Listening to people all around the state, as Wyoming navigates its latest budget crisis, I get the sense that people are tired. They seem to be growing accustomed to the idea that maybe we can’t afford to adequately fund our public schools, or provide basic services for children or the elderly. They’re starting to give up.
I see some state officials and lawmakers starting to give up, as well. After years of talk about diversifying the state’s revenue streams, the moment of reckoning is here and there is a noticeable lack of action.
I’m tired too. But as the parent of a child with a developmental disability, I don’t have the luxury of giving up.
My 10-month-old daughter, Etta, has Down syndrome. While we’re incredibly fortunate — she’s a happy, healthy baby girl and we have lots of family support — her diagnosis means she will always face unique challenges. Even though my wife, Hana, and I will always put our children first, as Etta gets older she’ll require services we cannot provide ourselves. We don’t know exactly what her needs will be, which is why it’s so crucial that Wyoming have a safety net.
The state’s latest round of proposed budget reductions includes significant cuts to home and community-based services for children and adults with developmental disabilities. Most families and providers refer to this program simply as “the waiver.” Depending on the individual, services can range from basic things like physical or speech therapy all the way up to 24-hour care for people with the highest needs.
The waiting list to receive these services is currently about three years long, not counting the months-long application process. As part of the proposed cost-cutting measures the wait list would be frozen through the 2021-2022 budget cycle, meaning people who need services will have to wait an additional two years. Along with restricting access to services, this could be financially devastating for families of small children with high medical needs who do not financially qualify for Medicaid. Individuals simultaneously qualify for medical coverage through Medicaid when they are approved for the developmental disability waiver.
For reference, we submitted Etta’s waiver application shortly after she was born. By the time she reaches kindergarten she might be approved for services. I just checked the math, and we’re also on track to pay off the medical bills from her first week of life around the same time.
More critically, changes to the way individuals’ budget amounts are calculated mean that some people will lose 30 percent of their funding or more. In some extreme cases, the cuts can be as high as 50 percent. These people will not be able to afford services they need to live a happy, healthy, and dignified life.
Eventually, Hana and I hope to buy or build a small house that Etta can call her own. She will never be able to live completely independently, but home and community-based services can provide the extra support she’ll need to succeed as an adult.
Many children and adults with developmental disabilities simply need a level of services and care that isn’t physically or financially possible for an individual parent, caregiver, or family. Home and community-based services allow parents to continue their careers, provide for their families and, in some cases, stay out of crippling medical debt. They help many adults with developmental disabilities live semi-independently, and they allow individuals who need the highest level of care to remain in their own communities close to friends and family instead of being institutionalized. Not quite coincidentally, providing these services in home and community-based settings also saves the state money.
I’m not here to vouch for the efficiency or equity of the current system, and there may be opportunities for the Department of Health to find savings. But eliminating basic services for our neighbors who need them most should not be an option.
First, the state needs to fully fund these services through the biennium. The Joint Appropriations Committee left $20 million in unallocated funds in the supplemental budget for the full legislature to earmark when it reconvenes in March. This could provide a backstop for a variety of health and social services if no other funding option exists.
Next, the legislature needs to take concrete steps to create new sources of revenue for the state. Not next session, not after legislators clear their 2022 primaries, but here and now. Doing nothing — and asking the most vulnerable members of our communities to bear the consequences — is not acceptable any longer.