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RALEIGH (AP) — House budget writers rolled out deep health care cuts for the next two years Thursday, including one that would phase out a heavily scrutinized program that pays for non-medical care for mental health patients living at home.

The draft proposal by the House health and human services budget subcommittee would essentially eliminate the "community support" services program paid for through Medicaid. Lawmakers would direct state regulators to rebuild the program.

A 2007 government review of the program said it may have wasted hundreds of millions of dollars in overpriced or unnecessary care. Auditors found providers billed Medicaid to take children swimming or to the movies, or help with homework.

Although lawmakers and the Department of Health and Human Services have limited service hours and changed payment rates, budget writers still aren't satisfied, said Rep. Verla Insko, D-Orange, a co-chairwoman of the subcommittee. The Senate budget approved last month had no such elimination.

"We have not been happy with the expenditures in that program nor with the services that have been provided," Insko said. "This is an opportunity for us to get it right."

The community support changes are included in one of about 150 cuts to health programs and initiatives totaling more than $1 billion in cuts designed to help narrow a projected budget gap of $4.6 billion starting July 1.

The House health budget writers also have proposed saving $91 million by reducing reimbursements to doctors and hospitals that treat Medicaid patients, $49 million by cutting personal care services for the infirmed, and $50 million in services to the mentally ill, substance abusers and the developmentally disabled.

This budget "will hurt a lot of very vulnerable people — vulnerable people that we all want to serve and have been working to serve," Insko said.

The House had to look for more cuts than the Senate because April 15 tax collections fell dramatically, making revenue projections more gloomy. The Department of Health and Human Services, which comprised about one-fifth of last year's $21 billion budget, was expected to take the brunt of the reductions along with public education.

Spending reductions could change as the House seeks to approve a budget by mid-June. House and Senate Democrats then would have to work a final compromise this summer to present to Gov. Beverly Perdue.

Phasing out the community support program would save the state $59.8 million next year and another $116 million in 2010-11. The federal government provides matching funds.

Tens of thousands of people get assistance from the program, which evaluates what they need to function as they await or leave intensive treatment. The patients could get help with social skills training or assistance in taking their medicine.

Some state money in the program would remain to give transitional services for poor children and others to diagnose and treat mental health conditions.

John Tote, executive director of the Mental Health Association in North Carolina, said he's worried that reductions in community support and other mental health services would leave patients at greater risk.

"We have nothing else to pick up those folks that would be left without those services," Tote said. The mental health system is already fragile, he added, but "if these proposed cuts go through, it becomes horrific."

There was no immediate timetable when the new program would be in place, but Insko said some people getting the services could be moved to other mental health initiatives as the funding is eliminated for assistance.

Social service advocates are hopeful that tax increases would alleviate some of the deepest cuts, but House leaders doubt any agreed-on package would be big enough to make a marked difference.