OKLAHOMA CITY — Helen Marie Blocker wants to live independently for as long as her health will allow.

“I just don’t think I could handle living in a nursing home,” said the 84-year-old Norman resident.

Since April, a personal care assistant and home health care nurse have been stopping by her home to help her achieve that goal. The nurse helps change her bandages and answers her medical questions so that she doesn’t have to go to an emergency room for treatment.

The assistant spends several hours helping her with laundry, dishes, cleaning and errands that would otherwise be a struggle for Blocker, who is primarily confined to a wheelchair.

Blocker is one of an estimated 20,000 disabled or elderly Oklahomans who could qualify for placement in a nursing home but choose to live at home thanks to a federal-state partnership. That partnership, known as the Medicaid ADvantage Waiver Program, offers free care to lower-income residents who couldn’t otherwise afford it and would likely end up in a nursing home.

For decades, officials say the arrangement has been viewed as a win-win for residents and state lawmakers alike. State legislators save hundreds of millions by keeping residents out of nursing homes and emergency rooms. The state’s elderly, sick, dying or disabled, meanwhile, can continue to live in their own homes.

But this year, lawmakers slashed about $33 million from the state Department of Human Services’ budget, leaving the future of the program in doubt, said Lola Edwards, president of the Home and Community Based Services Council and Tulsa-based Complete Home Health.

Edwards said agency officials told her the $33 million in cuts will likely be spread over a dozen different programs, including the ADvantage program.

Other programs potentially facing cuts include childcare licensing and subsidies, home-delivered meals for older Oklahomans, early childhood services, vocational education and job skills training, adult day care as well as county Human Services office closures, according to a budget reduction proposal released by the agency.

“Cuts are coming,” said Debra Martin, a Department of Human Services spokeswoman. “Anytime you cut any program at DHS, you can’t help but hurt somebody. We understand people are anxious.”

Martin said no specific decisions have been made, but cuts would be announced in the coming weeks.

Edwards said officials are considering freezing the enrollment for new ADvantage enrollees, which would prevent at least 3,000 Oklahomans from participating. There’s also talk about increasing eligibility requirements to decrease participation further.

“They’d basically have two options — be at home with no options or go to a nursing home,” Edwards said. “It’s going to be devastating.”

The Department of Human Services’ budget analysis notes that depending on the cuts, an estimated half of people served might need nursing home placements, which would come at a higher cost to the state, and there won’t be enough beds available.

Meanwhile, 82 different businesses spread across the state employ an estimated 10,000 Oklahomans who count on the program for their jobs.

Without a steady stream of clients, the businesses will struggle to stay afloat, Edwards said.

“There will be businesses close and employees laid off,” Edwards said.

Janelle Stecklein covers the Oklahoma Statehouse for CNHI’s newspapers and websites. Reach her at jstecklein@cnhi.com.