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Legislators complain about wrong disabled policy

Some Louisiana legislators expressed perturbation over the state’s Department of Health and Hospitals abruptness in moving to privatize group homes the state has maintained for the developmentally disabled. More appropriately this emotion would be levied at themselves over their lack of alacrity dealing with the disposition of past privatization fruits concerning this clientele.

Members of the Joint Legislative Committee on the Budget complained that they and the relatives of individuals living in these homes, which are geared to serve moderately mentally and physically disabled individuals, received next to no warning of the decision before it was announced that the facilities were not going to be closed immediately and that over the next few months they would be privatized or, failing that, their residents dispersed to other homes. The move by the state came as a result of necessary mid-year budget cuts and similar previous utilizations showed that costs per client are significantly lower with comparable or better care in private facilities.

But it must be acknowledged even as legislators pontificate about how forcibly quick decisions of this nature – which aren’t that hasty in that closing such facilities has been a long-term goal of the Gov. Bobby Jindal Administration and before – threaten outcomes that provide for maximal care and peace of mind for client’s relatives, that in the minds of many of them there is another reason for their pique: as with any state-run operation, these homes are seen as devices by which to win votes locally. Being able to campaign with taking credit for providing this service, as well as the state jobs attached to it, is off the table when the state no longer directly provides the service or jobs. Legislators do not like it when executive branch officials take away their ability to be perceived as doling service and employment opportunities, so this was part of their angst although none will admit that.

Yet ironically, in the larger question of the state getting out of the business of direct provision of living spaces for the developmentally disabled, it is legislators themselves who are not addressing about the right thing nor making efforts to see that it is done. As the state has reduced its role, it has been slow to implement the cost savings from the growing privatization campaign which delays possible benefits going to that client population.

In recent years, beginning before Jindal assumed office, the state has had a strategy to shed itself of some of the supports and services centers for the most severely disabled and downsizing others to group homes. The strategy was to close and sell the facilities and, according to Act 555 of 2006, to use proceeds to fund more Medicaid waiver slots that would permit home- and community-based care. However, this has occurred at a snail’s pace where the state still has the facilities (one is no longer residential and four have been turned into glorified group homes) with costs still being even higher by keeping them operating with far fewer clients so that no proceeds have been forthcoming to fulfill that new law. This statute also would apply to the closing of these group homes.

Legislators should not be so concerned about facilities getting closed as they should be getting the proceeds from their sale into reducing the tremendous backlog in the waiver program that will only grow as de-institutionalization becomes recognized as an option for some clients displaced through the closings. Further, the cost savings (such as maintenance) from taking these properties off the state’s hands can go to addressing the budgetary crisis in the state’s Medicaid system because the state’s fiscal structure forces so many reductions on it. They need to pay more attention to their oversight duties on this account, and not so much sniping over decisions made for efficiency and effectiveness sakes.

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