{"id":1865,"date":"2011-01-12T10:00:01","date_gmt":"2011-01-12T15:00:01","guid":{"rendered":"http:\/\/susansenator.com\/blog\/?p=1865"},"modified":"2011-01-12T11:05:34","modified_gmt":"2011-01-12T16:05:34","slug":"proposed-cuts-to-medicaid-a-new-hydras-head","status":"publish","type":"post","link":"https:\/\/susansenator.com\/blog\/2011\/01\/proposed-cuts-to-medicaid-a-new-hydras-head\/","title":{"rendered":"Proposed Cuts to Medicaid: A New Hydra’s Head"},"content":{"rendered":"

There is something you don’t think about when you are an activist for a cause:\u00a0 it is so boring.\u00a0 Just when you think you have won — pyrhhically of course — you think you can rest your sword for a moment, and then pop! there’s another head on the Hydra.\u00a0 You gotta get up and slay that damned thing again.\u00a0 The problem with this metaphor is that it is not a satisfying action like a real head wallop would be; there’s no blood, no green slime.\u00a0 No, my Hydra is something as amorphous as a statement drafted by a group proposing something stupid.\u00a0 In this case, the Executive Office of Health and Human Services (EOHHS) in Massachusetts has proposed making cuts to Medicaid-funded initiatives.\u00a0 The targets?\u00a0 Adults with developmental disabilities.<\/p>\n

Are you jumping up from your seat, hand on your sword, yelling”Let me at ’em!\u00a0 Show me the monsters who would take funding away from people who already have so little support to count on!\u00a0 This won’t happen because it is so obviously wrong!”<\/em><\/p>\n

You go looking for the monsters and you can’t find them.\u00a0 That’s because it is a group of people you normally trust, like Ann Hartstein, Secretary of Elder Affairs, Jean McGuire, EOHHS Assistant Secretary of Disability Services and Policy, Rachel Richards, Director of the MassHealth Office of Long Term Care and Elin Howe, DDS Commissioner.\u00a0 I’ve met some of these people face-to-face at dinners and conferences, along with the Governor.\u00a0 They are good people.\u00a0 They are in this field for a reason, or at least they were:\u00a0 to improve the lives of those in need in the Commonwealth of Massachusetts.\u00a0 I truly believe that.<\/p>\n

But — they are making a big mistake, and they are dealing our kids a heavy blow with this new news.\u00a0 According to the ADDP (Assoc. of Dev. Disability Providers)<\/a> and the ARC of Massachusetts<\/a>, the Hydra head takes the shape of cuts to Medicaid:<\/em><\/p>\n

\n

“[The above EOHHS leaders] met yesterday with representatives of elder and disability services community.\u00a0 The meeting titled “Secretary’s Review” was held to announce cuts in long-term care spending in MassHealth.<\/span><\/p>\n

Specifically, reductions<\/span><\/strong> subject to hearings scheduled in late February and planned for March 15 include:
\nDay Habilitation\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 3.7%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Day Hab
\nAdult Foster Care\u00a0\u00a0\u00a0\u00a0\u00a0 6.2%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 AFC
\nAdult Day Health\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 7.5%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 ADH<\/strong><\/span><\/p>\n

The cuts would be implemented in the last quarter (April-June) of Fiscal Year 2011 and then be carried into 2012.\u00a0 The total cuts which are for FY’11 followed by FY’12 include:<\/p>\n

Day Hab-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 $1.3 M & $5 M (M=Million)
\nAFC-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 $1 M & 4 M
\nADH\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 800,000 & 3.3 M<\/p>\n

EOHHS also plans a subsequent reduction in group adult foster care ($1.25M & $5 M).\u00a0 Director Richards noted that administrative burden reductions would accompany the cuts and it is hoped that this will ease the financial impact. “<\/p><\/blockquote>\n

There you have it.\u00a0 Our Executive branch, fresh from re-election, has targeted the one remaining ace-in-the-hole of Residential Support for the Post-22 Developmentally Disabled crowd.\u00a0 The cuts will affect nearly ALL post-22 on the spectrum who need a day program because they’re not working, who need living support…<\/span><\/strong><\/p>\n

