An Alabama Department of Mental Health (ADMH) official said Friday that a state program providing services to people with developmental disabilities and mental health challenges could suffer from possible federal cuts.

Kathy Sawyer, associate commissioner for ADMH, said President Donald Trump’s threats to cut federal aid to the states could harm the agency’s Division of Developmental Disabilities, which gets most of its funding from Medicaid.

“We had one meeting nationally, and every 15 minutes, they were interrupting, saying, ‘We just got a new initiative, a new memo,’ so it’s just so uncertain,” Sawyer said. “But my appeal to you all, is to remind you that 80% of our dollars are those dollars.”

More from Alabama Reflector

The Division of Developmental Disabilities operates three waivers that help people with developmental disabilities receive services they typically can only receive in an institution or care facility in their own homes or communities. These services include crisis intervention services, independent living skills training and employment services.

The division currently provides services for 5,100 individuals through home and community-based waivers. Swayer said there are about 1,700 people on a wait list, and that number is growing.

“We continue to increase enrollments in all three of the waivers, but despite our work and our desires, the waitlist continues to grow,” Sawyer said.

The Trump administration and a GOP-led Congress are considering Medicaid cuts to fund extended tax breaks. The potential cuts include lowering the federal government’s 90% funding match for Medicaid expansion states, which could push more costs onto states, and imposing additional eligibility requirements, such as work mandates for enrollees.

In late January, Trump’s freeze on federal assistance caused confusion and concern among Alabama agencies and nonprofits that rely on federal funding. The Alabama Medicaid Agency reported being temporarily locked out of its federal funding portal. Organizations like the United Way of Central Alabama warned of significant operational risks, with vital services — such as housing for veterans, meals for seniors and child support programs — potentially at stake.

Families with aging caregivers are struggling as they wait for services, leading to an increase in individuals with developmental disabilities being placed in hospitals or abandoned at emergency rooms, said Sawyer, who also serves on the Alabama Department of Human Resources (DHR) board. She also said the state has also seen a rise in cases where children with developmental disabilities end up in the custody of DHR due to behavioral challenges that their families are unable to manage.

ADMH Commissioner Kimberly Boswell expressed some concern over uncertainty at the federal level that may impact Medicaid funding, adding that “if we lost federal funding on that side, we would be in an immediate lawsuit,” but said that she is hopeful the uncertainty won’t last.

“I tend to just hope that rational conversations are going to eventually happen and that things will kind of sort themselves out,” Boswell said.