Day Hab Cuts Endanger Health
Mass Health Proposes Cutting Day Hab Program that helps people with challenging disabilities function in the community.
Leaders of the Massachusetts Mass Health (Medicaid) program are leading an effort this month that seeks to trim $5 million from the very program that the State is turning to in its own effort to reduce the census (and cost) of state institutions.
The day habilitation program overwhelmingly serves people with disabilities who have a variety of medical and behavioral challenges that limit their ability to be employed in a DDS program or be competitively employed in the community earning an income.
Over the last several years, the Commonwealth has turned to Day Habilitation programs to provide the day activity for state owned and operated group homes, as well as hundreds upon hundreds of people with disabilities who have moved from state institutions into community settings.
In fact, the Administration’s Community First, Institutional Closure and Olmstead Plans make heavy use of Day Habilitation services by moving former residents of Fernald and other closing state institutions into state owned and operated group homes and private provider day habilitation programs for non-residential supports and services (the state doesn’t operate similar day activity programs).
The proposed Mass Health Day Hab cuts means that there will be less staff on hand to serve many frail individuals who have a variety of challenging health concerns, as well as cognitive impairments.
The participants in these programs are among the state’s most vulnerable and fragile citizens, including people with disabilities who utilize molded wheelchairs, feeding tubes, and may have challenging health and incontinence issues that require individual assistance. Since the largest part of the operation of these programs is staffing, reduced funding will make it challenging to deliver all needed therapies and assistance.
Mass Health leaders have proposed to relax day habilitation regulations to achieve cost savings that will reduce the hardship on community day hab programs. ADDP members are not convinced that so-called relaxing of regulations is wise for such a fragile population or fiscally prudent. ADDP has written to Mass Health and requested that the department share it’s analysis (if one exists) regarding how such relaxation would reduce cost or better serve day hab participants.
Further complicating the funding for day hab programs is the impact of the Commonwealth’s ongoing series of blizzards. Since day hab programs are not paid on snow days, many programs are rapidly losing operating capital needed to maintain worker salaries and benefits. In fact, many providers report that the fiscal loss from recent storms either match or exceed Mass Health’s proposed cuts in FY 11.
ADDP has written to the Secretary of EOHHS, Dr. JudyAnn Bigby, who oversees Mass Health and asked her to reconsider; and pull from consideration Mass Health Day Hab cuts for the current year.
The letter to Secretary Bigby follows:
February 3, 2011
JudyAnn Bigby, Secretary
Executive Office of Health & Human Services
One Ashburton Place
As we return to work from one more snow day, ADDP would like to formally request that Mass Health withdraw its request to institute a Day Hab rate reduction in the remaining months of the FY 11 budget.
As you well know, Day Habilitation programs are not reimbursed on snow days.
As a result of the frequency of snow days this fiscal year, many day habilitation programs have already experienced fiscal losses that are equal to or exceed the amount that is projected to be taken from their program should the FY 11 DH rate cut go into effect on March 15 (pending outcome of the rate hearing). ADDP is requesting that all Day Hab providers track and report their weather related losses. When these losses are compounded together, it places many day habilitation programs in a fiscally precarious position. If the reason for implementing a rate cut as of March 15, 2011, is to reduce Medicaid expenditures then that goal has already been achieved due to the decline in Medicaid billing.
By withdrawing the FY 11 rate reduction for Day Habilitation programs, Mass Health/EOHHS can help preserve the fiscal integrity of these programs which are fragile at best. We respectfully ask you not to push ahead with a FY’11 rate cut due to the losses Day Hab providers are already experiencing.
We do understand that you may wish to proceed with the FY 12 rate cut, pending outcome of the rate hearing; however we would request you delay the February 23-24 hearing of this request to spring, pending further action in the legislature on House One and the Mass Health budget.
ADDP would prefer to place all of our energies in working in a collegial manner to support the Governor’s program and appropriations for the department, rather than opposing your efforts before DHCFP and subsequently the legislature.
May we please schedule a meeting or phone call to discuss this request?
President & CEO, ADDP