Programs to Aid Mentally Disabled Could Receive a Boost in Funding

The Virginia General Assembly is considering a sharp increase in funding for community living programs for people with mental disabilities, continuing the state's efforts to reverse long-standing gaps in care.

The increase is being led largely by Republican budget writers in the House of Delegates, who announced a plan yesterday to increase state spending by $38.1 million over two years for programs for people with mental disabilities. The money would allow 800 people with such conditions as Down syndrome to live in group homes close to their families, or receive in-home nursing or other local services, instead of being placed in state institutions that are predominantly in the southern and western parts of the state.

The House plan rivals more modest proposals by Gov. Timothy M. Kaine (D) and the state Senate; both have offered enough money in their budgets for 150 additional people to receive vouchers that pay for their care through Medicaid, the federal-state program for the poor and the disabled. Members of both chambers will review the plans and negotiate a compromise, which must be approved by Kaine.

"We felt we had to continue our investment to these families," said Del. Phillip A. Hamilton (R-Newport News), who helped develop the plan. "We've taken some time to address our waiting list, and we wanted to continue the progress we've made."

Until several years ago, Virginia moved slowly in providing community placements and services, which generally are about half the cost of institutional care. In 2002, a national study found that about one in four Virginians with mental or developmental disabilities lived in institutions, twice the national rate.

Over the past four years, however, the state has added more than 1,350 group-home slots to address what many lawmakers acknowledged was the state's poor track record.

But the state still has a waiting list of 4,056 people, about half of whom are considered in urgent situations, such as an elderly parent taking care of an adult child. Advocates said that in a tight budget year, the potential for hundreds of additional slots shows a change in how the state is addressing issues of people with mental disabilities.

"This does show how far we've come," said Nancy Mercer, executive director of the Arc of Northern Virginia, which advocates on behalf of people with mental disabilities.

The differences in the three proposals are significant. If the House plan were to pass, for instance, Fairfax County and the city of Falls Church could help 93 people obtain community placements and services. If Kaine's or the Senate plan were to pass, the county and city would receive five slots.

Source: Washington Post

TURN Community Services Assists Disabled Citizens

This workroom is used to provide on-site employment sponsored by Smead to TURN clients.

By: Cathy Wentz
Residents with disabilities in the Cedar City area have a wide variety of services available to them through TURN Community Services.
Susan Johnson, director of operations for TURN in Southern Utah, said the agency provides any service that allows an individual with disabilities to remain integrated in the community where they live. Those services include family support services for a young child living at home as well as transition services for students in the schools and employment.
There are services for adults who live with their families, residential services and day programs, in individual or group settings, to assist disabled citizens who are unable to work. One of those programs is a day care program for situations where disabled citizens require daytime supervision such as someone suffering from age-related Alzheimer's Disease as well as other problems.
"We really try to tailor it to what the state offers and what we can offer," Johnson said.
She said TURN owns a small building next to its main office in Cedar City with some residents living there. However, their residential areas are all over the city, with many of the people that TURN helps renting their own apartments, and the agency goes to them.
Johnson said it is easier for TURN to own the property for some of its group homes because they can be maintained better for those who require 24-hour service.
"And we can do rent control and keep them low-cost," Johnson said.
She also said they work very closely with local housing authorities to make sure the people they serve qualify for available housing subsidies, and that their homes fit into those categories.
Linda Reeves is Director of Program Services for TURN, and she runs the rural program that provides services to disabled people at their homes in areas such Panguitch, Kanab and Beaver. Reeves also runs the day program in Cedar City.
She said the day program brings in individuals that do not have work skills to come in and learn skills and have a safe place to participate in activities rather than just sitting at home.
"They can be with their friends and visit," Reeves said.
She also said TURN tries to place individuals in jobs in the community if possible to see how they do.
"If they are able to work in an outside job, then that's our goal," Reeves said.
There is also a workroom on the premises where TURN clients can be employed making file folders for Smead, a local company.
Johnson said TURN got its start in 1973 when a group of parents from the Salt Lake City area had children with disabilities and wanted them to receive services in their own communities rather than having to be placed in institutions. Those parents got the program started in the Salt Lake area.
Johnson said TURN has merged with other non-profit organizations in Southern Utah and has grown that way. She said one of the organizations with which TURN merged in Cedar City was Iron Parke Corporation. That happened in 2001.
She said TURN has also merged the Association for Retarded Citizens of Washington County, which is located in St. George. She said that ARC is doing advocacy work, but not providing services at this time. TURN took over the provision of services in the Washington County area.
Johnson said TURN had an acronym a long time ago when the organization first began. She said the group continues to use the word TURN because they like the idea that people can turn a corner, turn their lives around and turn dreams into reality.
Although Johnson said she does not know the specifics about the first federal aid TURN received, the group that started TURN wanted to get more community-based programs and the government provided some funding for that. She said she believes they found a program that would help them get started, incorporated as a non-profit organization, and have been expanding ever since.
Johnson said most of the funding for TURN is through Medicaid-sponsored programs. The organization has contracts with the Department of Services for People with Disabilities through the state's human services department. She said the state provides funding directly to individuals who choose TURN, which is contracted as a Medicaid service provider, to assist them with the services they require.
Johnson said TURN has a contract with Five-County Area Aging, and receives grants for some of its programs such as housing.
"We also have some really nice donors in the business world who have helped with some of our programs," Johnson said. "In a non-profit (organization) you pretty much run by the skin of your teeth, and then try to get people to help you with donations."
Johnson said as a non-profit company, TURN is always faced with the fact that it will be looking for funding. She said although the SPD is wonderful resource for funding, they provide only the minimal amount needed, and not everyone served fits into that category.
She said the organization does its best to stay consistent with the growing economy in the area and provide good wages and health benefits for the staff.
"That's always a challenge," Johnson said.
TURN Community Services is located at 295 S. 300 East in Cedar City, and can be reached by phone at 586-1128.

