I want to talk about the danger to community services for those with a developmental disability during this Legislative session. The current political landscape does not look promising for community services as the Legislature struggles to close a projected shortfall for the coming two years.
During the legislative session three budget proposals are created, the Governor's, the Senate and the House of Representatives. Although these proposals will differ slightly from one another, we can be sure that there will be significant cuts offered in the discretionary spending areas of the budget. Services for developmental disabilities are in this area of the budget. I have seen the proposal for the Governors supplemental budget and though some of them may change for the better, we cannot count on it.
Currently the Governor proposes the elimination of all medication coverage for persons on Medicaid, with the exception of those provided within a medical facility. If this is allowed to stand, persons with developmental disabilites who do not have the resources to pay for the everyday medication that allows them to function and reside in the community, would no longer have medication available to them.
All dental care, with the exception of emergency pain control, would be eliminated. This could mean that unless a tooth is pulled, there is essentially no treatment and if the patient needs pain medication after leaving the dental office it will not be available, because it would be an outpatient medication.
Eyeglasses would be eliminated.
These are just three of the programs currently scheduled for elimination. Others are proposed for reductions in funding from 2% to 50% depending on the program.
Although this is not an accurate figure, if say you had 120 hours of family support service available to you, it could be reduced to 80 hours.
Providers of Residential Services would receive enough of a cut that their ability to hire and retain employees will be seriously impaired. Case managers working with the unserved will be eliminated. Job placement services for those leaving school will no longer exist.
For all of us, and the ones who need service, this may well be our Alamo.
Now is the time for all good persons to heed the call to arms to prevent the loss of services that those who came before us fought so hard to attain and to keep them from slipping into the abyss of the closet.
Now is the time to heed the call Stalin gave to his Commanders when the Germans were twenty miles from Moscow. The message was simple, "not one step back".
I am asking that each of you join me in the upcoming battle to preserve meaningful services in the community for those with a developmental disability and I ask you for one simple thing, ten minutes of your time to contact your representatives in Olympia on this issue. I further ask that you coordinate your effort through The Arc so that the message will remain in front of our Legislators throughout the session.
Some of you will be thinking that there will be enough others to carry the load or let the good intention of calling fade like a distant memory. At this point in the history of Community Services I cannot over stress the importance of your involvement.
For those of you who do not think you have the skill to articulate the message, I would say you only have to look at a stammering child asking you for something to realize that although the words are not perfect and the child is stammering, the message comes through loud and clear.
I ask this Chapter to take on the task of coordination and to ensure you have the information needed to make the call.
If you are a person with a developmental disability, a parent, a friend or perhaps a service provider, tell how these draconian cuts will affect you or the ones you care about.
Ten minutes of your time is not a great deal to request and that ten minutes you spend may well be the factor that saves a service or for that matter many services.
Even if it looks like we are not going to be totally successful, we might just be able to accomplish what those at the Alamo did and give those who follow a greater chance to prevail.
I want to thank each and every one of you for listening. I hope that each of you has a joyous holiday season and until we meet again may God forever hold you in the palm of his hand.
By Lew Isham
Lew Isham has been a member of The Arc of Kitsap County for over thirty years. He currently serves on the Board of Directors of The Arc of Washington State.
This budget is shameful and inhumane. We need to advocate for a continuum of care and realize that due to acuity some people will need a higher percentage of the pie. This is the natural bell curve that is well documented and validated within the Supports Intensity Scale which DDD is using for clients.
ReplyDeleteAfter listening to the presentation by Maryanne Lindeblad and Don Clintsman from DDD to the House Early Learning and Human Services Committee on January 13, 2011, I decided to look into the cost comparison of care of a resident in an RHC versus that of a resident in a SOLA. As Don stated, services at an RHC are comprehensive, including an attendant counselor, nurses, physicians and other support staff, transportation, dietary support, active treatment (employment skills) recreation and socialization while a SOLA has 1 staff person for 3-4 residents with no other care support. Representative Ruth Kagi asked if a SOLA was like “supported living but with state employees” to which Don answered “correct.”
These figures are taken from DSHS client services July 2006- July 2007. What you will see is that due to all services being removed from the cost of care in the RHC, those services will need to be found elsewhere. I took the figures for those services that would most likely be used by the residents, added them up and have found that in actuality, the cost of care of a resident living in an RHC is extremely cost effective for the care that that resident receives.
ICF/MR
(Intermediate Care Facility for the Mentally Retarded) Dollars per client
Cost of care per resident in and RHC $ 141,422
Cost of care for most of these services that would be needed if resident lived in SOLA $ 163.444
Cost difference -$ 22,022
Questions I would like answered are:
1. Given that there are 4-6 times as many 911 emergency calls per resident from assisted living and group homes as from an RHC, how can moving residents into group homes with minimal supervision and oversight not increase the load on our emergency services?
2.Given that RHC residents need very comprehensive care, how can we avoid the considerable increase in costs for hospitalizations, medical professional care and prescriptions once they are living outside of the RHC?
3. Given that RHC residents have a much higher acuity of care in assessed areas which require higher staff –to-resident ratios, how can moving to a SOLA with a staff-to-resident ratio of 1:4 not put both the residents and staff members at great risk of injury?
4. Where are the cost savings that DDD states will occur with moving residents out of RHCs? Without these savings, how can DDD “free up funds” for the vastly increased need for respite and crisis management care that such a move would entail?
I have taken figures from the DDD assessment Acuity Scales to indicate the 3 highest areas which would require more staff. The acuity level difference between the two settings is significant.
Acuity Scale assessment ICF/MR
N=76
Interpersonal Support 57.8%
Behavior 36.8%
Protective Supervision 77.6%
“Community”
N=14,496
Interpersonal Support 41.3%
Behavior 17.4%
Protective Supervision 52.7%
My question regarding this would be:
1.How can you move the residents with need for more intensive care to an environment with less support and both maintain safety and health, and cut costs at the same time?
Thank you,
Cheryl Felak, RN
Disability Advocate
(1)http://clientdata.rda.dshs.wa.gov
(2) Information from 911 emergency call logs from licensed assisted living and group homes in Seattle and King County Medical Service call logs for Fircrest data
(3)https://www.dshs.wa.gov/RDA/