Friday, March 13, 2009

For Detailed Reading

For those who are interested, the minutes from the ongoing DDD vs. AAPPD case are available here. Most interesting are the court's minute entry containing the facts and findings from the injunction that was issued on Wed. They are available here. It is 21 pages long, but makes for very interesting reading. Here are a few excerpts to whet your curiosity:

"2. The Legislature passed, and the Governor signed SB1001 on January 31, 2009. SB1001 became immediately operative, as it contained an emergency provision. SB1001 attempted to reduce the deficit through a combination of amendments to the prior budget appropriation bills, lump-sum reductions to prior appropriations, transfers of fund monies to the general fund, expenditure reductions and mandatory transfers to the general fund, mandatory personnel expenditure reductions, general fund reductions related to federal matching dollars, and some specific directions to state agencies.
3. The Defendants had little or no time to come up with a plan to implement the DES budget reductions mandated by SB 1001.
4. Defendants conducted an internal crisis decision-making process to determine how they would reduce spending and services within the DES-DDD program of services without guidance or priorities from the Legislature and without an open or public process by which defendants disseminated any information about what was being considered, or that afforded any public input from anyone, including stakeholders in the DES-DDD program, such as beneficiaries, providers and taxpayers."
This is the nuts and bolts of what happened. The Legislature passed a bill ordering the DES to cut approximately $150 million out of their budget, with very little direction as to where exactly the cuts were to be made.
I'm beginning to agree with those who say that making laws is like making sausage- you really don't want to see the process. Unfortunately, since this politicking and process affects people we serve, interested parties NEED to look into it.

"8. As of March 2, 2009, defendants had not notified any beneficiaries or providers about which beneficiaries’ services would be suspended or reduced. This circumstance will likely cause many providers to provide significant amounts of unreimbursed services.
9. Indeed, there is enough circumstantial evidence to create a prima facie case that the defendants are counting on service providers to continue providing a significant amount of unreimbursed services in order to prevent immediate and irreparable harm to multiple program beneficiaries.
10. After hearing, the Court is left with the inescapable conclusion that the haste with which SB 1001 was implemented by DES/DDD has served to create nothing less than mass confusion, anxiety and uncertainty among defendants’ agents, beneficiaries and service providers, as to which beneficiaries will be losing some or all of their services, and for how long. This uncertainty is caused by defendants." (emphasis mine)
This is exactly what happened. As providers, we were finding out from our families who had and had not received termination letters. We did not receive an official list of children whose services were being terminated until the afternoon of 3/6/09- 8 days (including a weekend) before 3/13/09, which was supposed to be the last day for families to receive services. So far as I'm concerned, mass confusion and anxiety describes the situation pretty accurately.

"19. All DES-DDD program beneficiaries have individual service plans (“ISP”). ISPs are essential to plan for the highly individualized, home- and community-based services for each program beneficiary. The ISP is developed by a team that includes the beneficiary, the family and/or legal guardian, therapists and other provider representatives, and DES-DDD itself. The ISP is the document through which services are arranged, provided, evaluated and adjusted when necessary for every DES-DDD beneficiary.
20. In implementing the provisions of SB 1001, defendants have not adhered to the ISP process for any program beneficiaries in accordance with federal or state law and DES-DDD program requirements. Defendants acknowledged that in not one instance (for approximately 29,000 DES-DDD beneficiaries) has DDD evaluated the individual needs of a beneficiary before implementing these spending and service reductions and suspensions."
It took reading further for me to be sure, but I think that when they talk about ISPs, that is a general term that also includes the IFSPs that govern the services for kids ages 0-3. This speaks to the illegality of making blanket changes to services without complying with the proper procedures (including getting consent of the person being served and/or that person's family or legal guardian).
There is much, much more in the minutes than what I'm able to post here. It is definitely worth the time to read in its entirety, even if you have to do it in 5 minute increments between changing diapers and chasing little ones. :)

I leave you with this final thought:
“[i]t is not only the harm to the individuals involved that we must consider in assessing the public interest. Our society as a whole suffers when we neglect the poor, the hungry, the disabled, or when we deprive them of their rights or privileges. Society's interest lies on the side of affording fair procedures to all persons, even though the expenditure of governmental funds is required. It would be tragic, not only from the standpoint of the individuals involved but also from the standpoint of society, were poor, elderly, disabled people to be wrongfully deprived of essential benefits for any period of time.” (emphasis mine)

Regardless of how you personally feel about some of the safety nets that are in place for the poor, these programs keep many people, particularly children, from serious harm. I agree that there are people taking advantage of the system, and that in some cases reform would be beneficial. However, in general, parents and caretakers for people with disabilities are NOT the ones who are abusing the system. The parents I have talked to are overwhelmingly grateful for the services that their children are receiving. What the DES did was to throw the baby out with the bathwater. Nearly every support coodinator or DDD employee that I have talked to has said something equivalent to, "let me at the budget, and I can show you where the money is being wasted." I have no doubt that this is true.

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