Caseload Forecasting for Disabilities

Silhouette of people with sunset.

Senator Emily Randall (D- 26th Leg. District, WA) has introduced SB 6056 – Concerning the budgeting process for services for individuals with developmental disabilities

This is a hopeful beginning to the generation of appropriate funding for the needed supports to allow the people in this vulnerable population to be included in their communities as they would desire, improve their quality of life and help provide a more meaningful life as they would choose.

In our opinion, this means more choices and less restrictions, appropriate assessments of needs and supports and increased stability in all areas of life – home, work and community.

This bill will help address the issue of the mysterious people who live in the world of “the  no-paid services caseload” withing DDA.  No one knows who these people are, if they are even in our state or alive or what their support needs may be.  It will at least provide case managers for this population in hopes of being able to provide supports if these people are in need.

But, caseload forecasting is not just counting heads.  We need to understand what the range of support needs is and how many people are in each acuity level in each setting to better assess appropriate funding for these supports.

The Joint Legislative Executive Committee on Planning for Aging and Disability Issues (JLEC) had a work session on January 9, 2020.  A link to the session is highlighted.

 

JLEC – January 9, 2020   (Olympic Neighbors presentation begins at 48.00)

Olympic Neighbors, Father’s Group of Jefferson County, Developmental Disabilities Funding Crisis Task Force (DDFTF) members provided much information to the committee.  The chart below is taken from their information.

State Funding for Supports - Jefferson County Father's Group

Regarding residential supports – in theory the SOLA and Supported Living are essentially the same supports – the difference is that the SOLA is state operated and Supported Living is typically private-non-profit/profit agencies providing the support.

There is a significant difference in the wages for the caregivers in these residential settings – that of the state employee versus agency employees – but does that alone account for the difference in cost for these residential settings?

I think there may also be differences in acuity levels of the residents in these settings.  There may be higher percentage of higher acuity residents in the SOLAS which also could be reflected in the higher cost.

This is an issue that hopefully can be addressed in Caseload Forecasting.  We cannot base our funding on the “Average” for the whole population.  We must break out acuity levels and look at the average for that level.  This method will provide a much better understanding of the necessary funds for appropriate supports.

 

Stop the Charade

Stop the charade and listen to Senator Walsh tell the honest truth in the statement prior to the public hearing on SB 5753.

Personally, I’m tired of being ridiculed by so-called advocates who talk about parents who have fears – look at the mess we are in -parents and caregivers of those with significant support needs know all too well about the realities.

These fears are based on reality. For those who ridicule us, go visit people like Kevin in the hospital and tell his mom that she is just fearful of what can happen.

Kevin’s 33rd day in a hospital room.

The last 4 days Kevin has become increasingly desperate. The nursing staff at

the Medical Care Unit where he is are such a great group of professionals. They

have tried to keep him occupied, even taking him on wheel chair rides around

the floor, but each day that passes he grows more restless. Kevin is a 5 year old

(6’2” tall) that wants to go back to his safe/familiar room, surrounded by his

things. He also wants to go for hikes, to the store, the movie theater, and the

library. Now he is hitting himself in the stomach and legs with such force that

his legs and abdomen are completely covered with purple and black bruises.

This is the only way that he can deal with this overwhelming stress. He is

limping because he hurt his left leg during the self-injuring actions that now

are happening continuously throughout the day. Yesterday he became

increasingly anxious with each passing hour, pleading for his “Bellingham

house”. He began to scream, hit his room door and window and security was

called. Kevin hit his RN and one of the security guard during the incident when

they attempted to keep him safe in his room. Throughout the day he was

heavily medicated with no success. At night, he managed to escape from his

room and run downstairs to the hospital lobby and then outside where he was

wrestled by security until Bellingham police arrived.

After he was guided back to his room by the police he was finally medicated

with an IM injection of B52 (Benadryl/Haldol/Lorazepam). He has been asleep

since then, in a way I feel this is better for him to stop his mental anguish and

physical self-inflicted pain.

This situation is a disgrace, my child deserves better from our system. He will

severely injure hospital staff or will be gravely injured by medication

administration and/or being restrained.