Provider Pay Cuts Provoke Fierce Opposition

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Georgia Health News


Andy Miller


Pat Ellis held hands with her son John while waiting to get into an already packed state board room Thursday.The Ellises traveled from Commerce to Atlanta to attend a hearing that focused on proposed state cuts in payments for certain residential and day programs for the developmentally disabled.John Ellis, 39, who has Down syndrome, has been going to Jackson Creative, a service center for people with disabilities, for 18 years. Four to five days a week, John does activities ranging from community volunteer work, including folding church bulletins, to attending music therapy at the University of Georgia.“If the rates are reduced, [John’s] days will be cut down, and the quality of services will be cut down,’’ Pat Ellis said. “It’s such an important part of his day.’’The Ellises were part of a huge crowd of people with disabilities, family members, consumer advocates and service providers who attended the three-hour hearing. The atmosphere at the event was often emotional.The proposed rate changes are being considered by the board of the Department of Community Health, which runs Medicaid in the state.The revisions were proposed after the federal Centers for Medicare and Medicaid Services required Georgia to review its rates under ‘‘waiver’’ services for thousands of people with developmental disabilities.The new rate schedule was determined by a consulting firm that surveyed providers. State officials at the Department of Behavioral Health and Developmental Disabilities (DBHDD) said most rates will actually be increasing, not decreasing.Program providers have been involved throughout the process, said DBHDD spokesman Tom Wilson on Friday.“No one is questioning the value of the services to the individuals receiving them,’’ Wilson said. “What’s at question is how much the people of Georgia should be expected to pay for them.’’ In some cases, he said, providers were spending 70 cents or less of each dollar on direct care.The overflow crowd Thursday uniformly urged the state not to rush to change the rates. They called for either maintaining the current pay structure or taking more time to study the proposed changes. Many in the crowd wore stickers with “New Rate Models’’ crossed out.Betty Peeples of Cartersville told state officials that her daughter Angela, 34, has benefited greatly from attending a day program for people with disabilities.“I do not see [the pay reductions] as being good for anyone,’’ Peeples said. The cuts will affect jobs – both at service centers and for parents who will no longer be able to work, she said.

‘Do no harm’

Tojuan Hawkins, 36, who has autism, told the public hearing that his Lawrenceville day program allows him to have a job stringing and bundling shoelaces. He also does ceramics and artwork at Creative Enterprises, a training and employment program. “I don’t want anything to jeopardize my job,’’ he said.Leigh McIntosh, executive director at Creative Enterprises, told GHN that the changes ‘‘could potentially put us out of business.’’Elsewhere on Thursday, DBHDD Commissioner Frank Shelp told state lawmakers that the Community Health board would not take up the rate changes until March, instead of February as previously planned.If the changes are approved, said DBHDD spokesman Wilson on Friday, they probably will not be implemented for more than a year.Meanwhile, a bill has been introduced in the Georgia House that would require legislative approval for provider rate changes.All About Developmental Disabilities, an advocacy group and services provider, said in a statement that it is ‘‘concerned with the overall instability to the provider community that any immediate changes to rates might cause. . . . More cuts to an already overburdened and under-resourced service system would pose concern for both individuals and family members and their ability to keep much-needed services.’’Some developmentally disabled Georgians live in ‘‘host homes,’’ which for them are essentially what foster homes are for minors. This program is targeted for a rate cut.Ryan Whitmire of Lutheran Services of Georgia, which provides host homes, told the Thursday hearing that the proposed reduction would cost his nonprofit $80,000. “It’s a huge hit,’’ he said.Diane Wilush, president of the Service Providers Association for Developmental Disabilities, told state officials that program providers have not seen a rate increase in eight years.“The underlying principle should be ‘Do no harm,’ ’’ she said.Wilush urged state officials to ‘‘go back to the table, include providers and families . . . and properly support quality.’’Bill Hogan said his 56-year-old son benefits from services from the DeKalb Community Service Board.“Without these, he would not be able to live and work as he does,’’ Hogan told the hearing. If proposed rates go through, he said, “providers will have to discontinue services,’’ which he said would be ‘‘catastrophic’’ to people like his son.