In current budget proposals, Support Services Brokerages for Adults includes an additional set of cuts to what has already occurred multiple times since October, 2010. This program has had specific cuts distinct from all Developmental Disability services. Given the array of cuts to all programs we do not support any additional cuts to Developmental Disability Services.
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.