Do funding changes cut care for disabled people?

HUDSON–Whether changes for fiscal reasons cited by officials really support people’s needs came up frequently at the meeting of the Columbia County Community Services Board (CSB) November 20, a session that also included an update on finding a location for a special education pre-school.

The County Board of Supervisors’ Human Services Productivity Committee has mentioned the County’s outpatient mental health clinic as a possible target. Supervisor Sarah Sterling (D-Hudson, 1st Ward), a member of that Committee and the Board’s liaison with the CSB, indicated that the committee’s plans are currently too uncertain for her to report.

CSB Chair Beth Schuster and county Human Services Director Michael Cole both said that if somebody is scrutinizing or has an issue with something regarding mental health or human services in the county, they should speak directly with the CSB. “It is the CSB’s role to see adequacy of care,” Mr. Cole said.

Ken Stall, executive director of Coarc, a non-profit organization that provides services for people with disabilities, reported changes in both service coordination and workshops. Medicaid Service Coordination was discontinued a year ago, and Coarc had to replace it with managed care, Mr. Stall reported. One result was that clients had to replace their service coordinators with care managers. The service coordinators were part of Coarc’s team; the care managers work for private agencies. Some Coarc service coordinators got new jobs as care managers and continued working with Coarc clients, but “even if they’re the same people as before, they treat the clients differently,” because they now have different bosses and support a different type of organization, Mr. Stall observed.

Coarc’s workshop provided employment for many disabled people. “When we started, we had over 100 people in sheltered workshops,” Mr. Stall said. They worked at below minimum wage, with pay based on productivity. But then funding for that type of workshop was discontinued.

“Now we have integrated workshops,” Mr. Stall continued. “For every disabled person, we have to hire a non-disabled person. And everybody gets paid minimum wage. To satisfy these requirements, we must fire disabled people. Now our workshops have probably 30 people, who rotate into the integrated business two at a time. That’s the only way I can do this. Meanwhile, by the end of the year, we’re slated to lose $400,000.”

Mr. Stall also mentioned the self-direction program, meant to enable individual clients–with the help of their families, their “circle,” and the “support broker” who gets assigned to them—to “design and buy the services they want.” But “there is a shortage of support brokers. They aren’t paid enough,” he said. And “it’s the family who employs services.” But they often don’t know how to be employers and offer fringe benefits.

“You can hire anyone to be your personal support except for people living in the same house.” And, said clinical psychologist Nancy Hoag, “sometimes the proposed caregivers themselves are eligible for services. Many cases of people recommended for Self-Direct don’t have proper support. It’s disappointing for some families. And some people don’t even have family or circle support,” she said.

Mr. Stall said that currently there are about 30 families with self-direction, and there could be 100 to 200.

On another topic, Mr. Stall reported that Coarc’s special education pre-school, The Starting Place, plans to change locations, probably to the Galvan Armory, which also houses the Hudson Area Library. The Starting Place has been at Columbia Memorial Hospital since Coarc sold its building on Hudson’s Prospect Avenue. Mr. Stall thanked the hospital for its generosity but noted. “They can’t keep us forever.”

“Over a year ago, Galvan committed to” reconstructing the Armory basement for The Starting Place. But it has turned out more expensive than thought. One reason is the need have a bathroom for each classroom. Furthermore, “it’s not the ideal location,” said Mr. Stall, citing parking problems and the lack of an outdoor play space.

Also at the meeting:

• Christina Fish Acker announced she was about to leave the CSB after several years. “It’s been a privilege to be part of the board and be part of the Intellectual/Developmental Disabilities Subcommittee,” she said. “This has been a major part of my life”

• There was a discussion on getting disabled people jobs following the recent increase in the minimum wage. “Employers are looking for more productivity,” said one person at the meeting.”

The next meeting of the Community Services Board will take place at noon Wednesday, January 29 at 325 State Street in Hudson.

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