Source: Cedar City Review

Disabled day care centre to close

A day care centre for disabled adults in Gwynedd is to close despite a protest by supporters.

Canolfan Segontium in Caernarfon is attended by 24 adults, many with severe disabilities.

Protestors said the care at the centre was exceptional and there was concern about what would happen to the people who used it if it closed.

Councillor Dai Rees Jones said the closure was not to save money but to improve the care of individuals.

Will and Dilys Parry Williams travelled to the meeting at Caernarfon from their home at Tregarth near Bangor.

Their daughter Rhian Mai, 37, has attended the centre since she was 18.

I can say, hand on heart, that this decision has not been taken to save money Dai Rees Jones, councillor

Mr Parry Williams said he was very disappointed the council was not looking at building a new centre, but rather at finding places for those who attended at various other locations in the county.

"My daughter has had the same carer, Karen Owen, since she started at Segontium, and we consider her part of our family," he said.

"Our daughter has a severe disability and although I have great respect for the other establishments within the county I don't think they have the facilities to care for her.

"What those attending the centre need is continuity of specialist care."

Cheryl Williams from Bethesda has a sister, Sharon, 49, who attends the centre.

"I don't think the council has thought through the closure properly.

"I accept the building where they are is unsuitable but what we need is another centre."

Elizabeth Pitts, from Llanberis has two daughters who attend the centre - Linda, 34 and Janet , 33.

'Individual care'

"There is no-where else where they can go," she said.

Social Services portfolio holder councillor Dai Rees Jones said the decision was taken so that the level of care could be improved - on the basis of individual need.

He said the council had not contacted families beforehand because there had not been anything concrete to say.

There was, he said, some money available if alternative care could not be organised for those attending the centre, and another centre needed to be built.

"I can say, hand on heart, that this decision has not been taken to save money," he added.

 

Source: BBC News

Hundreds of Disabled and Seniors at Capitol to Protest California Budget Cuts to Life Sustaining Services and Income

By Jovan Agee

After the nonpartisan Legislative Analyst's Office today released its report on Governor Arnold Schwarzenegger's proposed 2008-09 state budget, hundreds of Californians—all people who use or advocate for the state's In-Home Supportive Services (IHSS) program—criticized the unnecessary and drastic proposal for 18 percent cuts in vital domestic services. Those cuts would mean that low-income people with disabilities and seniors lose precious hours of help with meal preparation, clean-up, housekeeping, laundry, and food shopping, all of which make it possible for them to avoid or delay costly and unnecessary institutional care.

"Which day of the week should I go without my meals, Mr. Governor? That's what you and other lawmakers are asking me to decide if you go forward with these cuts," said Herb Meyer, 76, a disabled consumer of IHSS services in Marin County.

