I am very excited about writing this issue of my blog because I think it is on a very important and timely issue. Over the next few months I will present different perspectives of self-advocates, families and providers regarding how they feel about Medicaid budget cuts.
In this month’s blog, providers from Arizona, Ohio, and Colorado were interviewed. They did not wish to be identified by their full names.
The Answers
Medicaid services in many states have been cut in the past few years. First, I asked providers if they had experienced any cuts to their state Medicaid budgets.
S.W. from Arizona said, “The rate providers are paid for our home and community based waiver has been cut. The people we serve have talked to me about how concerned they are about losing their staff and services. We are also worried about keeping the same quality of staff we have had in the past.”
J.R. from Ohio said their Medicaid funding had been reduced. Ohio has 88 counties and each of those counties has to raise their own state match for their Medicaid funding. Ohio is a diverse state with urban and rural counties and this can make it hard for the rural counties to make the state match. He said, “the state of our economy has forced us to have people live together whether they want to or not.”
M.E. from Colorado said, “Our services were cut by 4.5% last year. We also have had a delay in the growth of services in the past 2 years.”
In addition to affecting the amount of services they can provide, cuts to Medicaid can also change the way states deliver and pay for services.
S.W. said: “All organizations and agencies have to be more effective and productive with the resources we have. Staff have to be more creative also when they are working with the people we provide services to so that all the people we serve feel safe and still feel like they can do all the things they have in the past.”
M.E. says that Colorado has proposed capping their behavioral services program. Their day programs were recently capped at 200 days for a 50 week year due to shortfall in their budget. In 2009 Colorado went to a fee for services model, and he says that after 3 years everyone agrees it was a mistake. But he says that there is a light at the end of the tunnel: “We will have 173 people taken off our waiting list in the 2014 budget.”
Providers are also trying to work with self-advocates to educate legislators and the rest of the community about how cuts affect service delivery.
S.W. said, “We are educating ourselves, the individuals we serve, and other providers and community organizations or agencies to work together so we can educate our legislators. Everyone wants to be treated with respect and dignity.”
J.R. said, “Families have developed partnerships in all of our communities so we can educate and support each other.”
M.E. says, “The providers all work together to stay in contact. We have a state newsletter to share information with all interested parties. We have a strong partnership between people with developmental disabilities and the organizations or agencies that support them. I think we have a great partnership that is invested in working very hard to make it the best it can be for all citizens of Colorado.”