Lawmakers Credit DD Advocates for Funding Wins
By: Chris Dornin, Special to The New Hampshire Challenge

Hundreds of parents, professionals, clients and advocates for people with developmental disabilities packed House and Senate budget hearings this spring, by far the biggest showing from any interest group. Key lawmakers said the massive and eloquent turnout gave them the political cover and ammunition to increase spending for developmental disabilities by 11 percent amid the worst state budget crisis since the Great Depression.

The $11.6 billion budget also gets rid of the dd wait list backlog, at least for the first year of the two-year budget. A small backlog may reappear in year two, depending on how much the area agencies and some frugal families can stretch their scarce resources. That’s according to Matthew Ertas, who heads the Bureau of Developmental Services.
Students aging out of special education would still wait up to 90 days allowed by law for program funding, and providers would need additional time to hire staff, design a service plan and carry it out. The process is similar for older consumers in family crises that demand long-term supports from an area agency. But people won’t wait years for services, as some have in the past.

A late July ruling in Belknap County Superior Court, if it holds up, creates a $110 million revenue gap, but dd advocates are cautiously hoping it will have little or no effect on their constituency. For the substance of the court battle, see related story in this issue.
Attorney Richard Cohen directs the Disabilities Rights Center that has sponsored a number of class action suits against the state over the years. He is not worried now.

“In a nutshell, the $110 million hole has no relation to the waitlist,” he explained. “The legislature and governor will live up to the commitment to end the wait list they made in SB 138.”

Two years ago that law went into effect, ending the wait list backlog over the following three years.  The new budget, as first approved, pays for that third year and most of the fourth.

Dennis Powers heads the Community Support Network, an umbrella organization for the 10 area agencies that serve people with developmental disabilities. He called the budget a coup for that constituency.

“I share everyone’s surprise and pleasure at what happened,” Powers said before the court ruling. Now he’s taking a wait-and-see approach on the high court appeal. If the Supreme Court affirms the lower court, then lawmakers might have to cover the revenue gap.  We’ve gotten no indication they’re holding back any of our funding,” Powers said. “We’re not doing anything actively yet, just watching to see what happens.”

Rep. Cindy Rosenwald, D-Nashua, chairs House Health and Human Services and said she feels really good about the huge win for folks with developmental disabilities, if it endures.

“Twenty years ago we closed Laconia State School, and I know there are families who have cared for their children at home ever since,” she said. “When they’re gone, they’re so anxious to have a safety net for their children.”

Ertas asked for $47 million last December to end the wait list backlog and got $36 million, half in state money and half in federal matching funds. That’s a 50 percent increase from the $24 million line item in the two-year budget just completed. The larger budget for area agencies and the Medicaid home and community based care waiver that funds them is going up from $319 million to $366 million.
“We’ve got nothing to complain about in this economy,” Ertas said before the court ruling.

Senator Maggie Hassan, D-Exeter, has a son with cerebral palsy and helped make the case for the disabled in Senate Finance.

“Those families were enormously important,” she said. “They shared some very difficult and personal stories with us. I’m so grateful to them for that. They did a phenomenal job at all the public hearings.”
She said the real challenge was to find the money to do it.

“We had to ask if a budget item was for public safety or if it would bring in federal matching funds,” Hassan said. “The wait list was a top priority in terms of those criteria. We literally found half a million here, two million there and five million there.”
The political struggle was also personal for Hassan. Her son with cerebral palsy became 21 in June, and he was on the wait list.

“I got a call from his provider that there may already be some funding for him,” Hassan said. “I’d like to know how many other families are getting calls like that now.”
Sandra Pelletier heads the Gateways Community Services area agency in Nashua and said the new money would help eliminate her backlog of 36 people and another 29 people in the coming year. She hopes an innovative service model can save some money and help the second-year budget meet everyone’s needs.
 
“We’re giving families more autonomy and control over a set amount of money for a client,” Pelletier explained. “We find they can stretch the dollars farther. Some share employees to save money. Some recruit their friends and neighbors to provide services for a few hours when really needed. That taps into manpower the agency could not reach by itself. They’re making really good spending choices.”
The budget will not support a hoped-for 2 percent rate increase for dd services along with direct care raises. Nor will it pay for recommended system-wide improvements in training and quality assurance. And nobody knows what the legislature meant in asking the governor and state agencies to come with an additional $20 million in cuts over the next two years. If every agency state shares that pain evenly, some 200 employees in Health and Human Services would lose their jobs, according to a June report by the Center for Public Policy, a bipartisan think tank in Concord.

Rep. Suzanne Butcher, D-Keene, has a grown son with autism and chairs the wait list oversight committee. She was proud lawmakers kept their pledge to end the infamous backlog. She was also pleased about a new law she sponsored to create a dd quality assurance commission with all the stakeholders. It will monitor services from many perspectives.
Brian Collins, who directs the Community Partners area agency in Dover, said his wait list has 55 people, and he expects another 12 to need services in the coming year.

“I’m blown away by what the legislature did,” he said. “These times are unprecedented since the 1930s. People kept asking me all spring what would happen. I never expected they’d serve the entire wait list.”

Rep. Trinka Russell, D-Stratham, has two high school sons with cerebral palsy who will need area agency programs in a couple of years.
“I can tell you I’m pretty happy now,” she said. That was right before the Superior Court decision came down.