Budget Cuts Have Large Human Impact

Pamela Piering, Director of Aging & Disability Services, Seattle-King County Area Agency on Aging

Effective July 1, 2009, elders and adults with disabilities in King County receiving Medicaid-funded long term care services will experience reductions made by the State Legislature in order to balance the biennial budget 2009-2011. Unfortunately, in many cases, these individuals will be affected by multiple reductions. 

The following reductions will impact Medicaid-funded clients in King County:

• Adult day health centers are experiencing extreme budget cuts—one of many areas where seniors and people with disabilities will feel the impact of service reduction. ________________

  Homecare Service Reductions. About 8,000 people who receive personal care in-home assistance will have their hours reduced. Medicaid clients with physical and/or developmental disabilities currently receive assistance with essential tasks such as bathing, dressing, meal preparation, feeding, medication reminders, toileting and mobility. Beginning July 1, each of these clients will experience a reduction in the amount of time homecare aides spend with them. On average, clients will see a decrease in their personal care hours of between three to nine hours per month.
  
  
• New Rules for Relatives Providing Care. Over 1,500 individuals or "clients" who currently have a relative supervised and paid by a Home Care Agency to provide personal care will no longer be able to use that relative for agency-provided care. If the client wants to continue with the relative for care, the relative must leave the agency and become an independently contracted provider. The client will then be responsible for supervising and managing their own care. If the client chooses to continue to use the Agency, a non-relative must provide the Agency care.
  
  
• Adult Family Home and Long Term Care Rate Cuts. Approximately 2,600 individuals in King County receive Medicaid-funded long term care services in adult family homes (AFH), boarding homes or other residential facilities. The state is reducing the rate it reimburses these facilities for each Medicaid funded client. Adult Family Home rates will be cut by 4%, significantly impacting the ability of AFH providers to operate these homes. Other residential facilities—supported living, group homes and licensed staffed residential programs for persons with developmental disabilities—will receive a three percent rate reduction.
  
  
• Adult Day Health Reductions and Rule Changes. Adult Day Health (ADH) Centers in King County are experiencing extreme budget cuts. New eligibility language eliminated service to almost 30% of ADH participants in King County. According to new criteria, all ADH clients living in state-funded residential facilities, including adult family homes, licensed boarding homes, DDD group homes and companion homes, are no longer eligible to attend an ADH program. This affects over 400 clients in King County. A quarter of the ADH program sites have already closed or will be closed in the next few months. Clients who live in their own homes will remain eligible, but Medicaid will no longer pay for transportation to and from the Center. Providers will receive a $15 increase in the program rate to help transport participants. However, the increase represents a fraction of the cost of providing this service. Families and friends will undoubtedly need to be involved in providing transportation. 
  
  
• Essential Needs. Other reductions include cuts to low-income dental care, mental health services, and necessary items and supplies such as "durable medical equipment" and "liquid nutrition." 

This has been a difficult year for state funding for all public services across the board.  Advocates are working with policymakers to explain the impact of these cuts, to seek mitigation where possible, and to begin to rebuild essential home and community services as the economy improves.