Brokerages currently serve over 7,000 individuals with developmental disabilities statewide and are poised to take deep cuts in the coming weeks.  Every communication with legislators matters as the 2012 short session draws quickly to a close in the next week.

Resources:

OSSA Position on Budget Cuts

Dear Legislator Tips on Letter Writing

Find Your Legislator

Sign the Change.org Petition

Adopt a Legislator Project

Specific to Support Services Brokerages the following cuts have already occurred:

• Quality Assurance funding eliminated.  Overall impact, nearly 6% reduction to operations, October 1, 2010.
• 2% reduction Targeted Case Management as of August 1, 2011
• 6% reduction to administration: as of August 1, 2011.  The overall impact of these two reductions is 4% of operational funds.
• Elimination of services for Brokerage customers who are not Medicaid eligible as of October 1, 2011.  This was a 10% reduction in brokerage operational funding and 10% cut in customers in services.
*This net reduction to date in the past 18 months is 20%.   With the additional proposed cuts, our overall reduction is nearly 27%.  

Current proposals include an 8% Personal Agent (Targeted Case Management) cut and a 4% brokerage administrative funding cut.

Cuts to Personal Agent funding (Targeted Case Management is the federal language) are cuts to services.  Each time this funding cut occurs, a direct impact to customer services occurs.  Customer services include reducing the work of Personal Agents who:

• Provide consultation, maintain regular contact with individuals and families and monitor progress of the service plan, organizes and conducts meetings as needed.
• Provide extensive support and education of customers and families regarding employer rights and responsibilities, including monitoring and administration of employer fiscal accountabilities.
• Interview customers who qualify due to disability for this type of support.
  Arrange for a variety of goods and services including but not limited to employment, community access, respite care, special medical, diet or recreational services, etc.
• Make referrals to outside agencies, describes agency and financial options to customers and/or families, and determines financial eligibility, guides customer and family through procedures.  Develop financial plan if needed.
• Facilitate the development by community organizations of services needed by customers that don’t currently exist or don’t currently accommodate the specific needs identified.
• Maintain records of evaluations, service plans, referrals, service provision, case notes, extensive other documentation and follow-up reports for each individual.
• Provide clarification and implementation of Oregon Administrative Rules and ethical practices.

In addition, Personal Agents are unique in DHS services in that they are required to monitor and approve the Medicaid funded expenses on a case by case, person by person basis.  No other part of DHS has case managers operating in this individualized, financial accountability system.

Unique to DHS disability programs is the complete elimination of services to 10% of our customers October 1, 2011.  As has occurred throughout DHS programs, brokerages have sustained a series of cuts which have already gotten to a 20% reduction with 7% additional cuts on the table.  In addition to eliminating services to 10% of previously qualified individuals, brokerage agencies have taken significant measures to address cuts:  reduction and freezing of wages and benefits; reduced positions, reduce mileage reimbursement, added furlough days; reorganizing and eliminating positions; cuts to elimination of training; cuts to all levels of services and supplies; closure of satellite offices; and other areas that impact indirect and direct support to customers.

The Oregon Support Services Association hosted a 10th anniversary party celebrating the opening of the first brokerage in Oregon last month. This fantastic gathering was nearly perfect, and it would have been if you would have been with us! You were sorely missed and deserve significant recognition for your accomplishment.

Support Services as we know them would not have been accomplished without your vision, leadership and heart. As you will see by the photo display on our Facebook page, the 125 people in attendance included individuals and families who launched the effort that became the Staley Agreement. It was much like a family reunion with great food, laughter, storytelling and deep appreciation expressed for the dedication by the team who made it all happen. We can share some of this with you from pictures and people sharing their experience.

Perhaps the best way to acknowledge you for your accomplishment is to ensure the continuation of the high quality of Support Services you helped create. You have our full commitment we will do everything possible, and things that seem impossible, to do so. After all, you lead the way and doing the impossible is what dreamers do. Thank you for your work, dedication and leadership. You have our highest regards!

The Oregon Support Services Association

Margaret Theisen (Full Access)
Dan Peccia (Self Determination Resources Inc.)
Bill Uhlman (Eastern Oregon Support Services Brokerage)
Barbara Hedrick (Creative Supports Inc.)
Ed Little, Jr. (Mentor Oregon Brokerage – South)
Barbara Charette (Southern Oregon Regional Brokerage)
Bev Herrin (Resource Connections of Oregon)
Jill Ferns (Integrated Services Network)
Howard Miller (Inclusion Inc.)
Larry Deal (Independence Northwest)
Katie Rose (Mentor Oregon Brokerage – Metro)
Jennifer Bickett (Community Pathways Inc.)
Sarah Knight (UCP Connections)

Message from Erinn Kelley-Siel, DHS Director

REQUEST FOR COMMENT: DHS is seeking feedback on the attached reduction options [ see links below] prior to their submission to the Legislative Fiscal Office.  Feedback should be submitted no later than 12:00 noon on November 11, 2011. Feedback should concentrate on alternative reductions that would help the agency achieve its savings target and/or on recommendations regarding the prioritization of the reductions on the list.  Ultimately, decisions about any proposed reductions will be vetted through the legislative process.

