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- April, 2010
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Agencies that assist people with disabilities get ready for budget cuts
April 28th, 2010
By Sandy Illian Bousch, Pioneerlocal.com
Agencies that assist people with developmental disabilities are looking for ways to do so with less money, should the state legislature approve Gov. Patrick Quinn’s proposed 2010-11 budget.
Cathy Ficker Terrill, president of Ray Graham Association for People With Disabilities, said the organization stands to lose $500,000 if Quinn’s proposed budget becomes reality. Terrill said the proposed state budget calls for a 2.5 percent cut of Medicaid-funded services to agencies such as Ray Graham, whose services include the Hanson Center in Burr Ridge. That would leave the Ray Graham Association looking for ways to cut expenses without cutting services.
“There’s not a lot left to cut,” said Terrill. She said Medicaid-funded services are a peculiar choice for cutbacks, considering the state receives a 62 percent federal reimbursement for every dollar spent by the state.
For every dollar the state doesn’t give to agencies like Ray Graham, it only saves 38 cents, Terrill said.
Terrill has been meeting personally with state legislators and has urged Ray Graham families to communicate their feelings, as well.
“We have sent the notice to all of our families and to our board,” she said.
Helping Hands of Countryside relies on the state for about 60 percent of its funding and stands to lose about $400,000 if the budget cuts are approved, said India Ehioba, director of marketing and development. Limits and delays in funding already have resulted in the elimination of six positions at the agency, which serves 275 adults and 175 children with developmental disabilities.
Ehioba said the lost jobs were not service positions, but she can’t promise what might happen if more money is taken from the Helping Hands budget.
“There will be more cuts,” she said.
In the meantime, Ehioba said Helping Hands staff is working to come up with ways to raise money of its own and to lessen its dependency on government support.
Similar efforts are under way at Westchester-based Aspire, which helps more than 1,000 children and adults each year through services offered at 21 locations in the western suburbs.
“The fiscal picture of the state of Illinois is bad,” even without the 2.5 percent cut, said CEO Jim Kale.
He said the latest proposal is just the latest chapter in what has been several years of cuts and under-funding by the state.
“It’s a challenging time,” he said.
Should the governor’s budget be approved, Aspire can expect to lose another $253,000, Kale said.
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Budget cuts threaten ability to live independently
April 27th, 2010
By David Klepper, KansasCity.com
Leana Daniels worked in restaurants in Kansas City, Kan., since she was 16.
In 2003, Daniels, a mother of three, was working as a restaurant cook when an employee used greasy water to mop the kitchen. Daniels slipped and fell hard, permanently crippling her knees.
She got replacement joints but was plagued by a postoperative infection, which worsened her chronic heart disease. Now she can’t work and can’t climb stairs, and she falls often.
“I needed a little help,” she said. “Someone to help me clean, do the laundry. I can’t do all the things I used to do.”
Social workers told Daniels, now 47, that she qualified for a state-funded program designed to keep Kansans with disabilities in their homes and out of institutional care. Someone could stop by for a few hours a week to do the chores Daniels no longer could do.
Yet when Daniels tried to sign up, she learned funding for the program had run out days earlier. Kansas lawmakers had cut the funding amid a historic revenue decline.
Daniels was told to consider a nursing home.
“ ‘Go to hell’ is pretty much what they told me,” she said. “They’d rather pay to put me in a nursing home than pay somebody a few bucks to come help me three hours a week,” she said. “You ask them for help, and you can’t get it. They say they’ll help people. They’re liars.”
The budget crisis affects every state function. Students learn in larger classes. Highway projects are on hold. Economic development programs are hobbled. Prisons are shuttered. But cuts to social services threaten the very independence of the people they were created to help.
Reducing services for Kansans with disabilities isn’t only a moral issue, advocates say. Studies show that help is most affordable when it is provided to residents in their homes. Nursing-home care is three times as expensive to the taxpayer.
Shannon Jones, the director of the Statewide Independent Living Council of Kansas, lobbies lawmakers to support programs that allow residents with disabilities to stay in their homes.
“I’ve been up here (at the statehouse) for 17 years, and I’ve never seen such dramatic effects on our disabled and elderly,” Jones said. “We’re not talking about a huge amount of money, and the benefits are clear.”
