Pat Young says
Government has a legitimate role in providing care for those among us who, through no fault of their own, are developmentally delayed. These are your neighbors who work in menial jobs in grocery stores, restaurants and other businesses in an effort to achieve a sense of independence. Some live independently, and some live in community group homes. However, they don’t have the same abilities as you or me, and they need a hand.
The past decade has been especially difficult for these individuals represented by ARC Gateway and similar organization across the State of Florida as funding has continued to dwindle. The entire service delivery system to some of Florida’s most vulnerable citizens is now reaching a crisis point. Federal and State laws have recognized the necessity of providing supports to these Floridians. Legislation and the courts have upheld that while states must provide services to these constituents, privatized supports in their local communities is the most cost effective and integrated alternative. While these individuals must be offered institutional care, it is of benefit to the state that they remain in their communities.
Recent proposed cuts in Florida for the Developmental Disabilities Home and Community Based Waiver program are so drastic that if implemented, they will force large numbers of individuals to seek institutionalization. Florida must offer institutionalization to all qualified individuals, including the 19,000 plus individuals on the waiting list. For those already on the waiver who are facing these reductions, their families will have no choice as they lose precious hours of supports which enable their family member to remain in their home while they go to work or become so frail in their old age that they cannot meet the personal care needs of the their family member. In addition, other individuals who have saved the state precious dollars by moving out of congregate settings to their own apartments under supported living services will no longer have sufficient hours of service to support them in their homes. Meanwhile, the number of individuals on the waitlist continues to grow with their only option becoming institutionalization.
Allow me to give you an example of a proposed cut and its long term affects. George (not his real name) lives at home with his sister. George’s sister is his caregiver. Lisa (not her real name), George’s sister, works but George is not able to take care of himself during the day. Therefore, ARC Gateway provides transportation to their facility for ADT (Adult Day Training). ADT is the alternative to mandated institutional active treatment which provides learning and stimulation activities during the five day work week for individuals who are not yet employed or those whom will never be competitively employed. If Lisa doesn’t have ADT for George then other arrangements would need to be made….such as placing him in a group home or an institution. I understand that Florida plans to phase out Adult Day Training from the waiver, thus making this 72.6 million dollar reduction possible. The loss of this widely used service will result in families seeking out of home placements due to the fact that they must work during the week. If institutionalization is the only option, the state will pay an average of $120,000 per year as opposed to an average cost of $28,000 for someone on the waiver.
In 1999, The United States Supreme Court wrote in their Olmstead Decision that unnecessary institutionalization of individuals with disabilities is a form of discrimination under the Americans with Disabilities Act. Most of these concerns have already been addressed in Olmstead decisions across the country in states that have chosen to drastically cut services and funding in their community based waiver programs and just continues to offer institutionalization to some of their states most vulnerable citizens. Again and again, decisions have been rendered that severe cuts making institutionalization the only option are in violation of the ADA and the Olmstead decision.
Recently, the Florida Center for Fiscal and Economic Policy stated, “Any service cuts are unlikely to yield significant savings in state general revenue in the short term, as there is little to cut without reaching the bare federal minimum or causing significant harm to the Floridians who must rely on Medicaid. Beyond the short term, such cuts will cost the state much more than they save.” Very well stated!