As lawmakers determine the annual budget, a statewide program that provides risk screenings for pregnant women and babies could be at risk for substantial cuts, advocates say.

Healthy Start, which offers education and counseling services to tens of thousands of at-risk pregnant women and babies, says it would lose nearly 30 percent in funding in a Senate budget proposal, which also includes language that would restructure where and how the program's coalitions are organized.

Proponents of the cut say the reductions would pare services that are duplicated by other programs like Healthy Families and Early Steps and trim administrative funding. But leaders of the program's coalitions say losing that money could threaten how many services are offered and limit access, particularly in rural areas.

About 80,000 pregnant women and 56,000 babies used services provided by the program last year, including home visits, childbirth and parenting resources and substance abuse education, according to the program. Its funding has fluctuated in the last decade, including a set of smaller cuts up to $5.3 million and a partial restoration of $4.1 million about five years ago.

"This would be a cut to the core," said Jane Murphy, executive director of the Hillsborough County coalition, adding that the program often refers expectant mothers and infants to other community resources for more care.

"Healthy Start is probably the glue for everything else… If you break one of the legs off, those other legs are going to suffer."

The proposed $19 million cut could also reverse Florida's progress in decreasing infant mortality rates and put more demand on bigger coalitions to serve populations in more far-flung areas, said Manny Fermin, the head of Miami-Dade's coalition.

Sen. Anitere Flores, R-Miami, who chairs the chamber's Health and Human Services Appropriations subcommittee, said the Senate wanted to avoid any duplication between efforts provided by different Healthy Start coalitions and other programs.

But she hinted Wednesday night that the Senate might agree to cut less from the program by Friday, when unresolved budget issues will be sent to the House and Senate budget chairs for further negotiation.

"We're working on getting final numbers to make sure what that duplication is and perhaps we'll be able to reduce some of those reductions," Flores said. "I'm hopeful that that's one of the bigger items we'll be able to resolve sooner rather than later."

Lawmakers have already resolved some healthcare budget issues, including agreeing on a proposal that cuts the time period Medicaid will retroactively cover after someone becomes eligible for coverage. The agreement limits the coverage to 30 prior days, which saves $38 million in the state general revenue out of $98.4 million in total spending. The House also agreed to a $9.76 million grant for central receiving facilities in the state, via a federal program.

But the House and Senate still disagree on some of the largest issues, including how hospitals are reimbursed for Medicaid care and how much money should go to nursing homes.