, especially in a down economy, provides teens with jobs that give them experience, a work ethic, training in various skills and a place to go besides the streets during the summer.
In Buffalo in 2009, the program allocated $938,000 to create 758 summer youth jobs, according to the city government. Last year, funding was cut to $428,000, which created 452 jobs. This year, Cuomo has proposed no funding whatsoever.
"As bad as the economy is now, why would you add conflict to that with young people on the streets this summer without jobs?" asked Assemblywoman Crystal Peoples-Stokes, a Buffalo Democrat.
In the judicial system, officials warn of additional court backlogs from a planned $100 million belt-tightening. On April 1, courts are expecting to largely end what's called the judicial hearing officer program.
Under the program, which costs $6 million to $7 million annually, a pool of about 300 retired judges -- including about 30 in the 8th Judicial District in Western New York -- handles such duties as supervising jury selections and hearing challenges to property tax assessment.
In Western New York, the hearing officers, who already receive pensions, help with rising caseloads and are considered especially vital in such places as family courts, where they can handle custody, visitation, orders of protection and the range of family matters. Another judge set to depart has 80 asbestos litigation cases on his calendar.
"There are consequences to a $100 million cut. None will be pleasant," said David Bookstaver, a spokesman for the Office of Court Administration.
The retired judges bring to the system deep legal experience and working relationships with attorneys on both sides that can be valuable to move cases along, said Justice Paula L. Feroleto, administrative judge for the 8th Judicial District. The regional district has a $385,000 budget for its hearing officers, who make $300 a day.
"Basically backlog," the judge said, predicting what will result from the loss of the hearing officers. "It will be more work for fewer people -- [and] slower time for case resolution."
Court officials say they are awaiting the outcome of the final budget talks before determining how many of the hearing officers might remain.
Funding for displaced homemaker centers also is scheduled to end. The facilities assist women who have lost financial support because of abandonment, divorce, disability or the death of a provider.
Through its 22 centers statewide, the program -- established in 1977 -- received$2.7 million last year to provide help with housing, child care, financial planning, career counseling, job searching and completing high school or college.
In Western New York, the cutbacks would force the closure of four of the five facilities operated by Everywoman Opportunity Center, according to Myrna Young, its executive director. Last year, the five facilities served about 1,500 people, Young said.
The two houses of the State Legislature have agreed on restoring some of Cuomo's cuts, but not many in the human services area.
The Assembly, for example, restored $34 million last week to the Elderly Pharmaceutical Insurance Coverage, the prescription drug program that helps Sailer. But the Senate has not not.
Cuomo says the cuts he proposed would affect 85,000 senior citizens, but advocates put the figure at 200,000.
The governor's plan would end EPIC benefits for about two-thirds of its enrollees, said Michael Burgess, executive director of the Statewide Senior Action Council. It would affect those who do not spend more than $2,860 a year on drug -- those in the "doughnut hole" of the Medicare Part D plan.
Sailer said Medicare's Part D not only will cost her more money -- she doesn't know how much more -- but also prevent her from getting certain brand-name drugs she says her doctors want her to take.
EPIC has a deductible for enrollees, based on income, and Sailer, who lives on Social Security and a small pension, said she has a $20 co-payment for most drugs.