Somerset — Oakwood, the mental health facility located here in Somerset, is one of the state’s Medicaid babies — an entity largely dependent on federal funding for survival.So what happens if that money is taken away?

 It’s a question to ask in the wake of the Medicaid crisis that the Commonwealth of Kentucky currently faces. On Monday, Gov. Steve Beshear contacted federal lawmakers in a plea to swiftly approve a proposal to provide additional Medicaid funding.

At stake is the “federal match rate for Medicaid (FMAP),” which is enhanced by the American Reinvestment and Recovery act. The bill is currently awaiting a decision by the U.S. Senate, meaning Kentucky’s own Senate Minority Leader Mitch McConnell is a key figure to whom Beshear is appealing.

The money would help the state government through its current economic hardship, including an epic budget battle in which Medicaid funding played a role. State lawmakers had counted on additional federal Medicaid funding to balance the $17 billion budget they passed late last month.

In Pulaski, when one thinks “state” and “Medicaid,” Oakwood comes to mind. The home and medical treatment facility for developmentally disabled individuals was at the center of a Medicaid mess in the mid-’00s, when CMS (the Center for Medicare and Medicaid Services) pulled its funding from Oakwood following a string of citations for incidents of abuse and neglect.

The state launched an appeal, knowing that without Medicaid, the whole of Oakwood’s $78 million operating budget at the time would fall on the taxpayers of Kentucky — as it was, Medicaid was paying about $60 million of that, covering the cost of clients to stay at the campus and receive its services. However, the appeal was unsuccessful, and for a short time, Kentucky with stuck with the entire Oakwood tab.

The potentially fatal wounds were healed last year when, under the leadership of the Bluegrass Regional Mental Health-Mental Retardation Board, the facility worked itself back into compliance with CMS safety standards. Excitement was the prevailing mood, as the facility’s employees were able to exhale and feel a sense of relief for the first time in years, knowing that Medicaid money meant the facility wasn’t likely to have to close.

But what about the state’s current mess? Beshear said that without the federal funds, Kentucky’s budget with be short $238 million, which could force major cuts to Medicaid and other government programs.

Would that affect Bluegrass Oakwood — and if so, how?

The answer: No one really knows ... yet.

When posed the question of what the ramifications to Oakwood might be, the Cabinet of Health and Family Services, which oversees Oakwood and similar facilities for the state, didn’t have much to definitively say on the subject. As with so much that has been discussed and debated during the hammering out of Kentucky’s budget woes, there are just a lot of unknowns — meaning answers are hard to come by for citizens and government officials alike.

“If the extension of enhanced Federal Medical Assistance Percentage (FMAP) is not passed by the federal government, it will create a devastating $238 million hole in the budget passed by the General Assembly last week,” read the statement. “If that cut had to be taken within Kentucky’s Medicaid program, almost $1 billion in expenditures would need to be cut, impacting patients, doctors, hospitals and hundreds of thousands of Kentuckians who depend on this program. A budget hole of the magnitude of $238 million threatens the entire budget, including funding for priority areas like education, public safety and health care.

“Because Gov. Beshear knew it was uncertain whether Congress would pass the extension, he chose not to include those funds when proposing his original budget,” it continued. “However, the leadership of both state legislative chambers insisted that it would pass, and included those funds in the budget passed last week by the General Assembly. Gov. Beshear and his administration have joined with other states and have been working for several months, through multiple letters, phone calls and meetings to secure this critical funding, and will continue to do so.”

Congressman Harold “Hal” Rogers’s office was contacted about the likelihood of the bill passing, but a statement could not be obtained by presstime.

State Rep. Tommy Turner, Pulaski’s native son in the state legislature, noted that without the Medicaid extension, Beshear would be left to make some tough decisions about what to cut. However, Turner felt confident that Oakwood — nor homes for the elderly or infirmed in the area that also depend on Medicaid — would not suffer as a result. In fact, he seemed equally confident that things wouldn’t get to that point anyway.

“Everyone feels pretty comfortable in getting (the extension),” said Turner. He said that if it doesn’t happen, Oakwood is “potentially” in trouble, but not necessarily.

“Historically, we’ve always protected those people — the mentally disabled, the very vulnerable —because they need help the most,” said Turner. “I just don’t see (cuts) affecting Oakwood.”