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Saturday, April 17, 2010

New Hampshire Editorializes on Budget Cuts and Disability Waiting List

From the Nashua Telegraph

Let’s not reinstate disability waiting list

There was cause for celebration only a few short months ago, when the state’s waiting list for people who qualify for services for the developmentally disabled was finally eliminated. But the joy was short-lived and replaced by trepidation.

Last month, reinstating the waiting list was one of the budget measures the House Finance Committee unanimously recommended to help balance the budget. The proposal called for $47 million in cuts, the first phase of $132 million in reductions that must be made to balance the state’s books. The proposal was later tabled pending further study.

Any cut the state makes will be painful, but restoring the disability waiting list would also be expensive and illegal. The Legislature should not look to the disabled for help balancing the budget. If it once again does, we strongly encourage advocates for the developmentally disabled to sue, since that’s often the only way to get the state to act.

For decades, hundreds of people in need of services or placement in a community setting, rather than in an institution, languished on the list for months or even years. At one point, there were more than 400 people in line. The state, in part to respond to lawsuits, whittled that list down considerably between 1999 and 2004. Then the list began growing again.

In 2006, lawmakers passed a bill that required that no one qualified to receive services wait longer than 90 days to receive them. The new budget-balancing proposal would have repealed that requirement.

Caring for someone with a developmental disability or an acquired brain injury can impose an unbearable burden on families that can’t get the assistance they are entitled to by law.

Parents are forced to give up jobs to care for adult children, and the disabled with jobs may lose them. While the disabled wait for help, their skills regress and the quality of their life erodes.

Keeping people on the waiting list would likely be found illegal under the Americans with Disabilities Act, Medicaid rules or even under provisions in the recently adopted health care reform act.

The U.S. Supreme Court ruled long ago that the developmentally disabled must be cared for in their communities in the least restrictive setting appropriate for their condition. When a waiting list that exceeds Medicaid’s standard 90-day period exists, that right is abridged.
By definition, a person who qualifies for services has the right, if those services aren’t being provided, to be placed in a group home or an intermediate care facility. The cost for each placement typically comes to between $150,000 and $200,000 per year.

The Supreme Court did say that the resources available to a state to care for the disabled can be a factor in determining whether a violation exists. But New Hampshire’s current budget crisis is not the yardstick that court or any other would use in deciding that question. What counts is the effort the state makes, given its means.

New Hampshire ranks 34th nationally when its per capita spending on aid to the disabled is measured against per capita income. That’s down from 10th in 1999. The state spent an average of $43,594 per person on such aid in 2008. That’s the lowest sum in New England and just a little over half what the state of Maine spends.

People on the waiting list want to live in their community, and it’s cheaper to help them do so. It’s also the law. The next time lawmakers take scissors to the state budget, they should keep them an arm’s length away from funding for the services to the disabled.

– Concord Monitor

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