House panel rejects bill to redirect spending to community care for state’s disabled population

A bill that would have required the state Department of Human Services (DHS) to redirect spending for people with disabilities from institutionalized care to community-based services was narrowly defeated on Tuesday during an emotional debate at the State Capitol.

In the packed House Public Health, Welfare and Labor Committee, Rep. Josh Miller, R-Heber Springs, began the panel hearing with strong backing from a roomful of supporters that traveled from across the state. Under HB 1300, Miller said DHS and the Arkansas Medicaid Program would study and redirect state funds if necessary to fully pay for community-based services for some people with disabilities now in the care of the state.

The program would also eliminate the current waiting list under DHS’ so-called “Development Disabilities Waiver,” which offers community-based services to nearly 3,000 individuals as an alternative to placement in an institution. In speaking for his bill, Miller told the House committee that people with disabilities have not had an advocate at the State Capitol for more than a decade on issues that affect them.

“If they had, my guess is they wouldn’t have a waiting list today. I think it is time to we do something simply because it is the right thing to do,” said Miller, who is disabled and uses a wheelchair. “We are trying provide an opportunity for these individuals and their families to have the ability to lives their lives the way they want to and to the fullest capacity possible.”

Miller said many lawmakers were opposed to his legislation because it would force DF&A to prioritize care for individuals with development disabilities who have been on been on the waiting list for upwards of 10 years in hopes of receiving home or community-based care.

Under the waiver program, persons with disabilities may receive additional services such as case management, support living assistance, non-medical transportation, adaptive equipment and crisis intervention help through the state division of Developmental Disabilities Services’ DDS’ licensed community providers.

“This bill will force some tough decisions. Do these folks behind me and in this room today deserve to continue to be swept under the rug and out-of-sight while we rush out of here to spend millions of dollars on healthy, able-bodied working adults?” Miller asked. “I’m not trying to have that debate, but just asking the question: ‘Do these folk not deserve the same priority.’”

Following Miller’s emotional plea, DHS’s Chief Legislative Officer Kelley Linck and Melissa Stone, director of the state’s DDS unit, spoke against Miller’s bill. Stone told the panel that DHS spent $56.7 million in fiscal 2016 to serve the individuals on the waiver list, and estimated her division would need another $43 million in state general revenue funds for other services through the state Medicaid match.

Stone said she personally shares the same view as Miller that paring down the waiting list needs to be a state priority, but said implementing HB 1300 in three years would be difficult because of state budget constraints and uncertainties.

“There is a row of clients sitting on the back row that we don’t necessarily want to come up here and oppose this because … many of them are in foster care and they are all waiting on DDS waiver services,” she said. “So, this is a very hard thing to say. We are opposing it based on financial restrictions. We do not have current funding to serve the waitlist as we are currently operating.”

In response to questions from lawmakers on the financial impact of Miller’s legislation, Linck said DHS officials are unsure of how the state will be impacted with expected changes in Medicaid and federal programs under the new Trump administration.

“We are not sure what is going to happen federally. We think positive things, we think there will be more open doors and more opportunities, but we can’t guarantee that today,” said the former Republican legislator who was hired by DHS nearly a year ago. “We know there are more stepping stones. We just don’t know where they exactly are in the water.”

Following testimony by the DHS officials, several individuals on the DDS’ waiver waiting list and their families came to the podium and pleaded with lawmakers to support Miller’s bill. Mark George told lawmakers that his daughter Tessa, who has Down’s Syndrome, had won a landmark case in 2003 against DHS when the state’s waitlist was at zero.

“During several previous meetings of this committee, you have heard about someone who has sued the state over the waitlist. I thought you might be interested in meeting the plaintiff,” George said, introducing his smiling 19-year old daughter. “Since that time, Tessa’s life has not been about her disabilities, but has been a testament to her abilities.”

After testimony from a long line of the bill’s supporters, lawmakers engaged briefly in discussion for and against the bill. The last speaker, Rep. Aaron Pilkington, R-Clarksville, called Miller’s proposal an “unfunded mandate.”

“I feel like we’ve already got a budget shortfall, we just cut taxes and we are now going to put another $54 million hole in our pocket for people that are already receiving benefits,” Pilkington said. “I mean this isn’t an easy vote, but we can’t let emotions trump logic here.”

Immediately afterward, the House panel rejected the bill following a close voice vote. Following a roll call, Miller’s legislation was rejected by a tight margin of 7 “nays and 6 “yeas.” Several lawmakers on the panel also did not vote or were absent during the hearing.

Earlier in the meeting, the House committee also approved HB 1267, a bill sponsored by Rep. Lanny Fite, R-Benton, which would overhaul the state Department of Environmental Quality’s (ADEQ) current waste tire program to create a used recycling fund for used tires.

Fite’s legislation, which is part of Gov. Asa Hutchinson’s list of legislative priorities for the 2017 session, would also create an electronic manifest system developed by ADEQ to keep track of used tires that are recycled, resold or end of up in state landfills or illegal dumps.

Currently, the program is funded through fees placed on the purchase of new tires and collected by tire dealers for DF&A, which deposits proceeds into a grant fund administered by ADEQ. Funding goes to waste tire management districts throughout the state that implement all facets of waste tire management, including collection, transportation, recycling, disposal and abatement projects.

“This bills brings accountability and efficiency to government,” Fite said.