Saturday, March 3, 2007

Defending the Defenseless

With it's recent ruling, the New Jersey Supreme Court took a major step forward in defending the defenseless. By striking down a number of eligibility restrictions that served as barriers for the developmentally disabled and their families to receive care, our fair state will take a major step forward to providing for those most in need of help. The question now becomes one of money, priorities and morals.

Ranging from high to extremely low functioning folks, I got to see first hand the ranging demands on both caregivers and families while serving at a non-profit housing provider in Michigan. I also learned the harsh reality it is somewhat easy to raise donations for children with developmental disabilities; however funds for adults are harder to come by. Government funding is often the only way to provide services to those in need.

In his effort to curb entitlement (mandatory) spending, particularly Medicaid, developmentally disabled adults and even children are squarely in the cross hairs of President Bush and his fellow "compassionate conservatives" like our own Representative Scott Garrett. Medicaid is a lifeline to roughly 9.9 million people with disabilities and their families, which accounts for 16.5% of Medicaid recipients. The most recent budget proposed by the President and supported by Garrett would cut $28 billion from Medicaid over the next ten years. Here's some of the ways they plan to do it, courtesy of The Arc:

Optional Formulary and Pharmacy Changes: Would adjust pharmacy reimbursement policies and would permit states to operate “closed formularies” that permit states to deny coverage for drugs, even when medically necessary. Under current law, states can restrict access to certain drugs as long as individuals can get
exceptions through prior authorization.

New Limits on IDEA-Related Services: Would phase out Medicaid reimbursement for some services, including some transportation and certain administrative costs related to Medicaid services (e.g. physical, speech, and occupational therapies) provided to special education students;

New Restrictions on Rehabilitation Services: Would define allowable services that can be reimbursed as rehabilitation services (to restrict reimbursement to medical services only). In particular, the Center for Medicare and Medicaid Services (CMS) wants to narrow the option to finance medical services only. This approach – which will be incorporated in new regulations later this year – may jeopardize such “habilitative” services as social skills training, employment-related rehabilitation, and some transportation services.

One of the primary goals of any provider of services to the special needs community is to make the lives of those they serve as independent as possible. This varies depending on the individual and their needs, but the cuts outlined above increase the barriers to achieving independence. Transportation, job skills and social skills are integral components of many treatment programs for higher functioning special needs individuals. Eliminating access to certain medications, such as anti-psychotic drugs, can mean the difference between a semi-independent life and being relegated to full-time institutionalization.

It is immoral that Bush and Garrett, among others, see cutting programming to the developmentally disabled as sound fiscal policy. However, if forced to engage the amoral individual, it is also important to point out this is bad fiscal policy. Every family shouldering the burden of these cuts becomes less productive in the workplace, if not having to completely be taken out of the workforce to care for their child or adult child.

Individuals who could live independently or semi-independently with the appropriate training and medical supervision, very well could become wards of the state when their parents die. With the nation's highest autism rate and over 19,000 developmentally disabled adults living with parents over 60 in New Jersey, this should be of very real concern for those watching property taxes. I could go on, but you probably get the point.

We must not continue to balance the budget on the backs of the defenseless simply because they don't have lobbyists. The Constitution empowers Congress to levy taxes to "provide for the common defense and general welfare of the United States." While traditional Republicans and Democrats can argue until they're blue in the face over how far that goes, they must unite to stop the conservatives without conscience who are attacking the lifelines of those who can't fight back.

No comments: