Posted on February 20, 2017
Comments Off on Support Funding for Disability Services
Read this piece by Eve Franklin, Advocacy Director, Montana Association of Community Disability Providers as it appeared in the Helena Independent Record on February 16, 2017.
In 1902, Thomas McAloney, the Superintendent of the “Insane Asylum” at Warm Springs, asked the Montana Legislature to open a state institution for the “feeble-minded.” He believed that in spite of their “mental deficiency, as citizens of Montana they are entitled to an education.” His language and the description of treatment are shocking today, but Mr. McAloney’s words provide a window into the evolving idea that individuals with a developmental or intellectual disability deserved a supportive environment where they could experience personal growth and live a full life in the community.
Today, services for the intellectually and developmentally disabled would be unrecognizable to Mr. McAloney. Instead of isolating individuals in large institutions, the vast majority of services are now provided in the community. There are 60 private non-profit agencies located all over the State of Montana that deliver community-based services to approximately 2,700 people. Services are based on the principles of respect, dignity, participation in life decisions, and involvement in the community. Supports include group living settings, independent living, transportation assistance, job coaching, supported employment, and a variety of other services that facilitate a meaningful life in the community.
Quality services for individuals with a developmental disability are determined by three factors: a financially viable provider agency, a stable and well-trained workforce, and a supportive state Legislature. The 65th Legislature is currently making decisions about funding critical services. Montanans who receive disability services, their families, and providers have joined together to present priorities for this session.
One critical issue is the need to increase in the medicaid rates paid to provider agencies. These agencies function as a business and are faced with the same challenges all businesses face. They are subject to insurance increases, higher utilities, maintenance costs, and property taxes, just like any other business. There is, however, a major difference between disability service providers and other businesses, providers have one fixed payment source, the Montana medicaid program.
If budget demands are greater than revenue, they cannot charge more their services. Lack of adequate funding can lead to drastic actions, often with heartbreaking consequences. One provider was forced to close a group home in order to save other services. At a time of increasing demand, when providers are asked to serve more people with increasingly complex needs, and people waiting for services, it is devastating for clients and their families when services are reduced or eliminated. Our legislators could take a meaningful step toward ensuring stability in community services by funding a rate increase to reflect the inflation experienced by provider agency.
Of equal concern is the need to improve the salary of direct care workers. These are the folks on the front lines, who are responsible for creating a caring environment where clients feel safe and supported. Direct care workers are there every day, helping with daily hygiene, meal preparation, household chores and personal needs. They are watchful of health needs, and insure that clients are taken to medical and dental appointments. Their focus is to use day to day activities as a way to help clients learn new skills and become progressively more independent and confident. Clients also depend on direct care workers for emotional support. Direct care workers are there to celebrate special events like birthdays and holidays, and they are there when clients face difficult events like illness, deep disappointment, and loss. Ensuring clients receive quality services depends on a dedicated and stable workforce. However, a staff shortage in all agencies has reached a crisis level.
The salaries that providers are able to pay are simply inadequate to recruit and retain qualified staff. There are many providers who are unable to pay much more than minimum wage, some can manage a bit more but in all cases workers can find employment in a retail setting or a fast food restaurant and in many instances make several dollars more an hour. Staff care deeply for their clients, and often talk about the personal meaning they find in their work, but sadly, simply can’t afford to stay.
There is a request before the Legislature to fund an increase in direct care worker salaries, and it is impossible to overstate the need to provide workers with a wage that allows them to continue working in their field.
Montana has made significant progress since 1902 when Mr. McAloney first identified a core issue for people with intellectual and developmental disabilities. In 2017, lets honor that progress by providing the financial tools needed to provide quality services.