Retroactive Budget Cuts for the Disabled

PROVIDENCE (CN) – After cutting funding for the developmentally disabled last year, Rhode Island did it again in May, and this year’s 12 percent cuts will force caregivers to reduce or eliminate essential services to patients, and lay off staff or not pay them, 14 nonprofits claim in Superior Court.

     Plaintiffs, including United Cerebral Palsy of Rhode Island, include caregivers and patients who receive state funding.
     The state notified the nonprofits on May 6 that effective May 1 – 5 days before they were give notice – Rhode Island would “institute a rate cut across all services for the months of May and June.” The notice states that each individualized funding plan [see below] would be reduced by 12 percent.
     But the plaintiffs say the state intends to make the cuts permanent, and possibly even more severe: “Upon information and belief, from July 1, 2011 to December 31, 2011, the state intends to maintain, and possibly lower, the new unilaterally imposed funding levels for all of the corporate plaintiffs’ clients.”
     The patients and caregivers say they were not given notice of the budget cuts and so had no opportunity ability to appeal them. They are particularly aggrieved because the state reduced funding in July 2010, forcing the caregivers to lay off staff, reduce services and withhold raises.
     “The corporate plaintiffs cannot maintain the level of services and abide with the requirements of the certification and/or BHDDH’s [Rhode Island Department of Behavioral Healthcare, Developmental Disability and Hospitals] regulations if the state’s latest unilateral reductions in funding are not reversed,” the complaint states.
     State law requires the Department of Behavioral Healthcare, Developmental Disability and Hospitals ensure that the programs it oversees receive “such developmental, supportive and ancillary services as prescribed in an individualized program plan developed with the participation of the developmentally disabled person.”
     The department defines “individualized plan” as “the personalized document which describes specific supports for a person with developmental disabilities in such areas as vocational, social, medical and supportive living, and includes long term goals and objectives responsive to the individual needs of the person.”
     Eligible developmentally disabled people choose one of the plaintiff corporations for services and the corresponding plaintiff provider creates an individualized plan of service, which it sends to the Department of Behavioral Healthcare, Developmental Disability and Hospitals.
     The department then enters into a standard “Certification Agreement” with the provider, whereby it agrees to supply a specific amount of funding for services for the individual client for one year without adjustment, unless a new category of services is required for the person. The funding for clients is determined on Jan, 1 of each year and expires on Dec. 31.
     During the year, the caregiver plaintiffs forward a retroactive invoice to the state at the beginning of each month for services provided to residents during the previous month. The ratio of state aid to federal aid is 38 to 62 percent, according to the complaint.
     The plaintiffs say the state did not comply with federal regulations, laws that govern changes to federally funded programs, and failed to conduct studies to determine the effects of its funding reductions.
     They want the state enjoined from carrying out the budget cuts, as their annual budgets are based on the funding agreements they entered into with the state at the beginning of the year.
     They say that if the state is allowed to make such substantial cuts, they will not be able to maintain “sufficient qualified personnel to provide support services to meet the needs of persons choosing the services offered by the agency.”
     Plaintiffs’ lead attorney is John Breguet with St. Peter & Kasle, of Providence.

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