NASHVILLE, Tenn. -- TennCare is about to drastically change coverage for thousands of its most needy families. Quadriplegics and paraplegics and others with catastrophic situations are about to lose most of their home health care.

Video: Thousands Affected By Latest TennCare Cuts

Representatives of the state health care program said they have identified what it calls a runaway expense that is totally out of control.

Jessica Pipkin cannot use her arms or legs, but she runs her house with her voice and her presence. She is one of around 10,800 TennCare patients who will lose their 24-hour home care nurse for a three-hour a day nurse.

Her alternative is to go to a nursing home, and but that would mean being taken away from her children.

TennCare said this decision is not inhumane but responsible. Twenty-four hour care is not provided by any private insurance, so why should the state provide it, said the state.

"We saw that health and private duty nursing, since it was unlimited and had unsustainable growth, that if we didn't put in some reasonable limits, we were going to have a budget crisis on our hands, not just in TennCare but potentially again in all of state government," said TennCare spokeswoman Marilyn Wilson.

TennCare said its home health care program cost more than $300,000 a year just to take care of people like Pipkin. Starting Sept. 8, her care will be capped at around $55,000 a year for home health care.

The Legal Aid Society of Middle Tennessee said it's not the right way to look at this hurting family.

"When you are imposing really these caps and limits, you're really excluding that from the discussion. I think people are just wanting an opportunity to tell their story, tell how the family has adjusted, how the sacrifice has been made and important it is for this family to stay together," said Gary Housepian of the Legal Aid Society.

TennCare is asking family members to help fill the need for the care created by the cuts.

In the past, people who have lost TennCare benefits have been able to appeal, but these particular changes in policy may not be open to traditional appeals.