Okay, plain English:\u00a0 this likely means your adult kid .\u00a0 Because we all know that getting funding for residential support from DDS was difficult to get in the first place:\u00a0 DDS funds are IQ based, many many on the Autism Spectrum would not have gotten DDS anyway…but they would still need support, right?\u00a0 So where would they go?\u00a0 They probably would have tried for the Medicaid-funded programs like Adult Foster Care (AFC) and DayHabs<\/span><\/strong><\/a> (which are not run out of the DDS budget).\u00a0 WELL, NOW THESE ARE GOING TO BE CUT!!!<\/p>\n

And as for those like Nat, more deeply involved with their autism, we had hoped that he could possibly get DDS residential funding and would not have to go for the now-to-be-cut Adult Foster Care.\u00a0 But guess what?\u00a0 My friend Cathy Boyle. founder of Autism Housing Pathways<\/a>, did some figuring, using data from the EOHHS site, and here’s what she came up with:<\/p>\n

“DDS only serves those with IQ of 70 or below (on average, 41% of those with ASD)<\/p>\n

527 with ASD between 18-21 in 2008\/2009<\/p>\n

Average of 132 (527 divided by 4) will turn 22 each year (probably a low number, as it assumes the 2008-2009 numbers will not increase in subsequent years<\/p>\n

****Implies 78 22 year olds with ASD (59%) are *not* DDS eligible each year****
\n<\/span><\/strong><\/p>\n

From FY08-FY11, the DDS Central Middlesex Area provided 24 hour residential to an average of 4 individuals turning 22 per year; multiplying this by 23 area offices implies an average of 92 people turning 22 per year who receive residential services, or 15% of those turning 22 served by DDS<\/p>\n

Implies ONLY 8 of the 54 with autism served by DDS will receive 24 hour residential!!!!!!!!!”<\/strong><\/span><\/p><\/blockquote>\n

HERE’S THE PUNCHLINE:\u00a0 So what would the remaining 22 year olds with ASD each year do for residential support??\u00a0 They would turn to Medicaid-funded programs, that are now to be cut.
\n<\/strong><\/span><\/h2>\n

Here is what you have to do when the monster rears yet another ugly head:\u00a0 you have to go to hearings.\u00a0 Your testimony is your sword.\u00a0 The Hydra is invisible; it is no one ugly person, no one horrible committee!\u00a0 This enemy is not “all politicians” nor is it “evil bureaucrats.”\u00a0 You can’t really put your finger on its slimy hide.\u00a0 The way you fight it is with long, tiresome treatises like this blog post.\u00a0 You write letters to the editor.\u00a0 You call Commissioner Howe, or Governor Patrick. You call your own Legislator.\u00a0 You go to the hearing and you try to give some kind of statement, known as testimony.\u00a0 You can even write it up and hand it in.<\/p>\n

Hearings are scheduled on the following dates for these programs:
\nAFC\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Boston on February 22
\nDay hab\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Shrewsbury on February 23
\nADH\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Boston on February 24<\/p>\n

Try to go.\u00a0 It is mind-numbing, inconvenient, boring, tiring.\u00a0 It is anticlimactic.\u00a0 Nothing gets decided then and there.\u00a0 You go downtown, you sit, you listen, you help fatten the crowd.\u00a0 Maybe you say something in a querulous voice.\u00a0 You go home with a headache.\u00a0 You hear a few weeks later that they are not going to make the cuts as bad as they said.\u00a0 You exhale, and go on with your life, making plans for your adult child.<\/p>\n

It’s boring and kind of ugly and shades gray and full of red tape.\u00a0 But it will eat up all or most of his adult supports.\u00a0 And it attacks when you least expect it, and when it’s through you will have next to nothing for him but your own home, your child’s bedroom — if you even have that.<\/p>\n","protected":false},"excerpt":{"rendered":"

There is something you don’t think about when you are an activist for a cause:\u00a0 it is so boring.\u00a0 Just when you think you have won — pyrhhically of course — you think you can rest your sword for a moment, and then pop! there’s another head on the Hydra.\u00a0 You gotta get up and […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-1865","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pSTth-u5","jetpack_likes_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/posts\/1865","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/comments?post=1865"}],"version-history":[{"count":3,"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/posts\/1865\/revisions"}],"predecessor-version":[{"id":1867,"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/posts\/1865\/revisions\/1867"}],"wp:attachment":[{"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/media?parent=1865"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/categories?post=1865"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/susansenator.com\/blog\/wp-json\/wp\/v2\/tags?post=1865"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}