People with Developmental Disabilities at Risk of Losing Services

By Laura Howell, Executive Director, Maryland Association for Community Services.

Developmental disabilities, like Down Syndrome, Cerebral Palsy and Autism, begin in childhood and prevent people from living independently without substantial help. Over 22,000 adults and children with developmental disabilities receive community based services, including residential, employment and day programs. Over 19,000 people with developmental disabilities are on the State’s Waiting List for these same services, and thousands of people waiting are in crisis.

When state coffers were full, the State largely neglected these important services, both refusing to provide minimally adequate inflation rates, and limiting access to services for people, many of whom continue to be in crisis.

Because Maryland now faces serious fiscal challenges, policy-makers want everyone to “share the pain.” This would be a more equitable proposition if people with developmental disabilities had shared in the good times as well, but this did not happen.

One in three developmental disability providers already have a negative operating margin. If the state cuts funding for services that are already significantly under-funded, it will create a severe crisis. Likely repercussions will include discontinuation of services for some people, especially those with significant disabilities, discharging of people who require uncompensated care, and closing of programs that are no longer fiscally viable. In addition, the basic safety and health of some people with disabilities may be jeopardized.

Some argue that if state employees must feel the pain, so too should direct support staff in the community. However, the workers in the community continue to earn far less that their counterparts in state institutions. Whereas the state reimburses community providers $9.18 per hour for direct support workers, recent job postings showed starting wages of $12.42 per hour for state employees. Although efforts by the State and providers to raise the low wages of community-based staff have improved the situation, community staff still lag behind their state peers. Telling community workers to “share the pain” will only push the best employees to better-paying jobs in other community settings, such as nursing homes and assisted living providers, and people with disabilities will suffer.

Lastly, reducing access to essential care and supports will ultimately increase the costs to the State of Maryland by shifting costs to state institutions, hospitals, and Medicaid.

Marylanders with developmental disabilities can not afford any further reductions in funding. While state policy-makers face difficult choices to balance the budget, this is one area they cannot afford to cut.

For the independent fiscal analysis by the Community Services Reimbursement Rate Commission of developmental disability providers in the community, visit here.

For information on the thousands of people waiting for developmental disability services in Maryland, visit here.

And for briefing on funding for developmental disability services and direct support staff wages, see the following document.