MTPR

Lawmakers Question State Health Department On Developmental Disability Program Cuts

Jan 22, 2018

In order to balance the state budget last year, Governor Steve Bullock and lawmakers signed off on $49 million in cuts to the state health department. The department’s response includes eliminating two-and-half-million worth of contracts to non-profits that serve people with developmental disabilities.

“I'm begging you to not cut those hours, because if we don't have those hours, we can’t live independently,” Kerry Jones said.

Jones was among the parents, day-to-day helpers, and non-profit leaders who addressed a committee of lawmakers Friday about how state budget cuts will affect people with developmental disabilities. Jones was one of the few people who relies on those services to speak to the Children, Families, Health and Human Services Interim Committee.

Lawmakers haven’t heard directly from many people with developmental disabilities in public meetings since the health department announced specific program cuts.

Committee members mostly heard from proxies. Like Tom Danielsen, from Billings, who spoke on behalf of his son.

“I just wanted to say that there is no greater feeling in the world than feeling the love of a developmentally disabled person when they direct it to you,” Danielsen said. “Because you know it is real, and it's coming from their heart straight to your heart. I’m telling you there are no easy answers. And I just want to tell you keep working, keep working, keep working, because the developmentally disabled community of Montana is relying on you.”

Eliminating contracts with private non-profits who provide case managers for people with developmental disabilities means there will be fewer case managers to assist people with day to day tasks that can help them live more independently. When those contacts end April 1, the health department says it will take over case management for roughly 3,000 people.

It says state case managers will take on a 50-60 person caseload.That’s about double what industry advocates say is reasonable. The health department says this transition will not reduce services, but people who work for and run the non-profits don't believe it.

Pat Noonan is one. He’s the government relations director for Anaconda-based AWARE. He says ending these contracts, when stacked on top of other cuts made to health care services in order to balance the state budget, could cripple services and topple an industry.

“And it is unraveling at a mind blowing pace,” Noonan said. “Just a little bit as to where we are year to date for AWARE, to give you a feel for this. Year to date we have laid off 40 direct care workers. We shuttered services in Flathead county. And we will be shuttering every service east of Billings. And in the state with the highest suicide rates in the nation, we’ve gone from 14 physiatrist to two, for the entire state of Montana.”

During the 2017 legislative session lawmakers passed a resolution stating that over the next two years they would study how the state pays for and provides developmental disability services. At the time, it was determined that over a thousand individuals were on a waiting list to receive community-based help for their disabilities, and there wasn’t enough of Medicaid funding available to pay for all the services.

Then budget cuts happened, putting more even more pressure on the overburdened system.

Representative Jon Knokey, a Republican from Bozeman, was among the lawmakers pressing the Department of Public Health and Human Services to explain its decision to cut services for the developmentally disabled.

Rep. Jon Knokey
Credit Corin Cates-Carney

“So what capacity, how many people, what is is it going to cost us, can you go through that plan?” Knokey said.

The health department announced it would take over all targeted case management for people with developmental disability a few days before Christmas. Since then, a clear plan for that transition has not been released, although the department says it’s working on it.

Frustration during Friday’s meeting occasionally bubbled up into political attacks, pitting the parties and branches of government against each other, with people trading charges of who had more fault in this situation that everyone agreed isn’t good.

Marie Matthews, DPHHS’s Medicaid and health services branch manager faced the brunt of the critical questions from lawmakers.

“There are budget reductions. That is why we are here,” Matthews said. “The revenue enhancers that went into the regular session and to the special session were not approved and we have a budget reduction, a $49 million dollar budget reception, sir, that is why we are here.”

At the end of their meeting Friday, lawmakers agreed to send a formal letter to DPHHS urging the branch to search for other options besides absorbing all targeted case management for people with developmental disabilities, and canceling private provider contracts.

Lawmakers want the department to consider keeping the contracts, and still saving $2.5 million, by paying contractors a lower amount. The committee studying the issue will meet again in March. The contracts are set to expire April 1.