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Fri September 13, 2013
Developmental Disability waiver changes cause concern
Two years ago the Wyoming legislature asked the Wyoming Department of Health to look into the high costs of Medicaid services in the state. The legislature wanted them to find ways to reduce those costs and see if there were also ways to reform Wyoming’s Developmental Disability waiver program, which costs the state 151 million dollars a year.
The most popular waiver provides funding for home and community based services that can keep a child with disabilities from being institutionalized. The Department is looking into the possibility of reducing funding for some people and using that savings to reduce a waiting list for others who also need services. It’s generated quite a firestorm as Wyoming Public Radio’s Bob Beck reports.
BOB BECK: To be clear, legislators told the Department of Health to cut and not expect any new money to reduce the waiting list for developmental disability waivers.
Lawmakers like Senator Charles Scott who chairs the Senate Health Committee said that the system allowed people to get funding for more services than they actually wanted or needed.
CHARLES SCOTT: The existing program provides all the services that the most severely impaired people need and by tailoring it more carefully to what they really need, we hope to be able to take care of a whole bunch of people that need the service, but are on the waiting list right now. Because we don’t have enough money to cover them all.
BECK: Wyoming Department of Health Director Tom Forslund says nearly 600 people are on the waiting list, and some have been there for as long as seven years. To get them off the list, they will need to find nearly 24 million dollars in savings. To try and find the money, Forslund says they have come up with a two tiered system.
FORSLUND: A comprehensive waiver will be designed for those individuals with the greatest needs; it takes a lot more money to serve those individuals. But then the vast majority of the people will be on what’s known as the support waiver where it will be a capped dollar amount of which they can use that money to purchase the different services they would like.
BECK: The idea is that the Department would review each client, put them in the proper category, and then determine the amount they actually need.
JEANNE THOBRO: We do not want to see people who have been identified for needing critical, life, health and safety services…lose those services and be put at peril.
BECK: That’s Jeanne Thobro of Wyoming Protection and Advocacy System Inc. It’s an organization that looks out for the rights of people with disabilities. P and A as it is called has forced the state to reform how it treated those with disabilities in the past. While she doesn’t oppose looking at the system, Thobro notes that the Department has been directed to make cuts, and that sends up a red flag.
THOBRO: We are seeing the potential of people who really do need services and have fairly gotten services, being cut away from those services. And far more people are not getting needed services because of arbitrary limits being set.
BECK: The 24 year old daughter of Linda Treese has been receiving services since 1991. The daughter lives at home, but Treese says her disability requires around the clock care.
LINDA TREESE: It provides her with therapy services, time for my husband and I just to take the break, it provides a weekend a month without our daughter, some equipment that we needed over the years, 24 years of wonderful productive support.
BECK: But Treese doesn’t like the change.
TRESSE: There are many people who are waiting so long to have some support, unfortunately they are taking away from those who are on and giving it to those who are not on. Which is very scary and very unsafe.
BECK: Other parents share this concern and some claim their children have already had money taken away. Many of those providing services to people with disabilities are also concerned about the cuts.
This is ARK Regional Services. It’s the oldest service provider to those with developmental and intellectual disabilities in the state. President and CEO Shirley Pratt she says reviewing the system is well intentioned, but these cuts are not going to be enough to get many people off the waiting list.
SHIRLEY PRATT: You can’t add the number of people they are talking about adding without adding more money.
BECK: Pratt is also worried that the state and the legislature are missing the fact that some people in the program are already underfunded. And Pratt has another concern. That’s that unqualified people may make decisions on the type of care someone needs.
PRATT: I know that the people at the state, their intent is good, but I think if you’ve got bureaucrats making decisions about people’s lives, when they haven’t been here, they’re not involved, they are not part of that on a daily basis. I think you are going to run into trouble.
BECK: Department of Health Director Forslund says thanks to public comment, they have decided to be more deliberate with possible cuts and when they decide to reduce funding, they will do it over time. But Forslund stresses that the law says they have to cut.
FORSLUND: So the question is how do you change it and protect the people that are already in it and not disrupt their lives in a major, major, way.
BECK: Jeannie Thobro of Protection and Advocacy wants the state to make sensible reductions and then realize that more money is needed. As an aside, Governor Matt Mead gave a speech the other day where he said if cuts don’t have the desired result, then the legislature should put more money into the system. For Wyoming Public Radio, I’m Bob Beck.