If tomorrow morning my employer told me that I had to take a 20% pay cut, I would naturally think about where I could cut my expenses. I would also begin thinking about ways to replace that income . . . a second job, perhaps. Apparently, it does not work that way with our government. Even though the projected $5.2 billion deficit is clearly a mix of both revenue (the state of Minnesota is collecting less in personal income tax and sales taxes, which combined account for nearly 75% of the state revenue base) and expense problems, our legislative leaders continue to be convinced that the projected deficit can be resolved solely through budget cuts.
And, as is expected, disenfranchised individuals . . . older adults, people with disabilities, the working poor and those living in chronic poverty . . . are facing a much larger impact than others.
The Health and Human Services legislation passed the week of March 21 by the Minnesota House cut $1.6 billion from general fund base spending for the FY 2012-13 biennium. The bills also reduce provider reimbursementrate for personal care attendant (PCA) and other services by 2%.
The legislation includes provisions to cut PCA rates by 20% for relatives who provide PCA services, and places the burden on the PCA agencies to report the direct service providers (DSPs) they employ who are relatives (defined as parents of adults, grandparents, grandchildren, siblings over 16 and adult children) of a recipient.
We also saw $268 million in cuts to the Health Care Access Fund and $23 million in cuts to federal funding for Temporary Assistance for Needy Families (TANF).
The Senate Health and Human Services legislation would also have a significant impact on tens of thousands of Minnesotans, including working people who would lose access to affordable health care, people with disabilities who would no longer have services that help them live independently, and individuals and families that would see essential safety-net programs disappear.
This legislation includes $103 million in cuts to waiver programs that enable individuals with disabilities to access home-based Medicaid services, which prevents a more expensive out-of-home placement in institutional settings. The cuts include capping growth in waiver programs and reducing rates for residential facilities. It is estimated that more than 830 Minnesotans with disabilities will be forced into an institutional setting–either a nursing home or hospital –as a result of these cuts. (Gov. Mark Dayton’s budget also reduces funding for waivered programs, but to a lesser degree.)
This is in addition to the anticipated changes in Activity of Daily Living (ADL) requirements for people with disabilities who need and use PCA services. The changes, which take effect July 1, 2011, would eliminate eligibility for approximately 2200 individuals. Combined with the 803 individuals mentioned above, institutional services for approximately 3000 individuals would likely erase any projected cost savings. At best, the state would simply be cost shifting. It also eliminates coverage for some services for Minnesotans on Medical Assistance (MA) and MinnesotaCare, including chiropractic, podiatry, specialized therapies for adults, eyeglasses and prosthetics.
There are numerous other important issues in both the Senate and House bills affecting individuals with disabilities and other disenfranchised communities. We just concluded round one, so there is still time to affect a change in this dangerous direction. It is important that members of the legislature and the governor’s office hear from individuals with disabilities, their families and others. It is critical that we share our stories and the impacts these proposed changes will have on our lives and the ability of people with disabilities to live productive, participatory self-directed lives.
Nothing about us, without us!
David Hancox is Executive Director of Metropolitan Center for Independent Living (MCIL)