People with developmental disabilities may soon face a loss of $50 million worth of services because of a funding problem program officials say would push the budget into the red by February or March if not corrected.
The needed cuts – the news of which is still spreading through the State House and Maine – would affect living arrangements for developmentally disabled people in a variety of ways, though details are being negotiated between service providers and the Department of Heath and Human Services’ Office of Adults with Cognitive and Physical Disability Services.
These cuts are in addition to any budget curtailment order in the current year – which is possible due to mounting revenue shortfalls, according to an Oct. 14 memo from Speaker Glenn Cummings (D-Portland), to House Democrats.
The Home and Community Based Waiver system provides residential services in group homes, day services and employment support and has a budget of $235 million, about 64 percent of which is federal dollars.
It began in 1982 as a way to move people from institutions like the now-closed Pineland Center in Pownal, into communities. What started with an initial enrollment of 200 has grown to 2860 consumers, with an average of 156 more people enrolled each year. There are 69 people on a waiting list. Essentially, the program provides help with everyday living tasks ranging from shopping to bathing. The cuts would reduce those services.
“This is a significant change for providers, but one that we think they can manage,” said Department of Health and Human Services Commissioner Brenda Harvey Thursday to the Joint Standing Committee on Appropriations and Financial Affairs. “The alternative is to keep paying the way we’re paying and not be able to pay our bills in February or March, at all. Of all the choices before us, we think this is the least impactful in terms of the individuals who receive support.”
Asked what caused the shortfall, Harvey and Jane Gallivan, director of the Office of Adults with Cognitive and Physical Disability Services, said that question is being explored internally and by an outside auditing firm, but in general an escalating need for services is to blame.
“The system is dependent on staffing,” said Gallivan during a telephone interview. “Paying for that staffing is driving up the cost and smaller and smaller settings are also driving up the cost. We do not think providers are getting this big windfall. We have here a service center with significantly needy individuals.”
The package of cuts being considered includes the following:
-Closing the program to new recipients as of Nov. 1;
-Stopping paying for medical and behavioral services that are above and beyond standard rates;
Moving as many people as possible from group homes into shared-living arrangements with friends or family members and cut the annual per-person rate of reimbursement by $5000 to $50,000 per year;
Eliminating funding for additional staff in shared living arrangements;
Eliminating funding for employment liaisons while maintaining job coaches where employers have already hired consumers of this program;
Conducting fiscal audits to make sure all services that were billed for were provided;
Instituting a funding mechanism that standardizes staffing patterns at group homes to decrease the variability of staffing levels at group homes; and,
Instituting an across-the-board 7 percent rate reduction for all in-home consumers and a 2 percent rate reduction for community support programs, both effective no later than Dec. 1.
Neil Meltzer, vice president of the Maine Association for Community Service Providers, told the Appropriations Committee that the proposed package of cutbacks would be devastating, particularly the 7 percent rate reduction.
“Quite frankly, I’m not sure how we staff those programs,” he said. “It will have a significant impact. I can’t say enough about how I don’t believe an across-the-board reduction is an appropriate approach.”
But Sen. Karl Turner (R-Cumberland) rebuked that statement sharply.
“We do not have the luxury at the state level to just print money and make the problems go away,” said Turner. “What we’re expecting is that if you don’t agree with a proposed solution, you have to come forward with another solution. We all would prefer a surgical knife rather than an ax or a hatchet to accomplish what we need to. In the meantime, the clock ticks and the budget problems prevail.”
Gallivan said she’s meeting with members of the Maine Association of Service Providers Thursday in hopes of coming up with alternative approaches.
“If we don’t rein in expenditures now, we’ll exacerbate the problem,” she said. “That’s the reason we brought this forward now.”
(Statehouse News Service)
