WILLMAR -- For the last 14 years, Robert Enos has been the primary caregiver for his 54-year-old brother, Michael.
He took over the full-time care for Michael after their mother died.
With multiple health problems stemming from a genetic disease called tuberous sclerosis that resulted in surgery for a brain tumor when he was 11, Michael is developmentally disabled, partially paralyzed and has frequent seizures.
"He's a great guy," said Robert Enos, with obvious affection for his brother.
They both say they got lucky when it comes to having a brother.
Michael has always been cared for by family, has never lived in an institution and has his own health insurance.
But when it comes to dental care, he's pretty much at the mercy of the state.
Michael uses a wheelchair and requires specialized care when getting routine dental work done.
Most dentists are unable to accommodate adults like Michael who have special needs and are wheelchair-bound.
So once a year, Michael Enos gets a dental check-up and gets his teeth cleaned at the State Operated Services dental clinic in Willmar, located on the former regional treatment center campus.
Medical Assistance pays $80 for the annual services for his brother, said Robert Enos.
Now, with Gov. Tim Pawlenty's efforts to trim $17 million from the Human Services budget, the Willmar dental clinic is scheduled to close next month.
It was originally set to close May 1, but in a letter to lawmakers this week, Chief Executive Officer of State Operated Services Mike Tessneer said notices to staff in the dental clinics have been extended for 30 days.
The closure of the Willmar clinic will put the Enos brothers "in a terrible jam," said Robert Enos. "I don't know what I'm going to do yet. I haven't figured that out yet."
The Willmar dental clinic is open once a week. There are a total of five such clinics in Minnesota, and some, if not all, of those could eventually close under Pawlenty's plan.
On its website, the Minnesota Dental Association expressed alarm at the possible closing of the clinics, saying it will greatly reduce access to dental care for vulnerable individuals. Most dentists are unable to accommodate individuals who are "medically complicated and behaviorally challenging," according to Dr. Bruce Templeton, president of the association.
Closing the clinics "will, in effect, mean abandoning these vulnerable patients with no other options for treatment," said Templeton.
Enos said he understands the budget issues are too big for the state to ignore. "I get that," he said. But it doesn't seem right that a budget cut is targeted solely at a group of "severely disabled" individuals, he said.
Legislators have objected to the dental clinic closings, as well as the layoffs of 200 employees that deliver other services to individuals with developmental disabilities and mental illness.
So far, the closure of the clinics has at least been stalled for a month while funding options are explored.
But despite legislative efforts to get a bill heard next week to restore the other cuts, the Department of Human Services is moving ahead with the layoffs from phase one of the $17 million budget reduction plan.
That plan includes $1 million in savings by reducing staff at Willmar's Community Behavioral Health Hospital and providing a lower level of mental health care there.
Rep. Al Juhnke, DFL-Willmar, said the state is moving ahead "willy-nilly" with the reductions even though legislators from both political sides object and are looking for ways to fund the dental clinics and to stop the state's redesign of mental health care.
Sen. Joe Gimse, R-Willmar, said a bill in the Senate would restore the $17 million cut if money from the federal health bill arrives before the end of the session. Gimse said he would vote to restore the cuts but would not predict the final outcome of that possible legislation.
In the meantime, Robert Enos is hoping for a total "reprieve" and that the dental clinic will remain open and his brother can get the care he needs.