Navigating the Budget Crisis: Looking to the Past or Investing in the Future?

/in , /by Sarah

Navigating the Budget Crisis: Looking to the Past or Investing in the Future?

This has been a relatively quiet time at the Legislature.  The quiet is likely because legislators are contemplating the reality of the 10- to 12-billion-dollar budget hole and how they are going to manage it.  Devastating cuts could be looming, and it is sobering. The bill cutoff is this Friday, February 21st; many bills will die, especially those that have any fiscal impact. Tough decisions are ahead and the potentially catastrophic cuts at the Federal level make it all the more difficult.  Next week we expect to see Governor Ferguson’s budget released and we anticipate even deeper cuts than were in Governor Inslee’s budget.

Sometimes difficult decisions can present opportunity.  In Governor Inslee’s budget he made the bold recommendation to close Yakima Valley School and Rainier School.  These are both very old institutional facilities for individuals with IDD, also known as Residential Habilitation Centers (RHCs). Rainier opened in 1939 and Yakima Valley in 1958.  At the peak of state-run institutions in the late sixties and early seventies, there were more than 4,000 people with IDD residing at them. Our state still has four RHCs that house about 450 residents with IDD. This represents less than 1% of the Developmental Disabilities Administration (DDA) caseload but consumes 10% of the DDA budget. The cost for the care of the individuals and the upkeep of the facilities averages almost $1700 a day per person.  In stark contrast, the average daily cost for personal care and all waiver services for individuals living in the family home is only about $170 a day – more cost-effective by a factor of ten.

These facilities opened at a time when families had few supports and options.  Children with disabilities could not go to school and there wasn’t Supplemental Security Income or Medicaid to provide income and services. Families were left to fend for themselves.  These facilities were opened as a way to relieve these families.  Families were told that their child would be cared for throughout their entire life and that keeping them at home would ruin their families.

It is now recognized that with intervention, people with developmental disabilities grow and develop and are capable of achieving major developmental milestones. We have community resources that were not available when these facilities were established. All these factors help parents keep families together and have improved and extended the lives of individuals with IDD.  All the research shows that community-based care is “best practice” for individuals with IDD.

 

The 1999 Olmstead Supreme Court decision made clear that unnecessary institutionalization is discriminatory. Individuals have the civil right to live in their community.  18 states have now closed all their institutions.  Except for Washington, all the West Coast states have closed all of their institutions or have plans to close them in the near future.

We are at an important moment.  The threat of cuts looms large. We may be facing a time of scarcity of services.  Some people think that we need to preserve these institutions as a “last resort” placement. However, if we do this, the cost of these placements will continue to rise, and the availability of community resources will shrink.  The question we need to ask ourselves is “Do we want to continue to look to the past and perpetuate old models or do we want to look to the future and have appropriate community placements as the “last resort”? We need to invest in and strengthen the community so that everyone can live, work, learn, and play in the community.  If not now, when?

Together!

Cathy Murahashi

 

Advocacy Days Blog: Medicaid Matters

/in , /by Sarah

Medicaid Matters

Medicaid is often seen just as healthcare, but it plays a much larger role, especially for individuals with intellectual and developmental disabilities (I/DD). For these individuals, Medicaid provides critical funding for vital services, including residential, personal care, respite, and job support. In fact, nearly all services from the Developmental Disabilities Administration (DDA) are funded by Medicaid.

Watch Corinna’s story about why Medicaid Matters to her.

Medicaid is a partnership between the state and federal government. In Washington State, the federal government covers 50% of Medicaid Waiver services, while the state pays the other half. Some services, like personal care, have a slightly different funding ratio of 56% from federal and 46% from state sources.

Why should you care?

Washington State is facing a fiscal crisis that is projected to be between $10 and $12 billion over the next four years. Since most of our DDA services rely on Medicaid funding, state legislators have limited options for budget cuts without risking service reductions, eligibility changes, or decreased rates. Currently, many bills that require additional funding are being “held” until they determine the financial situation.

We know that DDA has been chronically underfunded. Cuts to our system would only cause harm.

Recently, parents Lee Springate and Bob Wheeler published an editorial in the Seattle Times expressing their concerns about cuts to state services.

“All adults with IDD are already facing service cuts because of the acute shortage of qualified caregivers. This is at a time when approximately 2,000 adults with IDD are living at home with parents over the age of 60 and in need of immediate placement outside the family home. The remaining 11,000 adults living at home will need to transition to community placement within the next 10 to 20 years, resulting in an unfunded state liability above $1 billion annually (by year 20).”

While we face these potential cuts at the state level, there are significant threats to funding happening at the federal level that could seriously impact our Medicaid services. These changes could happen quickly, so we need to be proactive with our advocacy.

What Can You Do?

For individuals with I/DD and their advocates, this situation underscores the need to advocate for our Medicaid services. It’s vital to reach out to our state legislators and Congressional representatives to protect these crucial services.

Your voice is crucial in advocating for the future of Medicaid services!