Wednesday, February 17, 2010

The WCHO, the Governor's budget, and DD services

The Washtenaw Community Health Organization (WCHO) board met last night. The Executive Director Patrick Barrie summarized the Governor's proposed budget for the Department of Community Health for fiscal year 2011. It shows an increase in Medicaid funding for MDCH of about 3% and a small decrease in General Fund allocations. This sounds much better than the dire predictions of up to 20% cuts in DCH programs, but the proposals are based on some shaky assumptions:

  • that the tax system will be restructured to lower the sales tax and imposes a tax on services;
  • that large numbers of teachers and state employees will retire and be replaced with new hires at a lower pay rate and decreased benefits;
  • that physicians and hospitals will be taxed to generate more federal funds that will go back to physicians and hospitals;
  • and that federal Medicaid stimulus funds will be extended for another six months.

The largest reductions proposed are in funds for people with substance abuse problems. These are often the same people who end up in emergency rooms and hospitals at greater cost to the health care system and the community than if they had received treatment before they reached a crisis situation. There has been much discussion at the WCHO board and committee meetings of plans to provide better access to services for people with mental illness and substance abuse problems. Early access saves money in the long run and generally improves the quality of life for these consumers.

So far in this budget crisis, there has been almost no discussion by the WCHO board of services for people with developmental disabilities other than to say that most people with developmental disabilities qualify for Medicaid and are therefore entitled to services. It helps that Medicaid funding is available and will probably increase.

We know, however, that the Michigan Department of Community Health is targeting for elimination programs for people with the most severe disabilties - group homes, sheltered workshops, and day programs. One might logically think that the state is motivated by a desire not only to save money, but to shift more of the responsibility from serving people with severe and complex disabilities from the state to local mental health agencies. But the state claims to have a higher moral purpose: specialized programs that serve only people with disabilities discriminate against them by isolating and segregating them from people who are not disabled. By eliminating these programs the state serves the noble purpose of rescuing people with disabilities from discrimination.

The mental health system fully supports people with mental illness and substance abuse problems in joining together in clubhouse programs and recovery and support groups. Other parts of the system encourage a full array of options for senior citizens, including group living in independent and assisted living facilities. But when it comes to people with severe developmental disabilities, the state is set on saving them from the horrible fate of having to associate with people like themselves. Now that's discrimination!

No comments: