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Friday, July 22, 2011

Good and Bad State Budget News for People with Disabilities


The recently passed Texas budget dealt people with disabilities good news, bad news and a couple of wild cards, and because the cuts didn't land evenly across the board, advocates are unsure how things will play out.

Overall, funding for human services took a 17.6 percent cut. The five state agencies whose responsibilities include providing services to people with physical, mental and other disabilities will receive about $53 billion in 2012 and 2013, down from $64.7 billion in the previous two-year state budget.

But some programs, such as community mental health services, emerged intact. Others, such as early childhood intervention, took big hits. And then there are the wild cards, like how funding shifts will play out for people with intellectual and developmental disabilities.

"I would never say this was a successful legislative session," said Dennis Borel , executive director of the Coalition for Texans with Disabilities . "But what was once horrible is now merely awful."

Exactly how the cuts will play out across the state is still unclear. Agencies, nonprofits and other providers are searching for other sources of money to cover the cuts.

They're also wading through Legislature-mandated changes that alter the way providers bill for their services and switch clients into different programs covered by Medicaid.

"This was the hardest budget to analyze because it's not black and white," said Amy Mizcles, director of governmental affairs with the Arc of Texas, an advocate for people with intellectual and developmental disabilities. "There's a lot to be seen. Starting Sept. 1, the start of the new budget year, things are going to start getting rough because we're going to start seeing the real impact of these cuts."

Money for people with intellectual and developmental disabilities — such as cerebral palsy or autism — took a hard hit. Legislators eliminated $65 million — or one-third — of the safety net budget used for services for people who live with their families at home, in group homes or in their own apartments.

That money goes toward services that are not otherwise covered for them by Medicaid, such as as speech therapy and day habilitation programs, which provide life skills training, job skills and other support.

Bluebonnet Trails Community Services, a publicly funded center in Williamson County that provides services for people with disabilities in eight counties, lost $1.1 million for 2012, a 30 percent cut from the $3.7 million in the current state budget that the center received for such services.

That puts at risk services for 450 people, about 26 percent of the total served by Bluebonnet with those funds in 2010, said Bluebonnet Executive Director Andrea Richardson .

The center will try to soften the blow by rationing services, but, ultimately, people will probably be cut from the rolls, she said.

"Right now, the families are in shock as we consider with them options for their family member receiving services," Richardson said.

Legislators tried to counter those safety net cuts by adding about $32 million to a similar program — the Texas Home Living Program — that is funded by Medicaid. But some of those cut from the rolls might not qualify for the program.

Austin Travis County Integral Care lost about $2 million, or 25 percent, of its budget for services for people with intellectual disabilities over the next two years. But between the Texas Home Living Program and other funding streams, probably no one will have to be cut from services, said Executive Director David Evans.

Money for Texas ' 13 state supported living centers, which are residences for people with intellectual disabilities, stayed stable. Legislators had considered closing one of the centers to save money but decided against it.

Statewide, Early Childhood Intervention took a big cut. The program — which helps children up to age 3 who have delays, disabilities or other developmental problems — lost more than $50 million (14 percent ) for the 2012-13 biennium. About 4,000 fewer children will be served each month, going from about 32,000 to 27,700, according to the Department of Assistive and Rehabilitative Services, which oversees the program.

The agency will reach that goal by tightening eligibility requirements for children. Families will also be asked to pay more, said the department's deputy commissioner, Glenn Neal . The maximum monthly fee, which is based on income, will go from $150 to $175.

Local Early Childhood Intervention providers felt the cuts acutely. Easter Seals Central Texas took a 15 percent cut, or $600,000, from its annual program budget, which means it will serve 90 fewer children per month.

Any Baby Can, an Austin nonprofit that administers an Early Childhood Intervention program and helps about 250 families at a time, lost $500,000 from its $2.1 million annual budget, Executive Director Ellen Balthazar said. That cut will force the nonprofit to serve 30 fewer families each month, she said.

No one knows how the new eligibility rules will play out.

Patty Fougerat started working with Any Baby Can after her 13-month-old daughter, Townes, was born two months early. Since then, the toddler has received monthly visits from physical therapists, nutritionists and other professionals that have helped her thrive, said Fougerat, a first-time mother who works for Wells Fargo.

An Early Childhood Intervention worker was the first to notice that Townes had a flat spot on her skull that needed to be corrected.

"They pointed it out before my pediatrician pointed it out," Fougerat said. "It's little things like that that have helped so much."

Mental health services fared far better than expected. Early proposals suggested cutting 20 percent in funding to outpatient services for children and adults. For Integral Care, which provided psychiatric services to about 16,800 people in 2010, that could have meant losing funding for about 2,500 people each year .

Ultimately, the funding remained intact. 


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