Individuals eligible for IHSS services have disabilities, are 65 or older, or blind, and are unable to live safely at home without help. The IHSS program uses state, county and federal funding to enable IHSS consumers to hire a caregiver. Most of the people who use IHSS also rely on federal funds called Supplemental Security Income (SSI), and state funds called State Supplementary Payments (SSP). They are among the 1.2 million blind, aged and disabled Californians who, who rely on this income for all of their living expenses; they cannot afford to pay for the home care services the state is proposing to cut.

People who rely on IHSS for home care and SSI/SSP are the targets of multiple cuts in the proposed state budget: the IHSS cut, no Cost of Living Adjustment for SSI; elimination of crucial Medi-Cal services; and cuts to other services and programs they rely on, including Adult Day Health Centers, and Adult Protective Services, among others.

Budget system must change to protect the poor

The coalition of home care supporters who rallied today at the state Capitol spoke out against the domino effect of multiple cuts and the unfair targeting of the poorest Californians.
"We need a fair balancing of this avoidable deficit crisis with a combination approach that includes raising revenue," said Frances Gracechild, Co-Chair of the Quality Homecare Coalition and Executive Director of Resources for Independent Living. "These across-the-board cuts are callous. When it comes to valuable programs like IHSS, state officials should stop blaming it on overspending. Increases in IHSS are largely pushed by demographic changes – California is growing and more people are living longer."

"For all those lawmakers who preach about performance-based budgeting, take a look at the IHSS program," said Joan Lee, Gray Panthers Statewide Liaison. "It saves the state money. It is not only a program that fits with what Californians expect for the most vulnerable residents of our state, but is responsibly managed and a good deal."

"Some of the tax relief that was prematurely given during the early Schwarzenegger administration should be returned by Californians who can afford yachts and expensive, luxury cars," said Bill Powers, Vice President of the California Alliance of Retired Americans.

Gov. Arnold Schwarzenegger cut taxes when he first came into office by what is now nearly $5 billion annually, and has never made up the revenue lost. Reinstating the "car tax" at the center of the Governor's first election in 2003 would have produced more than $20 billion for the state coffers by 2008.

Previous attempts to cut IHSS failed

Since elected in 2003, Schwarzenegger has made other proposals to cut funding to the state's IHSS program, all of which lawmakers have rejected. IHSS routinely earns bipartisan support because of the savings it produces—keeping people safely in their homes and avoiding costly institutional care. The Legislative Analyst has estimated in past years that the annual average IHSS cost per person is $9,924, whereas the annual average cost of nursing home care is about $60,000.

"The IHSS program has always received bipartisan support, and is widely praised as a model state program for helping the elderly and disabled live independently," said Tyrone Freeman, President of SEIU United Long-term care Workers Union and Chair of the California Homecare Council. "So why attack the funding for this program now? Lawmakers should lead state residents to understand why raising revenue would uphold our nation's and California's values? It makes no sense."

Violation of landmark U.S. Supreme Court decision
The cuts to IHSS and Medi-Cal and SSI/SSP also undermine California's compliance with the 1999 U.S. Supreme Court decision in Olmstead, in which the Court told the states that unnecessary institutionalization of people with disabilities violates the Americans with Disabilities Act.

"How can the governor say he upholds the state's responsibilities to comply with Olmstead and at the same time cut the services which are at the very heart of any compliance?" said Deborah Doctor, Legislative Advocate at Protection and Advocacy, Inc. (PAI).

The cuts also harm workers who provide home care.
"We object to the Administration's prediction that IHSS providers will continue to provide these for free," said Senior Assembly Member Lola Young. "Home care is work and deserves to be compensated. We'll see a higher rate of worker turnover, a loss of services, and a reduction in their quality of life. Workers in the IHSS program already live in poverty and many are eligible for food stamps. Few have access now to health insurance."

"The Governor believes that family providers will continue to do the work for free," said Laura Reyes, President of United Domestic Workers/AFSCME. "I have two problems with that assumption: First, almost half of all providers in this state are not family providers, but they too will be uncompensated for their work. Second, family providers help the state achieve savings through the IHSS program just like non-family providers so why is the Governor trying to target this group of workers. If there were no family and non-family providers the IHSS program would fail to exist and we would see budget deficits like the one this year every year because you would have over 400,000 elderly and disabled people receiving care at a much high cost."

"The cut in IHSS hours means consumers will have a more limited supply of home care providers, making it difficult to remain safely in their homes and possibly forcing them into institutions such as nursing homes," said Gary Passmore, Executive Director of the Congress of California Seniors.

