Day/Employment Cut Very Difficult to Implement

As is always the case with complex budget development, impacted by federal regulations and state law, there are key factors that will make it very difficult to implement some of the budget cuts in the pending SWM budget.

The pending budget cuts $9.7 million from Line Item 5920-2025, eliminate so called Day Hab Wraps providing assistance with toileting, feeding and behavioral supports.  Without these supports 1000 people with disabilities will likely be discharged from their programs.

If this were to become official, the Commonwealth is required to give 45 days contractual notice of the cut off of service; and then give each consumer 60 days to file an appeal, during which the State must continue paying for and delivering the service. To make this cut effective for July 1, 2015, the Commonwealth would be required to send out almost immediate notices to families.  Such a notice would likely create panic for those families resulting in protest calls to legislators, state agencies and the Governor's office.  Likely legislators who have been historically supportive of disability issues would prefer not to see this happen. 

    

Both the Governor and the House of Representatives funded Adult Autism Services at $12.3 million dollars.  The Governor lumped this amount into different line item, while the House created a new Line Item 5920-3005.  The Senate created a different Line Item and numbered it as 5920-3020 but cut the account by 50% reducing it by $6 million.

The irony is that Autism Adult Services are not funded by the State's General Fund, but are derived from a special federal account that can only be used for expanded inclusion based services consistent the intent of the Center for Medicaid & Medicare Services.  The funding source is from the Balancing Incentives Program (BIP) and is 100% federally funded, thus any cut to this account returns no dollars to the State's General Fund.

As acknowledged nationally and in Massachusetts, the demand for Autism Adult services is mushrooming with demand exceeding capacity.  The House and Governor's recommendation only annualized last year's mid year appropriation and then added $2 million for additional participants.  Last year, through the advocacy of a strong parent, consumer and political communities, Massachusetts passed the Autism Omnibus Bill expanding DDS eligibility to people with autism and other disabilities.  To not fund this now would be viewed as a contradiction with last year's welcomed Act.

The most cost effective program in DDS is Family and Respite Support, Line Item 5920-3000.  This line item helps families keep their loved ones in their own home, receiving in home therapies, nursing supports and respite for family caregivers when a crisis occurs or a break is needed.

If families didn't have this, they would likely turn to DDS Residential Services, be eligible per Medicaid regulations and thus costing the State over $100,000 more per consumer.  These families save the State millions of dollars a year and hundreds of millions over the lifetime of their loved ones.

Advocates were thrilled when the SWM restored Respite Care for Adult Foster Care families but surprised at the irony of then cutting the same benefit for intact families.

For people with disabilities who are fortunate to have jobs and day service, one of the most important supports they need is the ability to get to their jobs from their homes.

Traditional transit doesn't take people throughout the state to job sites; and many people with physical and behavioral challenges must have specialized transportation.

It's as simple as: 
No Transportation = No Jobs = More Dependency = Less Empowerment