After Missouri cuts funding for the disabled, some fear they may be forced into nursing homes
St. Louis Post-DispatchAug 16, 2018
For some disabled Missourians, the cuts mean fewer hours with the personal attendants who assist them with daily tasks they cannot perform.
Less help poses problems for
He relies on his attendants for the most basic of needs: They get him out of bed each morning and put him in bed at night, prepare meals for him and bathe him.
The cuts have forced him to nearly max out his credit card so he could pay for attendants to stay longer, time the state will no longer pay for.
"When you make a cut like this, I'm just dangerously close to going into a nursing home," Foelsch said.
Sending him to a nursing home would end up costing taxpayers more money and would force him to leave his job, he said. He teaches at
"All of my money is spent in a four- or five-block area. All the money that I have gets pumped right back into the
In May, Foelsch was able to qualify for another program that assists with the cost of his attendants. But the program has limited spots and he has to be reassessed each year to qualify. He fears he could be right back where he was earlier this year. And he worries about disabled Missourians with no options.
"At this point, there are several thousand individuals in the state that are needing more care but are having a difficult time due to those cuts," Weller said. "If you can't live on your own with the limited hours, what other options do you have?"
The cuts will force some into nursing homes, Weller said.
"What it comes down to is dignity and respect of a human life," Weller said.
The affected program, known as consumer-directed services, allows disabled Missourians to hire the attendants they want in their homes to help them with daily tasks and personal care. The attendants do not have to be licensed medical professionals.
Disabled Missourians are evaluated and must qualify for services based on the score that they receive. Last year, the state raised the threshold.
It's a subjective evaluation, and many who once met the threshold have seen their scores raised, according to state Rep.
Money to pay for the attendants comes from Medicaid, the state-run insurance program for the poor. And that spending was outpacing state revenue, state Rep.
"We were cutting things drastically everywhere else before we came to these services," Fitzpatrick said, citing higher education costs as an example.
Last year, lawmakers decided to cap the amount spent on the consumer-directed services. The cap resulted in
The cuts affected at least 7,844 disabled Missourians, according to figures from Fitzpatrick.
The state also cut rates to providers by 3 percent. That saved
Ultimately, of the
Advocates say less care can lead to an increased risk of hospitalization and ultimately higher costs.
"Just one hospitalization due to lack of care cancels out any savings," officials with
One hospital stay for a Medicaid patient is about
"It's bad. I've been at
Lavender said she worried about the long-term effects of cutting hours.
"How many people losing two hours of services a day, how many were left in positions in ways that created so many other problems," such as pressure sores, Lavender said.
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