Kansas saw revenues flatline when the economy soured. The choice for lawmakers was clear: Cut spending or raise taxes in a recession.
So far, lawmakers have opted to cut more than $1 billion, the biggest spending cuts in Kansas history.
As a result:
•The rate paid to in-home caregivers, doctors and others who accept Medicaid clients was cut 10 percent.
•The state pulled the funding for dental care to low-income pregnant women.
•A total of 1,500 Kansans with disabilities — but who get no federal disability payments — were dropped from a $100-a-month cash assistance program.
•Almost 6,000 Kansans sit on waiting lists for state services.
One of them is Connor Blakley, 6, of Gardner, who was born with severe developmental disabilities. His mother, Angi Blakley, said Connor suffers frequent seizures. The only word he can say is “mama,” although he likes to blow kisses to communicate with others.
Connor requires constant care. Angi Blakley and her husband, Jason, arrange their work shifts to ensure someone is always with Connor.
Connor is eligible for state-covered help — help with the medical bills and an in-home attendant so his parents can get a break. After all, they have another child to care for, 3-year-old Trinity.
There is not enough money to cover all those who are eligible, so Connor has to wait. The family used to get a $600 check four times a year, money that helped to defray the cost of Connor’s many medications. The state stopped sending the checks last year.
Hundreds of other Kansans are on the waiting list in front of Connor. The only way to move up is if someone who is higher on the list moves to another state, ages out or dies.
“Basically we’re waiting for people to die,” Jason Blakley said.
There’s another option: The Blakleys could put Connor in an institution. They shook their heads in unison.
“He’s our son,” Angela Blakley said.
Looking for answers
Some lawmakers say schools should have their funding slashed. Others would target economic development programs, corporate tax credits or highway projects.
But reductions to social services are unpopular, even with the lawmakers who supported them. Gov. Mark Parkinson, a Democrat, said cuts he has had to make to social services keep him up at night.
“I understand the devastating impact those cuts had,” he said. “We’re going to do everything we can to reverse them.”
Lawmakers acknowledge the many studies that show in-home care for people with disabilities is a far cheaper alternative to nursing homes.
“It’s heart-wrenching,” said Rep. Kevin Yoder, an Overland Park Republican and the chairman of the House Appropriations Committee. “This is the front line of what government is supposed to do. … Simply put, we can’t afford the same level of government we had two or three years ago.”
Legislators rejected any talk of tax increases last year. This year, however, Parkinson, other Democrats and Senate Republican leaders are calling for tax increases to avoid further budget cuts.
“Many of these people can lead productive lives if they have the resources to help them,” said Rep. Kay Wolf, a Prairie Village Republican who introduced a bill that would have raised the tax on alcohol to pay for services for Kansans with developmental disabilities. The bill was tabled.
The state Senate last week endorsed a budget that would restore some funding to social services, but it is contingent on nearly a half-billion dollars of tax increases. Higher sales taxes, tobacco taxes and alcohol taxes and even a tax on sugary sodas have been proposed, but none has gone to a vote.
The House budget would restore slightly more funding without a tax increase, Yoder said, but critics say the money would come from schools instead.
Meanwhile, frustration is turning to anger. As the House Appropriations Committee debated the bill Friday, a group of Kansans with disabilities stood in the hallway yelling, “People are dying. Shame on you.”
Advocates for social service programs say don’t want the state to fund social services at the expense of education. They say lawmakers should vote for a solution that funds both: a tax increase.
“Without a tax increase, additional cuts would literally be life-threatening,” said Rocky Nichols, the director of the Topeka-based Disability Rights Center. “These people are Kansans. They’re friends, family members.”
Watching and worrying
Lawmakers return to Topeka on Wednesday to try to resolve the budget crisis. Families who receive social services will be watching, hoping for an end to the cuts. One of them is an Overland Park family who never thought they would need the help.
“I’m a single mom. I don’t know how we’d get the therapies we need,” said Angel Friday of Overland Park, whose 17-year-old son, Carl Van Winkle, suffered a traumatic brain injury in a car crash last year. “We’d figure it out somehow.”
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Money follows the person: moving out of group homes
April 26th, 2010
Richard Hasselbach and Deborah Kadlec met in a nursing home and dreamed of a life together outside its walls.