Please note that these reduction options are not intended to reflect the policy or program recommendations of the agency. DHS is acutely aware that the reduction options on this list have significant consequences for Oregonians and the communities in which they live.

Department of Human Services Reduction Options
The list is posted on the DHS website at http://www.oregon.gov/DHS/aboutdhs/budget/2011-2013/index.shtml

Here is the DIRECT LINK to the list: http://www.oregon.gov/DHS/aboutdhs/budget/2011-2013/reductions/stakeholder-input2011-1108.pdf

Reduction Option List Format
Please note the following as you review and comment on the reduction options:

• The list is organized by major program area. Within each program area, the reduction options have been prioritized – but DHS has not yet prioritized the reduction options across the department.
• At the top of each list (in grey shading) are the reductions that the Legislature has already taken in each program in the 2011-13 budget. Some of those reductions have not yet been fully implemented. However, the savings associated with those reductions have already been included in the 2011-13 DHS Legislatively Adopted Budget.
• The list in total equates to $210-220 million in General Fund savings, the 10.5% target set by LFO. The entire list of reduction options would need to be taken in order for DHS to achieve the full savings target.
• The list is currently focused on program reduction options. Additional reductions to program delivery infrastructure and administration are still under review by DHS and Oregon Health Authority leadership.

Next Steps: If you would like to offer comment on the proposed reduction options, please send your comments to gene.evans@state.or.us. Please send comments NO LATER than 12:00 noon, November 11, 2011. DHS Leadership will review and consider all comments prior to submitting the list to LFO on November 14, 2011.

Conclusion
These are difficult times for Oregonians and for our state. DHS takes very seriously its obligation to the people it serves, our partners in that service, and to the taxpayers of Oregon. Thank you in advance for your understanding with regard to the difficulty of this task and all it entails. Your feedback is invaluable to our ability to do the best work we can with the resources we have.

The Oregon Support Services Association is hosting a 10^th Birthday Celebration of brokerages providing support services for adults with intellectual and developmental disabilities.  We invite you to join us for this memorable occasion, to acknowledge the hard work and success of all of us these past 10 years. We will provide more details later, including reservation information.  Please put this on your calendar and join us and feel free to forward the information!

Thursday, November 3, 2011
Red Lion Hotel, 3301 Market Street NE, Salem, OR
5:30 – 8:00 p.m.

- Margaret Theisen, President, Oregon Support Services Association

Statewide, it is estimated that 800 people will lose services. If you aren’t on Medicaid and you need help applying, call your Personal Agent at your brokerage as soon as possible.

How does eliminating services for people without Medicaid/OHP save the state money?

• The state currently provides services for customers who are not Medicaid eligible solely from the state general fund budget.  When a customer in services becomes eligible for Medicaid, the state can access federal funding on their behalf. If a customer is on a Medicaid waiver, the federal government funds approximately 60% of their services, therefore saving the state money.

I have a job; can I still apply for Medicaid?

• Most likely.  Currently, brokerage customers can potentially access Medicaid if they have resources under $2,022.00.  “Resources” means the amount of money left over in your bank account the following month after you’ve paid your bills.  Your primary vehicle or home does not count as a resource.  If you are an adult over the age of 18, your parents’ resources no longer count and the Medicaid worker would be considering your resources alone. There are also other incentive programs out there which help working people with disabilities qualify for Medicaid such as the Employed Persons with Disabilities (EPD) program. Ask your Personal Agent to set you up with a benefits planner to discuss your options.

I have private insurance already, why should I apply for Medicaid?

• You can keep your private insurance AND still be eligible for Medicaid. Your private insurance will remain your primary insurance benefit.  In some cases, once you become eligible for Medicaid, it will even cover your premiums on your private insurance or Medicare insurance plan, saving you money! If you are a brokerage customer, having Medicaid also increases the amount of plan dollars you are eligible for. Even if you are not utilizing all the money in your plan now, you may need additional supports some day.

Who do I talk to about my options for applying for Medicaid?

• Talk to your Personal Agent. They can help direct you to the right office and can assist with the application process if needed.  Sometimes it’s helpful to talk to a benefits planner beforehand to make sure you are taking advantage of all the incentive programs that might be available to you.

NOTE: The original entry was written by Erin Graff on the Independence Northwest blog. Some edits have been made to update the content.

