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.

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About ddxdx

A Family physician in the Idaho State Senate
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