Their health conditions made living on their own a challenge: Hasselbach, 63, is disabled from a stroke and lost a leg to a blocked artery. Kadlec, 52, has multiple sclerosis. They both use wheelchairs and need help with chores such as bathing, cooking and remembering to take their medicines. Most of their relatives live in other states.
Despite those obstacles, Hasselbach and Kadlec got their own apartment and a personal care aide last summer through the help of a federally funded program run by the state. The program, known as Money Follows the Person, is the nation’s most ambitious effort to move people out of nursing homes and other long-term-care facilities. It aims to help people live on their own and also save tens of millions of dollars for Medicaid, the state-federal health insurance program for the poor and disabled that pays for two-thirds of nursing home bills in the U.S.
Nationally, nursing home care averages about $75,190 per patient each year. Care in the home, through such services as meals-on-wheels and daily visits by a health aide, averages $18,000 a year, according to the AARP Public Policy Institute.
The program gives nursing home residents personal and financial help to live on their own or in small group settings, as well as payments for costs such as apartment security deposits, household furniture and alterations to make homes or cars accessible to the handicapped.
Georgia is one of 29 states and the District of Columbia participating in Money Follows the Person. Its experience shows both early successes and an illustration of the program’s slow start nationwide. Georgia had hoped to move 1,312 people from nursing homes and other long-term-care facilities by 2011. But through the end of last year it has moved out only 221.
Progress On Goals Wide-Ranging
Congress established Money Follows the Person in 2005, and states set a combined goal of moving out more than 37,000 residents from nursing homes and other facilities by 2013. Most states, including Georgia, started their programs in 2008. Two years later, just 5,774 residents have moved nationally, according to state data collected by Kaiser Health News.
The new health overhaul signed into law last month extends the program to 2016, adds $900 million to what was a five-year, $1.3 billion initiative and loosens eligibility rules.
“The impact could be very significant,” said Debra Lipson, a senior researcher at Mathematica Policy Research, a Princeton, N.J. based think tank that is evaluating the program for the federal government.
Most states are moving slowly for various reasons: problems finding affordable housing, resistance from nursing homes, stringent federal rules that limit who is eligible and what types of community settings they can move into, according to a recent study by Mathematica.
Alice Hogan, who heads the Money Follow the Person program in Georgia, said she considers the program a success. “Like most states, we wished things were going along faster but implementation has been more difficult than expected,” she said. “But personally I am not disappointed because I am very happy with those that we got out because each of them is a real person who is now in the community.”
State data show wide-ranging progress on goals:
- Texas has moved 2,029 people out of nursing homes and other long-term care facilities. That’s more than one-third of the national total.
- A dozen states have moved fewer than 60 people. States moving the fewest: Louisiana (10), North Dakota (19) and Delaware (22).
- Illinois, which set the highest goal, is furthest from its target. The state had set 3,357 transitions as its goal by 2013, but through last year has done just 58. “Meeting that goal by 2013 appears nearly impossible,” said Jean Summerfield, the Illinois project director.
Many states blame their slow start on the program’s requirement that people live in nursing homes and other institutions for at least six months to qualify for transition assistance. State officials said those residents are hard to move because they often have the most complex medical conditions and have typically lost their home and family support system.
Congress last month lowered the requirement to a stay of three months that is paid by Medicaid.
In addition, the program’s rules bar participants from moving into group homes that house more than four people, which effectively shuts out most assisted-living options.
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Springin’ de Mayo
April 23rd, 2010
“Springin’ de Mayo”
Friday, April 30, 2010 ~ 5:30 – 10pm
Colley Avenue in Ghent ~ FREEIn partnership with BOBFM, Hope House Foundation invites you to celebrate the coming of spring at the 1st Annual “Springin’ de Mayo” on Friday, April 30, 2010 from 5:30-10 pm, at the parking lot of Plaza del Sol at 2200 Colonial Ave in historic Ghent. The event is free and open to the public
Come out and enjoy music from 6:00pm – 8:00pm with THE DELOREANS and from 8:00pm – 10:00pm rock on with Gridlock 64. The celebration will include live dance performances from the Mambo Room instructors in their studio along with a free salsa less and there will be food from Plaza del Sol, Mexican restaurant in Ghent
Cinco de Mayo is not Mexican Independence Day, but it should be! And Cinco de Mayo is not an American holiday, but it should be! So, “Springin’ de Mayo” will become an annual event to merge the two and celebrate our diverse cultures.
