Monday, June 22, 2009

Louisiana governor's veto threatens program that allows intellectually disabled people to live in community

From The Shreveport Times:

A state program that allows developmentally disabled people to live at home or in the community rather than an institution is being threatened by Gov. Bobby Jindal's budget veto pledge.

The state budget went to Jindal June 18, and with the legislative session nearing its end Thursday, developmental disability advocates and family members here and across the state mobilized for a rally on the Capitol steps at 2 p.m. June 22 in Baton Rouge.

One agency that could be severely hurt by a veto is The Arc of Caddo-Bossier, a private, nonprofit agency. Janet Parker, executive director, said the agency would lose about $1 million in Medicaid reimbursements through waiver programs for children and adults. She has dire predictions if that comes true.

"It would close programs all over the state," Parker said. "This governor is showing his bias for institutional care."

State Republican Sen. B.L. "Buddy" Shaw, who represents part of Shreveport and all of Bossier City, said the possibility of reducing the Medicaid waiver program for individuals with developmental disabilities is "probably the most serious cuts that could be made ... in terms of direct effect to an individual."

The dilemma facing the state is how to control growth of Medicaid spending in coming years, after federal stimulus money runs out. The Department of Health and Hospitals is in the budget bulls-eye, since it administers the program and because budget cuts can only be made to health and hospitals and to higher education.

Jindal has said "the organic growth of Medicaid" — not just for waivers — would create "serious sustainability issues." The $28.7 billion budget he received last week included about $278 million in spending that is tied to other legislation that must be passed, called "contingencies." Those contingencies are on his hit list. Jindal has 12 days from last Thursday to make his veto decisions.

Then the House and Senate would have to vote whether to go back into a special session to look at the budget again. They could override Jindal but would still have to produce a balanced budget, Shaw said, adding that there may be some funds elsewhere that could replace cuts.

Charles Castille, DHH undersecretary, said the department has submitted an amendment to its resource allocation plan with the Centers for Medicare and Medicaid Services. If approved, that would reduce the amount per slot but not eliminate a slot.

"We hope we can save money and serve more with less money," Castille said.

In the fiscal year about to end, about $366 million will have been spent on the New Opportunities Waiver. Cuts would reduce that by $36.6 million, according to DHH. Nobody knows yet how many individuals could be impacted.

NOW provides personal care attendants to help with daily living, such as personal hygiene, light household chores, shopping, recreation, meal planning and preparation, eating, bathing, dressing, and using bathroom facilities.

There are 8,500 slots for waivers for Louisianans with developmental disabilities. But there has been a waiting list for years. Currently 9,500 persons are waiting, and the average time to get a waiver is 8½ years.

Sam Beech can relate. Her son, Silas, 16, waited seven years for a Children's Choice waiver. Silas has a severe seizure disorder and autism. The waiver provides Silas with a personal care attendant when his parents, who both work, cannot be with him. Beech said Silas cannot be left alone.

Losing the waiver might mean Beech would have to quit her job as public policy director at The Arc. But more important to her is that Silas, who attends Northwood High School, would miss out on many activities.

"It's not normal for a 16-year-old to be with his parents all the time," she said.

Beech added, with a sense of frustration, "There have always been people with disabilities and there always will be. It's time this country and this state get it right with people with disabilities."

Shaw agreed, saying that most people don't understand the needs of people helped by agencies like The Arc.

"They don't deal with it," he said. "For people who do, this is a most critical threat."

John Taylor is president of Evergreen Presbyterian Ministries, which serves 450 persons in Louisiana. He could not say Friday how much Evergreen depends on Medicaid but said a veto would be damaging. Evergreen, like other nonprofits, has already been through a 3.5 percent reduction earlier this year.

"If we get additional cuts we will have to make some fairly draconian changes to our programs," he said, citing the possibility of reducing staff, not replacing vehicles, and limiting trips for clients.

Sandee Winchell uses the word "devastating" to describe the possible fallout. She is executive director of the Louisiana Developmental Disabilities Council, an advocacy organization.

The result of a veto? "People with developmental disabilities will be back to square one." The New Opportunities Waiver and support coordination "are vital to people with developmental disabilities. The NOW waiver provides services to stay in their own homes."

Any cuts could also affect jobs, such as personal attendants, she added.

She said she does not know why Jindal seems to be targeting this population for spending cuts. "People with disabilities are really curious to know that reason."

Winchell said there could be 500 people at Monday's rally.

"For the first time ever, it is a real collaborative effort of all disabilities service groups. ... We're all joining together because it seems like these disability services are on the chopping block."