Monday, January 25, 2010

Budget cuts affect services for Kansans with disabilities

From The Topeka Capitol-Journal in Kansas:

LAWRENCE, Kan. — WyLma "Darlene" Mortell's dream is simple: She wants to work at a job that pays her enough to buy paper towels.

What most Kansans consider a household necessity is a luxury to Mortell (pictured).

"I want a job. I've been wanting one for a long time. I want to be where I can pay my bills without worry," the 53-year-old Lawrence resident said. "I'm tired of doing without necessities. I'm tired of living without."

Mortell has traumatic brain injury as well as a host of other health concerns — muscular dystrophy, asthma, diabetes, kidney problems and seizures. She uses a wheelchair and has difficulty with expressive language and memory. She takes 11 medications a day.

In spite of those obstacles, she is determined to re-enter the workforce and is relying on services provided by communityworks inc. under the Medicaid-funded Home and Community-Based Services waiver for those with traumatic brain injury to help achieve that goal.

However, communityworks inc. — like many agencies that serve Kansans with disabilities through Medicaid-funded programs — was forced to cut its budget by 10 percent on Jan. 1 in response to the state's budget crisis.

In his State of the State address earlier this month, Gov. Mark Parkinson said the state should raise the sales tax by 1 cent for 36 months to offset the estimated $400 million shortfall in the budget. After that, he said, Medicaid cuts likely could be restored.

Janet Williams, president of communityworks inc., said the agency is a service provider for those with disabilities in Kansas and Missouri to help them transition from medical care to supported living. The agency teams with physicians, hospitals, government and mental health agencies, businesses and families to develop support systems that help clients increase self-sufficiency at home and in the community.

The control of the plan is given to the individual client and its staff develops a support system to help them attain their goals.

Communityworks provides services to about 400 people, ranging in age from 9 to mid-70s.

To reduce its budget by 10 percent, Williams said staff — except for personal care attendants — took a 5 percent cut in pay, with the other 5 percent trimmed from employees' benefits, such as health insurance. Three employees were laid off.

"As a business consumer, it makes us reluctant to now know what's coming," Williams said, adding that 98 percent of the services the agency provides are Medicaid-reimbursed.

Williams said those with traumatic brain injuries have two options: Go to a rehabilitation hospital that costs $25,000 a month, or stay in the home and receive services from a community-based waiver program that costs on average $3,500 a month — $21,000 less. Williams said about 300 Kansans receive services provided by the HCBS waiver for those with brain injuries.

"The idea of the waiver is to get speech, occupational therapy and behavior therapy at home where they will use the skills and then to phase them out of the program," she said.

Most people, she said, receive waiver services from 21/2 to three years.

Each week, Mortell works with a cognitive therapist, who develops strategies to improve her memory and organizational skills, and a transitional living specialist, who is helping to prepare her to live independently. Communityworks also provides a personal care attendant.

Mortell wants to get to a place where she can work part-time again. In the past she answered phones and did filing for Oxy-Med Inc., a medical supply company in Lawrence. She also did secretarial work for Lawrence Community Shelter on a volunteer basis and lends a hand at Jubilee Cafe and Lawrence Interdenominational Nutrition Kitchen, which provide free meals to those in need. In the past, she served on the Public Transit Advisory Committee for the city of Lawrence.

Mortell said she has a hard time understanding how business executives can give themselves huge bonuses or how cities can worry about fixing roads and sidewalks when the money can be used to help the poor and disabled.

"Let them be in our shoes and let them know how it feels," she said. "People don't understand unless you've been there."