Childrens Services Redesign

 The Health and Welfare Department has undertaken an extensive two-year redesign of how they deliver services to children with disabilities. There were two main objectives of the changes. First, the new system was to have capability to individualize care plans. Currently, all children are eligible for two kinds of therapy, maximum 22 hours per week. Under the new plan a budget would be developed for each child and then the parents would decide how to best spend the allotted hours. The second aspect of the redesign was that the plan was supposed to be budget neutral; that is we weren’t cutting services to this group, just changing how they were distributed.

We took testimony in the Health and Welfare Committee last week since we need to approve the department rules that will make these changes occur. The children who receive these services usually have a diagnosis of autism or a related disorder. From my years of practice in Moscow I know the difficulties some of these families can face.

We had testimony on both sides, the department of course asking for support, two agencies in favor, but with some reservations, and two or three families and agencies opposed. I had received a dozen or so emails, mostly opposed. Almost everybody agreed the concept was good, but the details were vague. Some just saw that their services would be cut. I was confused by this, since the plan was supposed to be budget neutral. If some kids’ services were reduced, another kid would get more, I thought. Testimony ran long and the chairman delayed the vote until Thursday.

I was fortunate that I had constituents with a good perspective on this. I was of two minds. I like the change of delivery system, but the details were disturbingly vague.  The department sent us more details and examples on Wednesday. They showed how some kids now got 22 hours a week with mild problems, and also with severe problems. They called this the “One Size Fits All” model. But under the new plan even the most severely disabled only got 14 hours of therapy a week. I asked the presenter for H&W why. He replied, “Under the new plan the parents will be trained and can do up to 10 hours of therapy on their own a week.”

It dawned on me right then, the Department was planning to shift more care to the parents. This was not revenue neutral from their perspective.

With all my struggle to understand and make the right choice, it came down to not really making any difference. The vote was 7-1 in favor.  I voted for it. I vow to pay attention to how this affects the families I know in my district. I have to pick my battles.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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2 Responses to Childrens Services Redesign

  1. Archie George says:

    Wow, cutting back from 22 to 14 hours per week and calling it revenue neutral – only in politics!

  2. Laura Hamilton says:

    I am the single mother of four children and am living in Pocatello. Three of my children are disabled. One is mild and funtions currently without outside support. The other two are twins and one of them is moderately disabled and receives 22 hours of developmental therapy a week. The other is severely disabled and receives 32 hours of IBI therapy per week (many of the hours are required to be with me in the home ~ training I suppose). The hours with the re-design will be cut SEVERELY. There is no 14 hours of skilled therapy ~ if a parent chooses to use a skilled therapist to work with their child, then they receive 5 to 6 hours a week (every child is the same despite severity). H and W is pretending that parents get to “choose” what works best for them, but really they are holding a gun to many stressed parent’s heads and forcing them to choose respite (unskilled) care to receive any more than the 5 hours. My severe son has been kicked out of daycare (several ~ including the one for special needs kids) and is poorly controlled using anti-psychotic meds and physical restraints. He hurts himself and others on a daily basis and causes severe destruction to property. The ONLY thing keeping me going is the support I receive with the therapy hours. I will not be able to work and will be house bound with this child when his “re design” goes through. I will lose my job and will become dependent of welfare to live. I assume his behaviors will become even worse without the therapy and he will become at even higher risk for residential care. Budget neutral? what a joke ~ every kid gets the exact same budget and the state will save a bundle ~ Hmmm? wonder where that $ is going to go? Maybe to hire even more “management” people. This re design pretends to give choices, but it is just a skillfully constructed system to cut services to those that need it the most while making it appear as though the parent made the “choice” I am already at the breaking point ~ and now I really don’t know how my family is going to make it.

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