From The Arc of PA
Budget Cuts Proposed for Community-Based Waivers
On February 9th, Governor Rendell unveiled his budget recommendations for Fiscal Year 10-11. If passed by the legislature, the budget would provide sufficient funding for early intervention to maintain current programs and serve newly identified children with developmental delays. Also, the budget would again flat fund special education while significant increases would go to fund basic education for students without disabilities.
That said, the most outrageous budget recommendation by Governor Rendell pertains to the adult mental retardation community-based waiver programs, where a $17.3 million budget cut and no waiting list initiative to speak of are proposed.
Unfair Target of Budget Pain: The $17.3 million service cut unfairly targets Pennsylvanians with mental retardation for "budgetary pain" -
pain not inflicted on any other Medicaid-funded service funded by the DPW budget. In fact, Public Welfare Secretary Harriet Dichter has reported that the Governor's recommended budget for next year includes $363 million in state fund increases for "safety net services and increases required by federal law." What happened to the "safety net" for people with mental retardation?
Loss of Two-To-One Federal Matching Funds: To restore this cut, only $6.1 million in state funds would be needed since the funds would be matched with $11.2 million in federal Medicaid funds. It makes no sense for Pennsylvania to walk away from $11.2 million in federal funds for community MR services it is already receiving.
Another Year of Targeting Community MR Providers: While other parts of the Medicaid budget have seen annual rate increases, including the Governor's recommendations for a 4% increase for Medicaid managed care organizations and $24 million for nursing home acuity payments in next year's budget, community-based mental retardation service providers have not received funding increases needed to offset inflation for the past two years. This year, the Governor's budget doesn't just flat fund providers, it actually proposes to take money from providers. Community-based service providers are 100% funded by the public sector. They cannot cost-shift to other funding streams like nursing homes, hospitals, or managed care companies, who can rely on non-public funding streams like private insurance or private pay.
Changing Needs of MR Waiver Participants Unfunded: DPW's waiver contract with the federal government (CMS) requires it to authorize and pay for services to meet all waiver enrollees' needs as they change throughout each fiscal year. Since CMS started enforcing this national waiver requirement in Pennsylvania 3 years ago, DPW has included additional funding in its budget to pay for changing needs. The apparent lack of such funding in this year's budget request seems to violate the Commonwealth's contract with the federal government and is likely to harm people with mental retardation when their needs change and funding is not available to meet their health and safety needs.
No Real Waiting List Initiative: Over 3,100 Pennsylvanians with mental retardation are on the state's emergency need waiting list, of whom 389 have caregivers over the age of 60, yet the Governor's budget recommends funding to serve only 50 individuals with emergency needs. In addition, there are over 700 young people leaving special education and transitioning to adult life, yet the Governor's budget proposes to serve only 100 of these individuals. Without adult services, these young people with mental retardation will lose the skills they've developed over a lifetime of special education only to land on long waiting lists for services.
Families and self advocates must let their elected state senators and state representatives know they are outraged by the Rendell/Dichter budget proposal. Administration officials must be held to account and explain why it targeted Pennsylvanians with mental retardation for budget cuts.
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