Gary Alexander, director of the Department of Human Services, yesterday discusses the state’s proposal, still awaiting federal approval, to redesign its Medicaid program.

The Providence Journal / Kris Craig

PROVIDENCE — A proposal to reshape Medicaid would not hurt RIte Care, a state health care program –– at least for now, state officials said yesterday.

“There are no plans on day one to change RIte Care,” said Gary Alexander, director of the Department of Human Services. But, he added, “I don’t know if I’ll be here in two or three years, so I can’t promise there will be no changes.”

Alexander and other officials spent more than an hour yesterday outlining a proposal — awaiting federal approval — to redesign the state’s Medicaid system. They also answered questions from anxious health care experts, assisted-living managers and others gathered in the Student Union ballroom at Rhode Island College. About 100 people attended.

In general, officials tried to ease concerns that a plan aimed at saving $67 million won’t leave the elderly, the disabled and the needy out in the cold.

“We don’t want to see any services cut, especially for our neediest population,” said Alexander.

But some remain skeptical.

“We are deeply concerned” the proposal could “limit health care dollars coming into the state,” members of the Health Care Organizing Project, a coalition of more than 15 groups, said in a statement yesterday.

About 186,000 Rhode Islanders –– nearly 18 percent of the state’s population –– rely on Medicaid for treatment.

The first-of-its-kind plan — which needs a so-called “global waiver” from the federal government — would give the Carcieri administration more leeway in how Medicaid funds are spent. In exchange, the state would cap all Medicaid spending over the next five years.

Greater flexibility would allow the state to keep more people in their homes while they receive services, rather than move them into costly hospitals or other facilities, Alexander said. “We want to keep people as independent as possible.”

The plan would also allow the state to try new things and save money, Alexander said. Currently, the state must wait as long as 90 days to initiate programs already used elsewhere in the United States, he said.

But in the crowded ballroom, some audience members said they are worried the proposal would trigger eligibility changes for some who need treatment. Such changes require legislative approval, said Ann Martino, human services policy administrator.

Other questions were broader. Robert Fallon, a former human services director, wondered if President-elect Barack Obama’s health care plan would affect the Rhode Island proposal. “Will there be a new attitude?” he asked.

But Alexander said it’s too soon to predict how a new president may change the nation’s health care system. “He hasn’t even named a secretary of Health and Human Services,” he said.

The proposal, formally the Global Consumer Choice Compact to Health, comes at a tough time. The state is looking for a new Medicaid director amid a budget crisis and soaring unemployment.

“We all understand the problems with the budget. That’s why we’re trying to redesign the program,” Alexander said. “Yes, we face serious economic challenges. But if we think outside the box, we may be able to save some of these programs until better economic days return.”

pdavis@projo.com