Choosing Between Vital Parts is a Losing Proposition for I/DD

When it comes to full lives for Oregonians with intellectual and developmental disabilities, we want it all.  As a member of the Oregon I/DD Coalition, OSSA helped to identify four top priorities for the 2015 legislative budgeting session.  These four priorities, together, represent a pathway to richer lives for Oregonians with I/DD.  The four priorities are:

  • DSP Wages: Raise the wage for Direct Support Professionals.
  • Brokerage and CDDP Workload Model Budget:  Fund workload model at proposed 95% equity for CDDPs and Brokerages.
  • Fairview Trust:  Keep the promise of community housing opportunities for people with IDD and restore the Fairview Trust.
  • Employment: Continue funding to improve employment outcomes for people with IDD.

These priorities are listed in no particular order, for one very important reason: we cannot possibly weight one over the other if we are truly in support of people with intellectual and developmental disabilities.  Together, these elements of community employment, quality support professionals, community housing, and high-quality case management work together in a person’s life.  Each makes the other possible.

When I think about trying to prioritize our four adopted budget goals, it seems to me that I’d be choosing between the “neck” of the system (our case management force, connecting people to vital resources) or the “head” of the system (the resources people need to create full lives).  The head will not prosper without a neck; employment services, housing services, and provider organizations will not prosper without a strong case management force to navigate people to engage with them.  Likewise, the neck is pointless without a head; case management services are pointless without the employment, housing, and provider resources to which we can direct customers.  Choosing between vital parts is a losing proposition for the I/DD body.

(public domain source)

(public domain source)

Choosing between equally critical services, or offering one to be cut over another, is a non-starter for the OSSA.  However, this does not mean that OSSA is unwilling to engage in the process of tough decision-making, should it be required at DHS.  The Office of Developmental Disabilities has new, dedicated, and promising leadership in Director Lilia Teninty.  We do not ask her to make hard decisions in a vacuum, but instead are willing to provide important education on the impacts and ramifications of various options as they are considered.  We do not wish to instruct, but we are happy to support, the budgeting activities of ODDS.

OSSA sees an incredible opportunity at hand for the many components of the Oregon I/DD community to develop a strong, cohesive presence at the capitol.  Our strength is in the purity of our collective goal: to promote quality service and supports which respectfully further the rights, equality, justice, and inclusion for all Oregonians with intellectual and developmental disabilities and their families.

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The Time for Advocacy is Now!

Distressing news out of the capitol: lawmakers may be looking to cut $140 million from human services in order to fund a budget “hole.”  The question is, what does a $140 million cut to human services look like?  Though plan hours are not likely to be cut, vulnerable areas include provider pay rates and Brokerage funding for Personal Agents.  Brokerage Personal Agents and direct support providers have worked to implement dozens of system changes over the past two years.  With these changes has come a lot of additional workload and responsibilities, which is already cutting into the bottom line: time spent with Brokerage customers.  Any reduction in funding is going to cut further into that time.

The sun is shining on lawmakers at Oregon's Capitol Building.

The sun is shining on lawmakers at Oregon’s Capitol Building.

Now is the perfect time to flex your advocacy muscles.  Advocacy is defined as “the act of pleading or arguing in favor of something, such as a cause, idea, or policy,” and if you’re a human, chances are you’ve been engaging in advocacy your entire life.  Some people are certainly more comfortable speaking their minds than others.  The trick to being a good advocate isn’t about becoming a perfect speaker, it’s about finding the right message for you.  When you find a cause or idea that is true to your heart and soul, you will find that the words flow much more easily.

How have your Brokerage services helped you to live the life that you choose?  Please call, email, or visit your state representatives and senators, and let them know how important your Brokerage services are to you!  For more information, check out the Oregon I/DD Coalition’s special bulletin on the current need for advocacy.  You can find your legislators, and see the list of legislators on the Ways and Means Subcommittee on Human Services, the joint committee in charge of making legislative budget recommendations.  You can also get talking points and more information about each of the Coalition’s four priorities: Employment, restoring the Fairview Housing Trust, raising DSP wages, and funding Brokerage and county case management at 95%.  Each of the four priorities were selected because they fund the cornerstones of a full and meaningful life in Oregon’s communities.
Even small cuts to the 95% Case Management funding mean losses for Brokerages from last biennium, at a time when workload has greatly increased.  Let your legislators know that overworked/underfunded PAs mean that you can’t get the services you want, when you want them.  Urge them to fund the Workload Model for Brokerages and counties at 95%!

Brokerages Send Nearly 900 Messages to Salem Legislators in One Week

Last week, as part of the DD Coalition’s Week of DD Advocacy, support services brokerages statewide made a major advocacy push. Brokerage staff, customers, family members, direct care workers and community members worked hard to schedule visits, make phone calls, send letters, write emails and post video postcards telling their legislators they oppose cuts to essential brokerage services. Final tally for these efforts reached nearly 900 messages (and many more if you count hits to posted videos and an online petition!)

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

OSSA Position Statement for Brokerage Services 2011/2013 Budget

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.

Deadline TOMMOROW for Feedback on Budget Cut List – Brokerage Cuts Indicated

Message from Erinn Kelley-Siel, DHS Director
As a result of the ongoing economic weakness facing the state, and the potential for additional projected revenue declines in future forecasts, Oregon’s Legislative Fiscal Office (LFO) requested the submission of reduction options from all state agencies. LFO requested agencies to develop a total of 10.5% in reduction options, based on 2011-13 legislatively adopted budget level, including the 3.5% supplemental ending balance adjustment amount.  This list is due to LFO by November 14, 2011. To reach that target, the total level of reduction for the Department of Human Services is $210-220 million general fund.

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.

Approximately 800 People Set to Lose Brokerage Services OCT 1

As a result of budget cuts during the 2011/2013 session, the State of Oregon Department of Human Services has instructed support services brokerages statewide to exit customers without Medicaid from brokerage services on October 1st.

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.

OSSA Position on Budget Cuts

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