State Budget Cuts: Community Impact Series – Developmental Disability Services

This blog is in MBPC’s on-going series to bring to light the impacts that state budget cuts have on the lives of everyday Montanans.

We began this series with a post about cuts within the Department of Health and Human Services (DPHHS), which resulted in the closure of more than half of the state’s outreach offices. We have also covered cuts to mental health services, substance abuse disorder treatment services, and the unintended consequences of eliminating such services. Today we will cover the cuts that have impacted Montanans with disabilities.

Prior to the special session, decisions made by the legislature resulted in about $14 million in cuts to the rates paid to health care providers who accept Medicaid patients. These cuts have taken a toll on service providers’ ability to accept and provide care for Medicaid patients, including people with disabilities.

On top of cuts made during the regular session, the November special session resulted in an additional $18 million cut from targeted case management for children and adults with developmental disabilities, as well as mental health needs substance use disorders. The special session also resulted in cuts of nearly $12 million to in-home care for seniors and people with disabilities living in their own homes.

There are a wide range of cuts that impact Montanans with developmental disabilities. One of the most harmful hit targeted case management. Targeted case managers work with people age 16 and up who have developmental disabilities by helping them get necessary services and care.

These case managers help people get and keep jobs, transition to independent living, and find doctors and therapists. Case managers often assist clients with finding stable housing, trouble-shooting benefits paperwork, and checking on medications. Basically, good case management makes all treatment more effective and allows more Montanans to live in their community instead of often expensive and isolating institutional settings. Needless to say, they serve an important role for an individual with developmental disabilities, as well as for their families.

Medicaid and non-Medicaid targeted case management services were cut, meaning that youth and their families could have more trouble accessing and coordinating services for a young person with developmental disabilities. As a result, there could be an increase in emergency services being used.

Reductions in services mean that families will struggle to care for children and adults with disabilities who have fewer community-based supports. It will be harder for adults with disabilities to maintain independence and remain free of institutions. Helena Industries, which shut its doors in April, had provided employment and rehabilitative services for more than 900 people with disabilities annually. Opportunity Resources, Inc. has had to discontinue its case-management program for people with disabilities, closing their seven regional offices, and other organizations are reducing staff and services in an attempt to keep their doors open.

In mid-May 2018, the Butte-based organization, A.W.A.R.E., Inc., was awarded the $2.8 million statewide contract to provide targeted case management to about 2,500 Montanans with developmental disabilities after four organizations’ contracts with the state had been eliminated earlier in the year. A.W.A.R.E.’s contract started June 1, runs 13 months, and can be extended a year at a time for up to five years. The organization will operate with about a 60 percent reduction in the Medicaid reimbursement it receives for services provided to clients.

Recently, the legislature has discussed the possibility of restoring some cuts as revenue collections are finalized. Read our previous blog about where the state budget stands now.

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