For more information contact Elena Berry at 757-625-6161 X20 or log onto www.hope-house.org
All proceeds benefit Hope House Foundation a local non-profit organization providing independent living services to adults with developmental disabilities in Hampton Roads.
Proudly sponsored by BOBFM.
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Target Field is the most accessible in the US
April 22nd, 2010
By Kevin Duchschere, Star Tribune
The brat and beer were similar to ones Bruce Burchett had savored at the Metrodome, but the view from his seat at Target Field was something else again.
“People can stand up and I’m able to see,” he said.
A big deal? It is if you’re in a wheelchair, like Burchett, and you’ve been consigned for years to sitting behind the bouncing backsides of fans cheering the game-winning home run.
Perhaps the most overlooked accolade among those piled on the Minnesota Twins’ new ballpark is how well it caters to people with disabilities.
Dominic Marinelli, a national consultant who has worked on a number of new stadiums, called Target Field “the most accessible one in the country.”
“It sets a standard for the next ones,” said Marinelli, vice president for accessibility services with New York-based United Spinal Association. “We’re trying to use tricks from Target Field at Madison Square Garden [currently under renovation].”
It worked last week for Burchett of Fridley, who attended a day game against Boston with his wife, Linda, daughter Bridgett and grandson Trent Chromy.
The rail before him was well below eye level, unlike some that obstruct wheelchair users at the Metrodome. His perch was well above the jumping fans in front. An outlet box to recharge electrical wheelchairs was nearby, as they are in accessible seating areas throughout the ballpark.
Not only that, the brat was pretty good.
“I’ve got a very positive impression,” Burchett said.
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Take Action! Proposed cuts put community-based services for people with disabilities in jeopardy
April 19th, 2010
Action Alert from The Arc of Virginia
Please take action BEFORE Wednesday, April 21st!
Please call/email your state legislators as soon as possible! Amendments proposed by Governor McDonnell put community-based services for people with intellectual and developmental disabilities in jeopardy!
Note: This alert is a little longer than usual. We are on a tight timeframe and need you to know as much as possible about what has been proposed. Please read the ENTIRE alert. It is almost certain that this issue will impact YOU or someone you care about.
Background:
The General Assembly passed the 2010-2010 Budget on March 15, 2010. This week, Governor McDonnell proposed a number of amendments to the 2010-2012 Budget. The General Assembly will now meet for a reconvened “veto” session THIS WEDNESDAY, APRIL 21st at 12pm to vote on these amendments, finalizing the budget process.There are two VERY serious concerns about Governor McDonnell’s proposed amendments.
CONCERN #1: Amendments allow FMAP funds to be redirected
The Governor’s proposed amendments give him the authority to use new federal Medicaid funding (FMAP) for items other than the restorations of community-based services that were included in the General Assembly budget. Since the language requiring use of FMAP funds for these restorations has been removed, this action essentially leaves many critical services for people with intellectual and developmental disabilities “up in the air”.
What this means to YOU–
ALL of the restorations to community-based services are now in jeopardy, including:
• 250 new ID Waivers for individuals/families on the ID Waiver waiting list
• Elimination of the proposed 2/3 cut to respite services
• Elimination of the proposed 5% cut to HCBS Waiver provider reimbursement rates
• Elimination of proposed freeze on HCBS Waiver enrollment
• Monthly income for HCBS Waiver eligibility would not be reduced from 300% SSI to 250% SSI
• Elimination of proposed cut to Assistive Technology and Environmental Modifications
CONCERN #2: Amendment mandates “managed care” for all HCBS WaiversThe Governor proposed an amendment mandating the “managed care” model for all home and community based waivers (i.e. using insurance companies to coordinate/authorize care). The managed care model is used to “reduce and control costs” of services.
What this means to YOU– Based on what has been reported by advocates in other states, it is believed that moving to this model would have a detrimental impact on people with intellectual and developmental disabilities in the following ways:
• There will be “caps” or limits on HCBS Services.
