The state’s powerful Joint Budget Committee voted Thursday to make cuts to Medicaid caregivers and reduce services for Coloradans with developmental disabilities to help fill a massive budget gap.
The decision was expected, as Medicaid continues to take up a larger chunk of the state budget. The full Legislature will have to approve the cuts as part of the overall budget, but the votes mark a significant step in the budget-writing process.
The committee recommended capping the weekly paid hours per caregiver at 56 per week, although there would be a waiver program for exceptions such as a linguistic or cultural barrier or a rare diagnosis that puts someone at severe risk for illness. Budget members also changed a policy that automatically transitions youth with developmental and intellectual disabilities into the commensurate program for adults and puts them on a waitlist for access to 24-hour, seven-day-a-week supervision.
Ad:“People on the wait list don’t go without services,” said Tom Dermody, the non-partisan chief Legislative Budget & Policy analyst. “It may not be the preferred services or the entire suite of services, but they get what they need.
“These are incredibly difficult,” said Tom Dermody of the cuts.
Budget Committee Vice-Chair Jeff Bridges of Greenwood Village described the cuts as the worst part of his day.
“This keeps me up at night,” he said.
“This is bad for the people of Colorado, and we’re doing our best to cause the least harm. And our metric these days, genuinely, is are people going to die if we vote a particular way on these things? And it’s an awful place to be, but we’re trying to minimize harm.”
The Legislature faced roughly a billion dollars in cuts last year as well, and avoided cutting patient care. This year is different.
“We’re making cuts to things that are $35,000. We are really, the couch cushions are being shredded looking for these coins,” Bridges said.
Medicaid costs make up roughly a third of the state budget, and the costs are going up exponentially. Non-partisan staff said they still don’t have a clear idea of some of the Medicaid enrollment increases.
“Some of it may be that more people are becoming more aware of these programs and are applying for these programs. The underlying driving factors, I don’t know in terms of enrollment, in terms of utilization, the cost of services is going up, provider rates have increased, some services have been added,” said Dermody.
As the committee weighed its decision, families with children with developmental disabilities and others looked on anxiously. During one break, they spoke with Rep. Rick Taggart, a Republican from Grand Junction.
“It’s really gonna hurt a lot of people,” if the cuts are ultimately passed, said Kathy Fieber, of Littleton, the mother of an adult son, Ben, with Down syndrome and autism.
“Cut Costs, Not Care” was the message on the back of her blue t-shirt, which was worn by several others.
They’re members of the group Colorado Advocacy for Adults with Intellectual and Developmental Disabilities. It is encouraging lawmakers to avoid cuts to the part of the Medicaid budget that serves this population and find reductions elsewhere.
“There’s actually people in our group that, if they make some of these changes, they’re going to lose their homes,” Fieber said.
She said the state doesn’t have other institutions to care for this population.
“We’re talking about the most needy people that bring joy to their families and bring joy to people who work with them,” Fieber said. “So I would ask that they (lawmakers) … not balance the budget on the backs of the most needy people.”
Fieber discussed the intense pressure that families who care for adult children with disabilities are under. They care for their child all day, every day and get compensated for that care by the state.
“You get a daily rate, it’s not hourly. Ours works out to about, because our adults require 24-7 care, about $9 an hour roughly,” said Nicole Villas, from rural Gilpin County, the mother of an adult son, Aiden, who has severe epilepsy.
Villas said she pays three times that for Aiden to get private care, which is a four-hour outing from her home north of Blackhawk to Arvada.
She estimated the proposed cut to the program Aiden relies on would work out to about 15 percent.
“With a 15% rate cut, I’m not even going to be able to afford eventually to have help with him at all because nobody but a parent would do this,” she said, noting the costs for a certified nurse would be too much.
If those cuts ultimately happen, “there will be no chance ever for me to have help with him because nobody else will do this for this pay,” said Villas.
She lamented that, from her perspective, deep cuts, prompted by massive cuts to Medicaid passed by the Republican Congress and signed by President Trump, are falling heavily, in Colorado, on those with disabilities.
“We started with just one cut to fight last spring, but over the past six months, the number of cuts to our vulnerable adults just keep coming,” Villas said. “If you look at the cuts HCPF proposed to help pare down their (still increased) budget for next year, almost all of them target the severely intellectually and developmentally disabled members – both adults and children.”
The vote to cap payments for caregiver hours to 56 hours per week passed 4-2. Budget committee member Republican Sen. Barbara Kirkmeyer from Weld County voted against it and several other proposed cuts.
“So we’re going to cut the hours down to 56 hours, and we’re going to save a whopping $1.5 million,” Kirkmeyer said.
Democratic budget committee member Sen. Judy Amabile of Boulder also voted against that change. And said she had real concerns about it.
“I am also kind of a little bit gobsmacked, even though it is a lot of money relative to what we’re doing here, 1.5 million doesn’t seem like a big savings,” she said.
It’ll be up to the full legislative body to decide on a host of cuts to programs this year or come up with other areas to cut. The State Constitution requires lawmakers to pass a balanced budget.
Bridges said other members will have their chance to weigh in and show their own ideas for budget cuts to get the figure in balance.
“If you’re not willing to stand up there and take those consequences and say, this is what I would cut instead, then you have no right to criticize the people that are in this room standing up and making those hard decisions,” he said.
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