The 2005 report, 'Living Wages and Retention of Homecare Workers in San Francisco' by Candace Howes, shows that wages and especially benefits have a significant impact on the retention of providers. In San Francisco, when wages increased to $9 per hour and comprehensive health insurance was added in 1999, the one-year retention rate for new providers increased from 33 percent to 61 percent between 1998 and 2003.

Because of the Governor's cuts, some IHSS providers will lose their crucial health benefits; the cut in just a few hours of work could put them below the eligibility limits set by the Public Authorities to qualify for health benefits (San Francisco requires 25 hours of service per month and Marin requires 85 hours of service per month).

Background on IHSS

County social workers assess people for IHSS and can authorize up to 283 hours per month of services. Services include housecleaning, meal preparation, laundry, grocery shopping, personal care services (such as bowel and bladder care, bathing, grooming, paramedical services, accompaniment to medical appointments, and protective supervision for individuals whose mental status or cognitive functioning poses a threat to their safety and well-being). IHSS is the largest publicly funded nonmedical program in the nation designed to help impoverished people with disabilities, the elderly, and blind live safely at home.

The proposed cut is a double-hit on consumers in shared living arrangements who have already had their hours reduced. When IHSS consumers live with a roommate or attendant, the assessment of need for domestic and related services related to their safety is pro-rated and reduces the number of hours approved under the program.

Many consumers receive the maximum number of hours authorized for domestic and related services through the IHSS program:

Meal Preparation 8.68 hours/week
Meal Cleanup 1.75 hours/week
Laundry 2.50 hours /week
Shopping For Food 1.00 hours/week
Other Shopping Errands 0.50 hours/week
Total Hours per Week 14.43 hours/week
Total Hours per Week Cut at 18% Equals -- 2.60 hours/week

"The growth occurring in the IHSS program while partially due to changing demographics, is a positive indication that more people are receiving services in the community instead of being placed in nursing homes," said Ed Andreas, Chair, Nevada Sierra Regional IHSS Governing Board.

Proposed cuts contradict state's expensive IHSS Quality Assurance initiative; endanger safety
The Administration's IHSS Quality Assurance Initiative required the State Department of Social Services to develop Hourly Task Guidelines (HTGs), a standard guide and tool for county social workers to accurately and consistently assess service authorizations on a statewide basis and authorize services and time more equitably throughout the state. The HTGs established a normal range of time for certain tasks and a guide for granting time inside and outside the guidelines as appropriate to meet the unique needs of IHSS recipients.

The proposed cuts contradict those Quality Assurance Hourly Task Guidelines

"This proposed 18 percent cut to domestic and related services completely undermines the entire concept of conducting individual assessments to provide sufficient hours to—as the law requires—'ensure the health, safety, and independence of the recipient,'" said John Wilkins, an IHSS consumer in Fresno County and Co-Chair of the Quality Homecare Coalition.

Jovan Agee is the political and legislative director for the United Domestic Workers of America in Sacramento.

Source: California Progress Report

Disabled passengers face long wait

Disabled rail passengers in Kingston could be facing a seven-year wait to use two of the busiest stations in the borough, despite the Government granting money to improve access at the sites earlier this month.

New Malden and Worcester Park stations have been granted a slice of £370million from the Department for Transport, rumoured to be over £1million, to make the platforms step-free, but upgrades are not scheduled for completion until 2012 at the earliest.

An 18-month feasibility study will take place at the stations to determine what changes are required to allow less mobile rail passengers such as wheelchair users, older people and parents with pushchairs better access to the platforms.

 

Ann Macfarlane, vice-president of the disability charity Kingston Centre for Independent Living, said she was currently unable to use either station because of her wheelchair and said speed was of the essence.

She said: "It's important that the sooner before 2015 this can be put into place the better, as it means we might be able to go to work, meet our friends and do all the things that people expect to be able to do.

"The design will need looking at because a lot of stations are being made step-free so you can get on to the platform but not necessarily on to the train, so you can go and wave someone off but can't actually travel.

"It's a real inconvenience at the moment because you have to think very carefully in advance about planning your route."

The money was successfully bid for by station owner South West Trains and will also be used to provide facilities such as hearing induction loops, passenger information screens and improved lighting.

A spokesman said: "It's not ideal - it's a long time but we realise that it can't happen overnight and it's something that is worth doing properly.

"Lots of stations were built years ago, when the needs of disabled people weren't thought about so much in society, but it's time to bring these stations into the 21st century."

Source: Wimbledon Guardian