Saturday, July 9, 2016

DD Programs and Services: Defunded and Dismantled

Here is a list of news articles I have collected since June 24, 2016 announcing program closures, Medicaid cuts, and endless waiting lists for services for people with DD and their families. It seems that DD services are the perfect target for states and local governments to “save” money and balance budgets. As for Home and Community Based Services (HCBS), the 2014 HCBS rule from the federal government that is scheduled to be fully implemented by March 2019 is the perfect excuse to "liberate" people from needed services while claiming to protect their civil rights. 

Wyoming: “Wyoming cuts freeze enrollment in treatment for disabled” - The Wyoming Department of Health will have $90 million in cuts out of a $975 million budget. The state will also lose $41 million in federal funds. The state will freeze the DD waiver program, provider rate cuts may force some providers out of business, and Medicaid will no longer cover fillings, dentures, hospital calls, prescriptions and other services for adult dental care patients.

New Jersey: “Audit: Move to group homes caused problems for some disabled people in N.J.” - Two intermediate Care Facilities for people with intellectual disabilities were closed ostensibly to save money, but community living resulted in problems for many of the 204 people with profound disabilities who moved: poor quality care, missed medical appointments, and an inability to participate in needed programs because behavioral problems were not addressed. One client went two years without a functioning wheelchair and another consumed foods that were medically harmful and could have caused choking.

Kansas: “State cuts to affect services to disabled” -  “…service providers…saw a 4 percent rate cut to targeted case management and intermediate care facilities. This means people who depend on these services can expect to see less of them in the near future.” One provider of services pointed out that for every dollar spent on DD programs, the federal government contributes 60 cents. “For this reason, he believes making cuts to programs that support those with disabilities is an inefficient way of balancing the budget, as the state will see less than half the amount cut returned to the general fund…we shouldn't balance those cuts on the backs of the poor and disabled.”


Chatanooga -Regulations end partnership that allowed adults with disabilities to work handling recyclables” - The Orange Grove Center in Chatanooga announced that it will close after 24 years. It's a substantial change to a longstanding partnership regarded by most as a win-win: the city received a service at an affordable price while providing jobs to members of a historically marginalized population that might struggle to find work.” The reason cited is the federal HCBS rule that “requires” that services be fully integrated and support full access to the greater community. 

[NOTE: This is a common though incorrect interpretation of the HCBS rule. There are no specific requirements that mandate a maximum size for settings or that prohibit funding of congregate settings (more than 3 people with disabilities served together) or that prohibit a setting from serving all or primarily people with disabilities.]      

Johnson City:Dawn of Hope transitioning people with disabilities out of facility, in to community” -  “At Dawn of Hope over 200 people with a broad range of disabilities get services, from those who are able to work, to those who are non-verbal, not able to walk on their own, and who need around-the-clock care…” To comply with the federal HCBS rule, (see note above), the facility has been getting people out into the public, though some refuse to go and staffing for some people is a problem. While some are looking at work opportunities, for those with more severe disabilities this has been extremely challenging. 

Washington State:Caregiving company departing county” - “Creative Living Services, based in Tukwila, announced in June that it is pulling out of serving clients in Jefferson County…because of what it called ‘extreme staffing shortages’ and pay rates that it also says are ‘not sustainable or competitive’ in the area…Creative Living Services is the only company currently approved by the state to serve adults with disabilities and assist them to live and assist them to live as independently as possible, often with each other.”

Ohio: DODD report shows most don’t choose community” - Ohio has announced the closure of two Development Centers (Intermediate Care Facilities for people with intellectual disabilities) by 2017. So far this has resulted in most affected individuals choosing to move to other private congregate facilities or developmental centers. “Only 27 individuals of the 89 who have left [the centers] have sought waiver housing”, smaller homes in community settings with HCBS funding. Many of those who have moved have suffered incidents such as an unanticipated hospitalization or nursing home stay, arrest or detainment by law enforcement, or bodily harm.”

Texas: “Medicaid Cuts Affect Children with Developmental Disabilities” - “Cuts in medicaid funding are making it more difficult for Texas children with developmental disabilities to get the help they need….The North Texas Rehab Center has announced it will not renew its contract with the Early Childhood Intervention program….It's the unfortunate effect of $350 million in medicaid cuts that was earmarked for pediatric therapy.”

Illinois: “Editorial: Illinois fails a moral test” - “During the past fiscal year, Illinoisans were at the mercy of a state budget impasse that disrupted institutions, programs and lives…For the past decade, however, the needs of people with intellectual and developmental disabilities have been chronically neglected by those in power…The consequences of that neglect make it more and more difficult for area agencies to serve the needs of people who, as the late Sen. Hubert Humphrey once said, are in ‘the shadows of life.’”

Wisconsin: “Paul Lundgren: Finding housing is very hard for the developmentally disabled” - A married couple with developmental disabilities finds it almost impossible to find appropriate housing despite having a housing voucher that guarantees payment of rent.  “…no preventive measures are designed to help people such as Shawn and Terri avoid homelessness. They will have to become homeless before anyone will help.”

Pennsylvania: “Families Face Indefinite Wait for Services” - Supports are available until age 21, then families experience "falling over the cliff”. Pennsylvania has a waiting list of 14,000 people waiting for Medicaid funding through the “Medical Assistance home and community-based waiver” with nearly 5,000 people on the “emergency list.”

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