In a state budget bill that allocates over a billion dollars, $2.5 million can sound like small change.
That’s the amount that the Department of Aging and Independent Living (DAIL) wants to trim from the program budget for people with developmental disabilities.
But advocates for the disabled say the cutback will hit an already beleaguered program still reeling from $11 million in cuts over the last five years.
The Developmental Services Division provides services to more than 3,000 people with developmental disabilities. It partners with a number of service providers to carry out its work. The $2.5 million — which DAIL Commissioner Susan Wehry bills as a “policy reduction” — represents 1.5 percent of the program’s $170 million budget request for Fiscal Year 2014.
At the outset, Wehry said she had high hopes that DAIL could save the money by adopting more cost-effective policies. DAIL came up with roughly 20 proposals, but service providers rebuffed them all.
Now Wehry says program cuts are the “only sure way to save $2.5 million.”
“We have worked very hard with our compatriots on this and the ability to make changes is very difficult. After months of trying to find alternatives through policy changes and system, it is now our opinion that the only sure way to save $2.5 million would be through rescission,” she said.
Julie Tessler, executive director of the Vermont Council of Developmental and Mental Health Services, says most of the original proposals didn’t gain traction because they amounted to cuts.
“They weren’t policy changes. It’s a euphemism,” Tessler told VTDigger.
The Developmental Services program has been grappling with a growing caseload and mounting needs within that caseload — its budget request is $8 million higher than it was last year. Department officials point to a spike in the refugee population, the aging of both clients and their caregivers, and increased public safety needs as the major cost-drivers.
The $2.5 million “policy reduction” proposal was born during the first four months of FY 2013, when DAIL was on pace to end up $6 million in the red.
Still, according to Wehry, Vermont keeps these costs lower than the national average. And Tessler points out that the cost per person has stayed constant for the last five years.
The budget passed by the House hampers DAIL’s ability to make a rescission — it tasks a working group of lawmakers, service providers, Wehry and Secretary of Human Services Doug Racine with finding ways to save the money that will “benefit individuals with development disabilities and their families.”
Advocates support this plan — they are confident the group won’t come up with policy cuts that actually help people — but Wehry says the working group’s September deadline doesn’t give her enough time to carry out the changes.
Both parties made their cases to the Senate committees on Appropriations and Health and Welfare last week. Wehry told both committees she is confident there are ways to save money without putting people in harm’s way, while advocates argued that the program has withstood all the cost containment it can handle and any further reductions will destabilize the system of care.
One of the areas where Wehry is keen to scale back costs is the public safety budget. Service providers supervise people with developmental disabilities who are deemed a risk to public safety, often in costly arrangements where the staff-to-client ratio is high. The number of individuals with budgets of over $200,000 — permitted under DAIL rules only if there are “extraordinary circumstances” — has increased from 10 to 19 since 2007. The total number of people under supervision has climbed at the same pace, from 165 to 220, to a total tune of $2 million.
Wehry, who refers to this as “mission creep,” has suggested putting a firm cap on the $200,000 limit and, in certain cases, supplanting constant supervision with an on-call system. “We were spending a lot of money basically on containment,” Wehry said.
But providers caution that a cap will force them to stop serving these high-needs people because they won’t be able to do so in a safe way. And reducing staff ratios elsewhere in the program would also be harmful, advocates say, forcing providers to offer more congregant services.
Karen Schwartz, executive director of the Vermont Developmental Disabilities Council, said these arrangements strip people of their autonomy and often amount to “child care for adults.”
