A Step Backward for Developmentally Disabled Vermonters

Challenges for Change, Vermont’s government efficiency plan, has a tough act to follow when it comes to improving services for Vermonters with developmental disabilities—life-long cognitive or intellectual disabilities that usually makes independent living impossible. More than 20 years ago, Vermont began a community-based care system, which allowed the state to close the Brandon Training School. Vermont now has a nationally recognized program that produces better results for far less money—the goal put forward by Challenges for Change this year.

In the early 1990s, the annual cost of care, in today’s dollars, was $289,176 per person living at Brandon Training School. Vermont’s community-based system now costs less than one-fifth that amount. More important, because people can now stay in their homes and communities, their quality of life is better.

A recent Department of Disabilities, Aging & Independent Living (DAIL) analysis concluded that the agency already had wrung most of the inefficiencies out of its current community support system. If Challenges for Change can, in fact, improve the lives of more Vermonters, it is worth pursuing. But it shouldn’t be an excuse for service reductions that create more hardship.

That’s what happened after the last round of cuts. In response to the worsening recession, the administration and the Legislature cut the fiscal 2009 budget twice in the months after it was approved. About $5 million of the cuts fell on Developmental Disability Services ¹  and the 15 non-profit organizations that provide community-based services. This may look like a small amount, but even relatively minor cuts can exact major consequences.

The cuts hit the 3,734 Vermonters receiving services, in addition to thousands of home providers, family members, and agency employees. About a third of those receiving services live with their families and get minimal state support of up to $1,000 per year. Of the remaining two-thirds, more than 700 live with their families with the help of community and employment supports, respite care, case management and other supports. Most of the rest receive home support—they live with or are supervised by an agency staff person or contracted worker and do not live with family.

Most people receiving developmental disability assistance will never be able to live independent of services, although the level of help can vary over a person’s life. Respite services, home supports, community supports, and work supports are all critical functions in the community-based care system the state has established. When any or all of the services are cut, the person’s living situation—stable, beneficial, and cost effective—is disrupted.

Reports compiled by the state in early 2009 detailed some of the program changes necessary to accomplish the state’s budget cuts. Here’s how those changes affect people with developmental disabilities: ²

• Reduction of respite services and/or home supports for at least 600 individuals. About 50 percent of Vermonters who receive developmental disabilities services live with a family member, and respite services allow many of these family members a necessary break. Cuts to respite care mean that a family member may no longer be able to care for a person at home, requiring a more expensive, less beneficial living arrangement. The majority of people who receive home supports are living with a contracted home provider, for whom respite is a necessary part of the arrangement.
• Reduction of community supports. This year, 1,514 individuals are receiving community supports, which are designed to develop skills, social supports, and positive growth for individuals. The availability of community supports also often allows a family caregiver the opportunity to have a job. But the cuts have curtailed the amount and type of services available and limited family work opportunities. In Rutland and Washington counties community supports have been reconfigured. Individuals are now being supervised as part of group day programs, which tend to segregate people from the community—reversing the philosophy the state has embraced for the past 20 years.
• Elimination of funding for the purchase of sensory-related items, communication needs, therapies, fitness and health activities, and adaptive equipment. These cuts affect 340 people.
• Elimination of 70 full-time positions in the 15 non-profit organizations, and pay cuts, reduced hours, or both for 130 more workers. Some of these were case managers, the people who ensure that appropriate services are delivered for the lowest cost.

If Challenges builds on Vermont’s success, it can help many Vermonters with developmental disabilities live more productive and independent lives. But if the plan is simply a fig leaf for cutting the budget, it will further harm people and undermine years of investment in a successful system of care.

Source: Developmental Disability Services, Vermont Developmental Disabilities Council

Download a PDF of the fact sheet.

1. A service of the Department of Disabilities, Aging & Independent Living (DAIL) in the Agency of Human Services.[↩]
2. This is based on service reduction plans prepared as part of the administration’s fiscal 2009 budget rescissions by the nonprofit agencies who provide community-based services to developmentally disabled individuals. While those cuts have been enacted, there has not been a follow-up survey of the agencies to document which actions they have actually taken. This report assumes that the service reduction plans from fiscal 2009 have been implemented.[↩]