For disabled people like me, home and community-based services — paid for, in large part, by Medicaid — are what secure our freedom to live and work as equal citizens. Medicaid is the primary payer for community-based long-term services and supports in the U.S.
The significant Medicaid caps and cuts that were implemented by Gov. Steve Bullock and the Montana Legislature this year have decimated community-based services, even though they’re cheaper than the alternative — nursing facilities — which are an entitlement under federal law.
Advocates all across Montana have spent the past year trying to prevent individuals with disabilities from being forced into institutions of all kinds — nursing facilities, the Montana State Hospital, jails and prisons. Bullock's office and the Department of Public Health and Human Services have engaged the disability community on these issues, however, many of those engagements have turned out to be meaningless.
I say that not only because the administration has made certain decisions about where the cuts were made that disadvantage community services. I say that because now, when the governor requests a $20 million supplemental appropriation to provide DPHHS services, it includes money for the State Hospital but does not include any measure to reduce the Medicaid community services cuts.
Some legislators asked the governor for a supplemental to address at least some of the Medicaid community services cuts in March. This request was denied, as we understand that the Governor’s Office did not believe that they met the standard for a supplemental, which requires that the expense be due to an “unforeseen or unanticipated emergency.” However, for people who got their services from Helena Industries, which has filed for bankruptcy, or youth with mental illnesses who received services from the recently closed Sinopah in Kalispell or the Great Falls Youth Transition Center, and people who rely on personal care attendants to dress, bathe and eat, whose hours were significantly reduced, it really feels like an emergency.
Given that the record “unforeseen and unanticipated” 2017 fire season was the reason given for Montana’s financial state that brought about many of these cuts, they certainly appear to meet this test to me.