The safety net unravels for people with disabilities
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The safety net for people with disabilities is unraveling. It doesn't have to.
In this age of austerity we should we look for more efficient ways to support those with disabilities and hold down costs. Instead, we are taking two steps back from the progress we've made over the years to keep people healthy and to enable them to live in the community.
Imagine for a moment that you have a spinal cord injury and depend on a wheelchair. You may very well be concerned about diabetes, urinary tract infections, persistent skin wounds and a multitude of other medical conditions. You may need help with everyday living such as bathing, dressing, meal preparation or transportation. Now imagine that the program you relied upon to coordinate the providers that assist with those issues was just eliminated.
That's what recently happened to 1,200 adults with disabilities in the metro area.
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The Minnesota Disability Healthcare Options (MnDHO) program was a collaboration among the Minnesota Department of Human Services, UCare and AXIS Healthcare, the organization I serve. By integrating medical care coordination with housing, employment, day programs, access to fitness programs and transportation services, MnDHO helped keep people healthy and enabled many to live at home or in a community setting. The program ended in December 2010, primarily because changes in Medicare funding, combined with state budget cuts, made future funding uncertain.
Of course legislators and other government officials must scrutinize every aspect of the budget. But cutting funding for those most vulnerable not only reduces their quality of life -- it almost certainly will mean higher costs for everyone, because it will increase the need for hospitalizations and nursing home placements.
How do we know MnDHO worked? Here are the results for those served by the program: Members reported a 70 percent increase in healthy days after 90 days of service. $120,00 a month was saved by diverting unnecessary hospitalizations. We secured housing for those at risk of nursing home placements. Client satisfaction increased dramatically over the previously uncoordinated system.
Beyond MnDHO and AXIS, cuts throughout the system that have taken effect or are scheduled to be implemented are further unraveling the safety net. Examples:
Cuts in personal care assistant services.
Reductions in access to fitness programs.
Transportation cuts.
Cuts in occupational therapy services.
AXIS Healthcare is pleased to have secured new contracts with health plans and counties to continue providing coordination services to people with disabilities. Unfortunately, due to the aforementioned funding cuts, those services are not as comprehensive as provided under MnDHO.
My sincere hope is that we will eventually rediscover what has worked in the past and improve on it so that those holes in the safety net will be mended.
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Randall Bachman, of St. Paul, is executive director of AXIS Healthcare. He is a source in MPR's Public Insight Network.
