Pennsylvania budget cuts, policy changes are ravaging services, disability advocates say

Jim Gurreri challenges the state to find waste within his nonprofit, which relies on state funding to provide group homes and other services for people with intellectual disabilities.

The state won't find any, contends Gurreri, who has led the Arc of Cumberland & Perry Counties since 1982.

The absence of waste, combined with eroding state money, is causing him to eliminate 40 positions and trim services, including three group homes.

“I can only cut. That’s all I can do,” he said.

Advocates and providers of services for people with intellectual disabilities say policy changes, financial miscalculations and proposed budget cuts by Gov. Tom Corbett are ravaging services that fell short of needs even during the good times.

“It feels like a systematic dismantling of the community system,” said Gabrielle Sedor, a spokeswoman for Pennsylvania Advocacy and Resources for Autism and Intellectual Disabilities.

The state doesn’t dispute the hardship facing service providers. Administration officials have attributed the situation to assorted hard realities: the budget crisis, a shift from county-run to state-run services, and the state’s belief that providers, as a whole, can operate more efficiently.

“The Office of Developmental Programs has been faced with some difficult choices this year,” said Carey Miller, press secretary for the Pennsylvania Department of Public Welfare, which oversees programs related to intellectual disabilities. “We have to ensure quality of care, but we have to stay within the limits of the funds appropriated with us.”

Miller said the state has been working closely with service providers to help them address their costs and operate within the available funding.

Shift of services hurts

Many state programs would be cut under Corbett’s proposed budget. Facing a revenue shortfall of roughly $500 million, he would scale back spending to about the level of 2007. His proposal, for example, would cut funding for public education by 3 percent and higher education by 18 percent.

But advocates for people with intellectual disabilities contend that many organizations that provide services for people with mental disabilities have long operated on a shoestring. They point to the list of 16,000 people waiting for services.

That waiting list includes 3,500 people whose situations are considered emergencies, often because the parent or other person who cared for them is no longer able.

Pennsylvania Advocacy and Resources for Autism and Intellectual Disabilities represents service providers. A recent survey of its statewide membership found the organizations had laid off 490 employees because of the rate adjustments, with some eliminating services, Sedor said.

A major source of grief for the providers is the shift from county-run to state-run services.

Until recently, counties negotiated payment rates with providers. One negative consequence was that payments varied by county, resulting in variations in levels and quality of services.

The federal government, which provides about half the funding, eventually required a shift to state-run services for reasons that included the desire that comparable services exist in all counties.

The state must come up with a statewide fee schedule, with regional variations.

The transition is ongoing, with the state paying providers based on their estimated costs, and trying to reimburse them if they are underpaid.

But the state discovered it was spending far more than the available amount and had to scale back payments, which were passed to providers in the form of “rate adjustments.” Miller said the 2011-2012 shortfall is about $60 million.

The Arc of Cumberland and Perry Counties has a $14.8 million budget and about 330 employees. Its services include 22 group homes and the S. Wilson Pollock Center for Industrial Training, which provides jobs and vocational training for about 200 people with intellectual disabilities.

Gurreri said that as a result of the rate adjustments, CPARC will end up with 94 cents for each dollar it spends in the current fiscal year. He’s still waiting to find out his payment rates for 2012-13, but he said there’s every reason to expect money will fall short again.

So he expects to eliminate 40 positions. It will involve about 30 full-time and 10 part-time jobs. A few positions are vacant and will go unfilled. Some of the layoffs already occurred, while others will take place at the end of the fiscal year in June. He also holds out hope for good news from the state, which might lessen the cuts.

Gurreri said he has eliminated 10 positions at group homes. Those homes will continue serving the same number of people, although “quality of service will diminish, security to some degree will diminish.” At the S. Wilson Pollock Center, two people were laid off and two positions were cut, reducing the workforce to 61.

Gurreri expects to eliminate a program that enables people with intellectual disabilities to live with host families, and he expects to close three group homes, which would displace about a dozen people. If homes run by other local provider organizations can’t or won’t find spots for them, they could end up in a state institution, he said.

More services affected

At the same time, providers are bracing for the impact of Corbett's proposed 2012-13 budget, which will substantially change the way many county-level programs are handled. It will affect services beyond those for people with intellectual disabilities, such as services for the mentally ill and people with drug and alcohol addiction.

The money will come in the form of block grants, which counties can tailor to address local needs. One of the downsides is that the money will be cut 20 percent from last year.

While much of the money for intellectual disabilities will remain outside the block grants, the block grants will contain funds that in the past have gone to provide emergency services for people on the waiting list for permanent services. County officials could channel that money to other programs, advocates say.

While advocates emphasize that services for people with intellectual disabilities have long been underfunded, they don’t deny the existence of waste in some organizations.

Gurreri contends his organization isn’t among the padded organizations, and every reduction in funding will directly affect some of society’s most vulnerable people — those have no choice but to rely on the safety net.

“The state has said to me there will be winners and losers. We are a loser, at least in this particular year,” he said.

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