Economy Drives Cuts to Critical Programs

The national and state economy is having an unprecedented negative impact on Indiana's revenue. The Family and Social Services Administration (FSSA) has announced changes in three critical areas that affect people with disabilities.

• Vocational Rehabilitation Reductions. Specific programs for Supported Employment and Work Experience are reduced by up to 10% effective May 1, 2010. This will result in reductions of at least $2 - $3.5 million per year. The announcement indicated these reductions will be reviewed in light of what is hoped to be an improving economic situation.
  
  
• Medicaid Waiver Reductions – funding reductions for residential habilitation, respite and community habilitation. The rates for these services will be reduced by 7%, effective June 1, 2010. This is intended to be a time-limited reduction scheduled to expire by June 30, 2011. This change will reduce spending by $30 million per year, but it is hoped that by the end of the next fiscal year these reductions will be restored. It is important to note that this is not an across the board rate cut. Certain services – such as day services, therapies and behavioral management were not cut.
  
  
• Case Management, Quality Control and Assessment Reductions. In addition to these changes, contracts to IPMG, Liberty, Arbitre and other contractors are being reduced by up to a cumulative $40 million per year.

These are very difficult cuts for agencies that provide services to absorb. Many have expressed concern to us about how people with developmental disabilities will be impacted, with some fearing the reductions put people with developmental disabilities at risk of losing providers and the direct support staff that cares for them. These cuts come on the heels of reductions in many areas – including Medicaid reimbursement to hospitals, doctors, dentists, group homes, respite programs; as well as reimbursement to foster parents caring for children with special needs.

Some providers of employment and residential services are already operating on the edge, and direct support staff that care for people with disabilities are already making a livingat or only slightly above the minimum wage. There is a real risk that some providers will go out of business, forcing families to scramble for new providers.

The Arc of Indiana continues to work with providers, consumers and FSSA - recognizing the difficult times, monitoring the situation and working on additional answers.

We are seeking to simplify and change administrative and bureaucratic rules that increase costs but provide little value to individual lives. FSSA has assured us they are looking at these issues and will make every effort to reduce administrative burdens that drive up costs and do not add value.  

We also want to find additional savings that will make the restoration of these cuts happen sooner rather than later. This includes:

• Helping people who receive 24 hour residential supports and live alone find housemates that will allow them to share staffing costs.
  
• Improving lives while reducing costs to people with high needs by creatively evaluating and changing the services they receive.
  
• Making better use of technology like Rest Assured for people who are ready for more independence.

There is absolutely no doubt that funds that were available at the start of this fiscal year simple are not available now, in either revenue or reserves.Given the economic situation, The Arc of Indiana is committed to finding new answers. It will be difficult, but the times force us all to respond in new ways.

These announcements underscore the need to move forward with The Arc of Indiana's Building Pathways to Empowerment campaign. Through this effort we are taking a fresh look at Indiana's system of programs and services for people with developmental disabilities and their families, and asking people to come together to redesign and redefine that system to one that provides what people want and need in the most sensible way possible. We also need to look at how Indiana's revenue is structured to provide necessary services and support to people with developmental disabilities.

We need to hear from you!

• We are actively looking for innovative ideas on how programs and services can be changed and improved in ways that not only save funds, but that also will change the system and improve lives.
  
• We need to hear from you about how these cuts impact you. Let us know if your provider tells you they will no longer be providing services, your direct support staff changes, you cannot find a new provider of services, etc.
  
• If you are a provider of services or a direct support staff person, we also need to hear from you. We want to monitor this closely and share information back with FSSA.
  
• Lastly, we also need to hear about the good and innovative things that are happening now, despite these difficult economic times. It is said that necessity is the mother of invention. Let us know what are you doing that is helping people thrive during this difficult time.

The Arc of Indiana's web site will soon be updated to allow you to share your information and stories quickly and easily. For now, please email us at: thearc@arcind.org, and learn more about the Building Pathways to Empowerment campaign.

FSSA's announcement clearly demonstrates the difficult challenges we will continue to face until the economy starts growing in Indiana. The Arc of Indiana is committed to moving forward to change and improve Indiana's system of services, not only for those 17,500 people currently receiving services, but also for the over 20,000 people who continue to wait for services.

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