From the Wall Street Journal:
Around the country, shrinking state budgets and rising health-care costs are forcing drastic cuts in home services to people with disabilities. Because federal mandates restrict what states may cut inside Medicaid, states are often cutting basic services that help people with disabilities remain in their own homes.
This is happening even though home services are cheaper and more cost effective than institutional care. Experts say it’s politically easier to cut back individual services to people at home than to close a 24-hour facility. But many worry that the cuts could push more people into costly institutions or large group homes because that is where services are guaranteed.
“My biggest fear is having to go to an institution,” says Jimmy “Chip” Eubanks of Clinton, S.C., who has cerebral palsy and lives at home.
People with intellectual and developmental disabilities are particularly at risk for service reduction, experts say, because the per-person cost of their services is about 10 times higher than that of the average Medicaid recipient.
The cuts for the developmentally disabled are almost certain to bite deeper in the future. Part of the federal stimulus money this year was designed to prop up Medicaid. The federal infusion disappears for the fiscal year starting in July 2011.
Some of the biggest cuts are coming in South Carolina, where Medicaid already consumes about 20 percent of the state’s budget and is one of its fastest growing costs. In Aiken County alone, more than 5,000 people languish on waiting lists for various services. “We want to give families hope to keep their family unit together, but in reality there is very little we can put in place to assist them,” says the head of the county’s disabilities board.