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Florida Budget Cuts Endangering Lives Of Disabled

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By LINDSAY PETERSON | The Tampa Tribune

Published: October 31, 2008

TAMPA - State budget cuts are endangering the lives of people with mental and physical disabilities, say officials at agencies that help care for them. They warn of more cuts next year. After two years of shrinking government support, programs for the disabled are closing and cutting staff and services. If the trend continues, the service providers say, the consequences could be devastating.

"You're going to start to see more problems with people getting lost in the community, having accidents, running away and hopefully not dying, but we'll see some of that as well," said Richard Lilliston, of Hillsborough Achievement and Resource Centers. "They are jeopardizing the lives of people with disabilities, plain and simple. And it's all over money."

The state helps pay for the care of about 31,000 people with Down syndrome, schizophrenia, severe cerebral palsy and other serious mental and physical disabilities. In 2001, it began focusing on helping people care for their disabled family members in their homes, rather than in nursing homes or other institutions. But over the past two years, as the costs approached $900 million for the Medicaid program, the state Legislature cut services and provider rates and reduced payments to about 7,500 disabled people.

Now, Gov. Charlie Crist is asking all state agencies to show how they would cut 10 percent more from their budgets. It's a routine exercise, said Melanie Etters of the state Agency for Persons with Disabilities. "It's too early to say" there will be more cuts, she said. But with the state revenue picture as it is now, "we will feel lucky to maintain what we have."

Service providers are more gloomy. "We have received absolutely no encouraging news," said Suzanne Sewell of the state Association of Rehabilitation Facilities, which represents group homes and in-home service providers. "All the information we're getting is that revenue is down and there will be more and more cuts, unless additional revenues come into the system."

To meet the 10 percent request, the Agency for Persons With Disabilities has proposed millions in additional cuts to families caring for disabled people in their homes. It would also cut staffing to state mental institutions and cap payments to people with the severest disabilities.

'Dangerous' Cuts

People who need continual supervision could end up home alone; those with sensitive medical conditions could receive less nursing care.

"These kind of cuts are dangerous," said Jim Freyvogel, president and CEO of MacDonald Training Center, based in Tampa, which provides day programs and at-home support services for the developmentally disabled. "People can spiral out of control very rapidly. Slight reductions in nursing care can really do damage."

The state "is looking at where the breaking point is and trying to stay just above it," Freyvogel said. "But you don't know where that point is until things start to break."

"I have only one word for this: devastating," Sewell said.

The cuts from the past two years are already taking their toll. Gulf Coast Community Care has discontinued a support coordination program that serves 300 clients in Pinellas, Pasco and Hillsborough counties.

The families of many disabled people receive lump sum payments to pay for the services they deem most effective. State regulations require them to use support coordinators to find the right services and providers and organize their spending plans. But over the past two years, the state has cut coordinator rates three times.

"With these cuts, we can't even cover staff salaries," said Rochelle Therai-Ray, Gulf Coast chief operating officer. "It's a heart-wrenching decision. We looked at every way possible to make it work. But we can't do it. Not at these rates."

Pinellas Agency Loses $350,000

The Pinellas agency for people with mental disabilities, PARC, has lost $350,000 from its $16 million budget since last year, said Tre' Littlefield. About 700 people use the program, most in day training, where they can paint, make jewelry, garden and learn the basics of opening a bank account. Many earn money stuffing envelopes, putting together boxes or performing other tasks for companies that contract with PARC.

The center's counselors help the clients learn how to function in society, said Karen Higgins, PARC's chief program officer. "It can make the difference between being successful in the community or not."

In some cases, it can make the difference between being able to live independently or in an institution, Littlefield said.

Since the direct payments to the disabled were cut last month, more than 60 people who use PARC have either lost their services or had them cut back, Littlefield said. "We really try to go beyond what is expected of us, but it's getting extremely difficult just to meet minimum standards."

A Miami-based agency providing day training said earlier this month it planned to close its program in Naples next month. The program, which serves 56 people, is trying to raise money to stay open another year. It's also talking to another behavioral health company about a takeover, but nothing has been settled.

"We've lost a couple hundred thousand dollars over the last few years," said Kathleen Childs, regional vice president of the Sunrise Group. "The current funding no longer can support our staffing levels."

Hillsborough Achievement and Resource Centers has suffered staff cuts in work programs for the developmentally disabled. It had one worker for every three clients. Now it's one to 10, said Lilliston. "These cuts are destroying this industry," he said.

Reporter Lindsay Peterson can be reached at (813) 259-7834.

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