Missouri’s budget should strengthen community provider system, not weaken it

  

By Greg Kramer, MARF President

The 2018 Missouri state budget, signed by Governor Greitens, officially went into effect on July 1, 2017. This budget includes a total of $250 million in additional funding cuts, from the suggested budget sent by the legislature, which presents serious repercussions for Missourians with disabilities and their community providers.The Missouri Association of Rehabilitation Facilities (MARF) represents 80+ community provider organizations that serve Missouri’s most vulnerable citizens. These organizations provide safe, quality care for more than 8,400 individuals with disabilities.

The Missouri Association of Rehabilitation Facilities (MARF) represents 80+ community provider organizations that serve Missouri’s most vulnerable citizens. These organizations provide safe, quality care for more than 8,400 individuals with disabilities.

Missouri’s parents and families who have loved ones with disabilities rely on state-wide community provider organizations for supports. They depend on us to provide a safe home for their adult/child; to provide quality care when they can no longer do so; to assist their loved one in living as independently as possible…in their own homes, in their own communities, and most importantly, out of institutional settings. Now is the time to strengthen the system, not weaken it.

One of the most overused and misused descriptors of citizen groupings is “Missouri’s Most Vulnerable Citizens.”  However, this description does clearly define Missouri citizens with an Intellectual and/or Developmental Disability (I-DD).  This is a critical designation because it focuses on the need for prioritization when funding decisions are made.  Funding reductions suggest that no priorities have been identified. That simply isn’t true when it pertains to I-DD.

Community providers are the singular safety net system for Missouri. This is not an open-ended benefit package, but truly a framework of life supports for people, from birth to death, with significant functional, behavioral and medical developmental disabilities.

The fact is, the community-based provider system is uniquely designed to achieve the outcomes for which the expenditure of Missouri tax dollars was intended.  This system is efficient and effective, produces measurable outcomes, represents best practices, and ascribes to an actuarially sound rate structure (the Rate Rebasing initiative).  Programs such as this should be rewarded for their efforts, not penalized by funding reductions.

Missouri’s 2018 budget puts community-based living programs at serious risk. Deficits in funding can force these providers to close their doors. Consequently, access to group homes, semi-independent apartment programs, individualized supported living and community integration will decline.

It’s important to note that even a 3% cut to safety net providers for Missourians with developmental disabilities is significant. Reimbursement rates for community provider agencies have been significantly underfunded for decades, so reducing existing rates will impact wages and benefits for direct care staff and will result in higher turnover. Additionally, challenges with retaining and recruiting direct care professionals will clearly impact provider organization’s ability to deliver quality care. Without proper funding to maintain quality care, we are failing Missourians with developmental disabilities who regularly endure the greatest barriers to everyday life.

Funding for developmental disability services is not political and should be the last resort when it comes to funding reductions. The reality is the state cannot provide the services at a more affordable cost than contracted providers.  Ignoring quality provider funding for organizations that serve Missourians with developmental disabilities will result in further budget complications when forced to deal with crisis care, emergency room visits, and potential improper incarceration.

MARF is comprised of devoted organizations across the state who work tirelessly to positively impact the quality of life for those in need. We understand how community providers are critical to support the needs of individuals with disabilities and their families. Please join us to help the most vulnerable people in your community by contacting Governor Greitens’ office to express your concern with the budget restrictions for people with developmental disabilities.