• People with significant disabilities whose support needs exceed caps could be at increased risk of institutionalization.
• Funding for services/supports could be redirected to administrative costs/profits for insurance companies.
• Individuals/families could experience difficulty accessing/navigating supports and services.
More information about these proposed amendments can be accessed on Governor McDonnell’s website.The bottom line: In order to defeat proposed amendments that are harmful to people with intellectual and developmental disabilities – we need a simple majority in the House of Delegates OR Senate to vote NO to these amendments on Wednesday!
WHAT WE NEED YOU TO DO:
1. CALL YOUR LEGISLATORS AS SOON AS POSSIBLE!
• Sample message: “I urge you to REJECT Governor McDonnell’s amendment that moves home and community-based waivers to managed care. This would be very detrimental to people with intellectual and developmental disabilities! I also urge you to REJECT the proposed amendments that allow redirection of FMAP funds. The proposed FMAP amendments would jeopardize the restorations of community-based services for people with intellectual and developmental disabilities that were passed by the 2010 General Assembly in March. These critical services will literally “hang in the balance”!
• To find the telephone number of your legislators: Click here to use The Arc’s Action Center (talking points provided) or visit Who’s My Legislator (General Assembly Website).
• If your Delegate/Senator requests further information about the amendments, feel free to encourage them to contact your local or state chapter of The Arc:
The Arc of Virginia
Jamie Liban, Executive Director
(804) 649-8481, ext. 101 or jliban@thearcofva.org
2. EMAIL YOUR LEGISLATORS TOO!
We’ve got to get the message to our Delegates and Senators as soon as possible-BEFORE they get to Richmond to vote on Wednesday. We need everyone to both call AND email to ensure the message is delivered. Click here to use The Arc’s Action Center to send an email to your legislator today (when you are get to the site-scroll down to the bottom of the page and personalize your message).REMEMBER-It is very important that we take action SWIFTLY and in BIG NUMBERS!
Thank you for taking action on behalf of “A Life Like Yours”.
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Virginia ranks at the bottom for home-based services for people with disabilities
April 14th, 2010
By Elizabeth Simpson, The Virginian-Pilot
A study released Tuesday lists Virginia as one of the 10 worst states in the country in serving people with mental and developmental disabilities in home-like settings.
The study – The Case for Inclusion – is an analysis by the United Cerebral Palsy organization on the use of Medicaid dollars in supporting the disabled in community or home-like settings.
Virginia ranked poorly because of its high number of residents who live in state institutions rather than community homes, its long waiting lists for services, and the percentage of dollars spent on
institutional care rather than community services.
Virginia’s 42nd-place ranking fell one rung from last year’s study but was an improvement from the first study in 2006, when it ranked 49th.
The organization advocates for people with disabilities and promotes independence, community living, and disabled people’s control over their own decisions and resources.
The study used data from the 50 states and the District of Columbia in 2008. The study’s authors noted that most of the data came from before most states faced their most severe budget reductions because of the poor economy. Medicaid is a shared state and federal insurance program that provides services for the disabled and low-income people.
The study ranked Arizona as best in the country for serving people in community settings and Mississippi the worst. Virginia spent 70 percent of state funding for the disabled in home- and community-based settings compared with the national rate of 77 percent.
About 8 percent of the state’s residents with mental and developmental disabilities lived in large institutions, compared with the country’s rate of 3.7 percent, according to the study. Nine states have no large state-run institutions.
Virginia legislators have been working for years to find funding to reduce the state’s long waiting list for community-based services. About 6,000 Virginians who are mentally or developmentally disabled are on the list for a Medicaid waiver, which provides money for people to live in their own homes or other small, community settings.
Budget proposals early in the year called for freezing the number of waivers, but legislators found money in the final budget for waivers for 250 people.
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More opposition to the SEVTC rebuild
April 8th, 2010
By Page Winefield Cunningham, Old Dominion Watch Dog
Part one of a three-part series on the Southeastern Virginia Training Center rebuild.
As institutions for the developmentally disabled close around the country, Virginia is spending $23 million on a controversial rebuild of one of five such centers in the state.
Construction on a new facility for the Southeastern Virginia Training Center in Chesapeake is due to begin in July. Half of the center’s current residents will be moved into the new 75-bed center, while the rest will be integrated into new community homes slated for the Tidewater area.