The settlement agreement was intended to eliminate or significantly reduce the number of individuals with developmental disabilities waiting for services by increasing the availability of comprehensive services on a non-crisis basis and providing Self Directed Support Services for Adults for all eligible individuals.

Read more about the settlement and support services here.

Text primarily from The Arc of Oregon website.

SALEM — At the behest of Service Employees International Union, Oregon Senate budget chief Richard Devlin  sought to stifle criticism of an organizing drive that added more than 7,700 workers to the union’s membership and turned it into the largest in the state.

During a drive to organize workers who help care for developmentally disabled Oregonians, Tualatin Democrat wrote a letter to officials who help employ the workers, warning them not to say anything even “mildly” critical of unionization. He also suggested that a successful union drive would help boost legislative support for services for Oregonians with developmental disabilities. .

Several officials who received the letter said it appeared Devlin tried to tip the scales in favor of the union’s expansion. Devlin said that wasn’t his intent.

Nevertheless, Devlin’s letter illustrates how closely the powerful public employee unions and supportive politicians work with each other behind the scenes. In the end, SEIU won its organizing fight. As a result, the union has now passed the Oregon Education Association to become the largest union in the state, with 60,000 members.

SEIU financially backed Devlin’s reelection last year and has been a key supporter of the Democratic legislative leadership. The union continues to work with the Legislature to expand its membership. Union lobbyists are trying to push through legislation allowing them to organize an entirely new category of community health workers expected to be created this year as part of Gov. John Kitzhaber’s drive to reduce health-care costs.

The organizing drive for workers who help care for the developmentally disabled was particularly sensitive — and unusual. Several brokerages, most of them nonprofits, help people with disabilities such as cerebral palsy or autism get the services they need to stay out of institutions and live as independently as possible. Most of the caregivers paid by the state through the brokerages are actually family members of the clients, who are technically the employers.

Devlin’s letter (reprinted below), which he sent to the brokerages, came as a surprise. While many officials said they had concerns about how unionization would affect their clients, they had not mounted any major campaign against it.

“When I read it, it sounded threatening,” said Barb Charette, executive director of the Southern Oregon Regional Brokerage. She said Devlin’s letter made it clear that he had a powerful position over the state budget and left the impression their funding could be affected if they weren’t careful about what they said about unionization.

As a result of the letter, “I’m much more cautious” in talking about the possible ramifications of unionization, said Zee Koza, board president of Eastern Oregon Support Services Brokerage. Several other people involved in the care of people with developmental disabilities said they did not want to speak on the record for fear of affecting legislative support for their programs.

In his letter, which was sent last December and obtained by The Oregonian this week, Devlin said it was a “misuse of public funds to participate in efforts meant to dissuade support service workers from exercising their collective bargaining rights. Even mildly worded communications against collective bargaining will carry disproportionate weight because of your role in providing services.”

Devlin referred to his budget position and added: “If support service workers choose to form a union, I believe they will be able to significantly strengthen our collective ability to preserve funding and enhance services.”

Devlin said he decided to send the letter after hearing that some workers were being told that joining a union “might diminish their opportunities for employment in the future” and that he didn’t want anyone “thwarting” a worker’s collective bargaining rights.

Devlin insists he wasn’t trying to tilt the playing field in favor of the union and that he wasn’t trying to gag the brokerages.

Margaret Theisen, who heads a Eugene brokerage and is president of a statewide association representing them, said she was not aware of any workers being told that unionization would threaten their employment. She said the big question was whether increased costs for a union workforce would reduce the services that could be provided to clients.

Read the entire article and see Senator Devlin’s letter to the brokerages here.

The Oregon Support Services Association (OSSA) opposes all cuts to DD services and supports all bills that preserve DD services.

Position Statement:

If additional funds are available to “buy back” services eliminated in the Governors’ proposed budget, the OSSA advocates that additional funds be spread among all DD services.  If funds are returned to the Support Services system, we advocate the following priorities within that system as follows:

1. Restore the 10% reduction to Personal Agent Services
2. Restore services to non waivered individuals
3. Restore services to 18-21 year olds
4. Restore Administrative reductions
5. Restore Quality Assurance reductions

Final tally per the Employment Relations Board is 1,873 to 772. This means that Personal Support Workers are now set to be represented by SEIU and arbitration is expected to begin shortly.

A Personal Support Worker is defined in House Bill 3618. The majority of domestic employees and independent contractors working with brokerage customers will be affected.

Of a potential voting population of 9,000, just 30% voted. The union won the majority of votes cast.

Those affected include the majority of domestic employees and independent contractors performing services listed in House Bill 3618. This affects brokerage providers as well as those working with the Community Developmental Disabilities Programs and some mental health programs.