The Medicaid Cry(sis)

Like states around the country, Texas is suffering from a huge budget crisis. To fix this mess, legislators are looking to reduce the two largest line items on the government budget, Education and Health & Human Services.

HHS, which is funded by both state and federal coffers, has several components. The one which most directly affects people with disabilities is Medicaid. As many people with intellectual and developmental disabilities are unable to hold a traditional job, with traditional health benefits, Medicaid is critical for meeting their health care costs. In addition, this true “life support” also provides necessary attendants, job and life skills training, as well as the mechanism to live independently in the neighborhood of their choice.

This support is not cheap. Within Medicaid, 15% of the participants are people with disabilities, yet they make up 40% of the total spending. As non-government entities, such as business and the faith-based organizations, have chosen to abdicate care for people with disabilities to the government, this lifeline is understandably critical. in lieu of no alternative, it must be maintained.

People and families with disabilities have unique experiences to which most common families have little exposure. True dependence on another person for the basic needs of life creates fear in the individual, but an astounding level of stress for the caregiver. For each person with a severe disability, there are at least 4 other “traditional” people whose lives are directly affected.

Issues facing families with disabilities go far beyond the common concerns of picking kids up from school, worrying about which soccer squad they make, or even concerns about losing a job or making the monthly mortgage. Even in the most extreme cases of job and home loss, people with traditional skills can often scale down their consumption to fit their new circumstances, as the skills they have can usually transfer to a new profession. For people with severe intellectual disabilities, there is no room to “scale down”, as the only option to independence is seclusion in an antiquated state institution.

When trimming budgets, elected leaders often use a blunt sword instead of a precision scalpel. Wholesale reductions in Medicaid result in service providers going out of business, job training programs disappearing, and people forced to leave their homes and move to state institutions. In an ironic twist, the cost of institutionalization is actually three times higher per person than the cost of community support due to the excessive overhead the state creates.

Everyone needs a voice, and at some point in their lives, everyone needs help from a friend. To people with intellectual and developmental disabilities, The Arc of Dallas is that helping friend who provides a strong voice for people in North Texas.

--Clay Boatright

President, The Arc of Texas

‘Texas Tsunami’ will blow away services

Without a doubt 2011 will be uniquely challenging for people with intellectual and developmental disabilities in Texas. To overcome those challenges we need to prepare, engage, and more importantly, support one another. Here’s why.

A tsunami will hit Texas on September 1, 2011. Early reports indicate that anywhere from 13,000 to over 50,000 people will have their lives destroyed immediately. In addition, up to another 100,000 people will lose their jobs, quit, or significantly reduce their work hours as a result of this devastation. Thousands of marriages will crumble as the financial, physical and psychological stress becomes unbearable. Child abuse will skyrocket and some of the tsunami victims may become institutionalized.

Leadership to deal with this disaster will be nonexistent. Elected officials will blame the state budget and federal government, while offering no solution. Though a few pastors may say a prayer for those harmed, most will act as though nothing has happened even as members of their flocks search desperately for help. The general public will be relieved that the storm did not hit them.

The tragedy described above is very real. Services for people with disabilities are on the chopping block as state agencies submit their budgets for the next legislative session. Currently there are over 100,000 Texans on decade‐long waiting lists for services. Meanwhile, the state is developing plans to remove those services from many who had waited so long. Waiting years for someone to help their neighbor is wrong. Eliminating that help when a life depends on it is an abomination.

In rural Texas, a Native American was told for 35 years that there was no one, no service, and no money to help her. Only after her aging mother collapsed in their home did she receive emergency assistance. Today she enjoys the blessing of an independent life, a life which will be jeopardized when she loses her support. Expecting a now 75 year old mother to resume care for her adult daughter is beyond comprehension.

In Houston, a 7th generation Texan receives help from the state for her most basic needs, thus enabling her mother to hold a job and care for her own elderly parents. With no one else to help them, the loss of support will require the mother to quit her job in order to care for her daughter. In one fell swoop, this will reduce the quality of life for three generations.

A restaurant in Austin has a loyal employee with intellectual disabilities who lives in his own apartment nearby. Removing state support will cause him to lose his home and independence, and may force him to move to an institution away from his family and friends where his talents will go unheralded.

Near Dallas, a family of five receives help after school for their twins with severe autism. Each twin requires one‐on‐one attention at all times, as their disability can cause behaviors which are physically painful to others. Losing that assistance may force their father and sole provider to take a lower paying job in order to help his family during the day. This will greatly reduce their ability to pay taxes, support the economy, and contribute to their church. That family is mine.

The Texas legislature is now meeting and making decisions that will affect the lives of thousands of people who have no other place to turn. To our elected leaders the request is simple…please, do no harm.
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Clay Boatright is President of The Arc of Texas and past president of The Arc of Dallas. He and his family live in Plano.