Supporters of the rebuild say the residents with more severe disabilities have needs that can only be provided in an institutional setting. But opponents point to a study commissioned by the state last year showing that community homes in Virginia are already housing people with disabilities equal to and more severe than those of current SEVTC residents.
Researchers at the Human Services Research Institute, a national nonprofit with offices in Oregon and Massachusetts, compared the care needs and medical and behavior problems of Southeastern residents to 521 people with disabilities living in community homes around the state. They found that while the needs of SEVTC residents were on average greater than their non-institution counterparts, the developmentally disabled with the most severe challenges were not living in institutions but in the community.
Whether or not SEVTC should be rebuilt, the study found that Virginia is able to care for those with developmental disabilities outside the institution, said Jon Fortune, senior policy analyst for the HSRI.
“Person on person, there are individuals being served in the community that have the same challenges as any one of the people at the facility,” Fortune said. “But it’s also true that on average the people there have support needs that exceed the needs of those in the community.”
It’s a conclusion often cited by members of the Virginia Alliance for Community (ARC)—the advocacy organization that’s been leading the fight against rebuilding SEVTC.
ARC opposes institutions like SEVTC because they say it segregates the developmentally disabled from the community. But they’re also appealing to the steep costs accompanying the rebuild, which come out to $306,000 per resident when averaged among the 75 who will live in the SEVTC.
In a January letter sent by ARC to Gov. Bob McDonnell asking him to halt the rebuild, the group wrote, “Further, it locks Virginia into an outdated model of care that costs too much to build and too much to operate.”
ARC’s allegation that rebuilding SEVTC is “outdated” seems to be supported by national trends. The population of large state institutions has declined by 31.9 percent since 1998 and by 72.8 percent since 1980, according to a study done last year by the University of Minnesota’s Institute on Community Integration.
And over the last 20 years, states have steadily closed institutions until now there are nine states that don’t have any, according to the study. Given the findings of the state-commissioned study, rebuilding the SEVTC is “completely unjustified,” said ARC Executive Director Jamie Liban.
“Virginia is about to embark on a policy that no other state has undertaken in rebuilding this facility,” Liban said. “Virginia is the only state building a brand new institution.”
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New York lawyers denied access to patients
April 6th, 2010
New York State’s highest court has refused to order nursing homes to give state lawyers access to hundreds of psychiatric patients so they can advocate for their rights to treatment alternatives, living conditions or even release.
The Court of Appeals, divided 4 to 3, concluded last week that because the state’s Office of Mental Health had decided not to license the nursing homes, lawyers for the Mental Hygiene Legal Service lacked jurisdiction there.
In 1996, state mental institutions began discharging patients to nursing homes for continued but lower-level care. The New York Times reported six years later that many were confined to highly restrictive “neurobiological units” in nursing homes without lawyers to protect their interests.
The lawyers advocate for the patients on issues like getting or refusing care and treatment, discharge planning, privileges and access to fresh air, exercise, phones and visitation, which are limited in nursing homes.
The Mental Hygiene Legal Service, established in 1965 to guard the rights of the mentally disabled in institutions, investigated the newspaper report and sought access to the patients. The nursing homes said no, and lower courts agreed. Meanwhile, the nursing homes shut down the neurobiological units.
Sarah Lichtenstein, a lawyer for the five nursing homes in Queens, Long Island and Staten Island named in the suit, said their residents had privacy rights and the skilled nursing facilities could not unilaterally agree to letting the lawyers see them and their medical records. “If they requested to see a particular resident and the resident requested to see them, our clients would not prevent that,” she said.
Ms. Lichtenstein said most nursing home residents were there voluntarily. “If they want to live somewhere else and be discharged they can,” she said, though that can be “subject to what’s in their best interests healthwise. If they can’t care for themselves, it gets more complicated.”
Dennis Feld of the Mental Hygiene Legal Service’s Second Judicial Department, which brought the suit, said the service had been trying to get access to clients whom they had previously represented at state psychiatric centers for seven years. He said that the clients remained in restrictive settings and still needed advocates, and that now a legislative change would probably be required so the lawyers can carry out their state mandate to represent them.