Oklahoma DHS is about to run out of money to pay for care of vulnerable seniors and people with disabilities

There are honest arguments and discussions to be had about the place and role of government. However, we generally agree that the government has an important role in protecting the lives and health of Americans who aren’t able to protect themselves, including those who are elderly or have significant disabilities.

However, in Oklahoma, years of budget cuts have now compromised our Department of Human Services’ ability to fulfill this core function of government. As a result, thousands of Oklahomans who are elderly or have disabilities could lose access to vital services in just a few months. Without a supplemental appropriation, DHS doesn’t have the funds to pay providers for the care of more than 25,000 Oklahomans after April.

Years of cuts have compromised DHS’s ability to fulfill its basic responsibilities

This situation is the result of years of inadequate funding combined with a diversion of resources to make court-ordered child welfare reforms. These reforms, known as the Pinnacle Plan, have consumed what funding increases DHS has seen and then some. Divisions other than child welfare are down to two-thirds the workforce they had in 2011.

With DHS running out of administrative expenses to trim, cuts are now directly affecting clients and client services: lower staffing levels mean less oversight of child care facilities, less investigation of allegations of abuse and neglect of vulnerable adults, closed meal sites for food-insecure seniors, a temporary freeze on child care subsidy enrollment, and possibly longer processing times for SNAP and heating/cooling assistance. All told, a full third of the FY 2017 budget cuts came out of client services, including waiver programs providing care to Oklahomans who are elderly or have disabilities. In total, DHS has cut its budget by some $200 million the past two years.

Without a supplemental appropriation, DHS can’t pay waiver providers after April of this year.

Waiver programs, so called because they waive some federal Medicaid requirements, are an opportunity for states to develop programs specific to their needs. Five specific waivers operated by the state Department of Human Services are under threat now.

The Medicaid ADvantage waiver helps more than 21,000 Oklahomans in need of nursing home-level care to receive that care less expensively in their homes and communities. Four other waiver programs cover in-home and community-based care for Oklahomans with significant disabilities, including physical and occupational therapy, and assistance with bathing and dressing. More than 5,000 Oklahomans receive needed services through these waivers, with more than 7,400 people waiting more than a decade to join them.

In order to continue to pay providers for these programs after April, DHS needs a midyear supplemental appropriation. The agency is requesting $42.6 million in supplemental funds, of which $34 million would go to paying waiver providers for the last two months of the state fiscal year, while the remainder would address an adoption subsidy payments shortfall ($4.8 million) and the Pinnacle Plan ($3.8 million). 

What will happen on May 1 if the supplemental doesn’t happen or is underfunded is unclear. In order to qualify for these waiver programs to begin with, recipients have to be low-income, so it is highly unlikely that they could pay for these services out of pocket. Some elderly Oklahomans may be forced to move to nursing homes, which will only multiply the cost to the state. Providers, many of which are small, locally-owned businesses operating on very fine margins, may shut down. Between the aging and disabilities waiver programs, DHS contracts with more than 2,500 providers. Should the waivers fail, more than 25,000 Oklahomans who are elderly or have disabilities – as well as their families, friends, caregivers, and communities – will bear the brunt of the state’s failure to fund core functions of government.

The bottom line

Most disputes at the Legislature, whether it’s a teacher pay raise or a cigarette tax increase, are fundamentally about the budget. However, even with its other assorted budget challenges, the Legislature has the responsibility to find a solution that ensures the most vulnerable members of our community can access the care they need. If lawmakers don’t act soon, Oklahoma could leave our elders and those most in need of our protection in serious peril.

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ABOUT THE AUTHOR

Carly Putnam joined OK Policy in January 2014. She previously worked as an OK Policy intern. A Kansas City native, Carly graduated from the University of Tulsa in December 2013 with a BA in Sociology and Women’s and Gender Studies. As a student, she was a participant in the National Education for Women (N.E.W.) Leadership Institute and interned with Planned Parenthood. She is a graduate of the Oklahoma Center for Nonprofits Nonprofit Management Certification Program, the Oklahoma Developmental Disabilities Council’s Partners in Policymaking program, and The Mine, a social entrepreneurship fellowship in Tulsa. She previously served as board president for United Campus Ministry at the University of Tulsa. At OK Policy, Carly supervises policy staff and conducts research focusing on health care and the safety net.

12 thoughts on “Oklahoma DHS is about to run out of money to pay for care of vulnerable seniors and people with disabilities

  1. I have a parent with advanced MS. Because his disease is degenerative it means his healthcare needs become increasingly complex every year. Voters need to know that to qualify for paid nursing home care recipients must drain their assets to $2000 with only $50/mo to live on beyond their food and housing needs. The people our idiot legislators are wanting to cut such funding from usually have no other options. UNACCEPTABLE!

  2. My mother has COPD and other health issues; as well lives on a fixed income. Without Medicaid she is not able to get the medical attention that she needs. A cut in the funding is not beneficial to any elderly person, it’s a burden!

  3. This is pathetic I’ve been disabled all my life with mental and and physical disabilities it basically prevents me from working I think the government should really take a pay cut leaving people without health insurance taking benefits away from those who are born with a disability all over the years of old age is BS and it isn’t right and not fair they’re spending more for the United States military and not spending it on it’s people people are suffering are going to suffer more because of this the trying to cut Social Security now they’re trying to cut benefits state benefits off it’s not right I think Congress really needs to think to make these people accountable for stealing money out of state budget and Social Security they should be punished if they’re caught or if something doesn’t add up because people paid into this people pay taxes and the thing that I don’t get where the hell is the money going

  4. I have been a speech pathologist for 25 years and have seen the effects of illness and the need for assistance both in my practice and now in my personal life. I am sure that people who utilize assistance truly do need assistance and that many people are not getting the assistance that they need. Lack of legal assist lends itself to illegal resources and the furtherance of unhealthy behaviors, prison sentences and even death. It is not only physical fragility, but mental illness that is being unattended. I must say that as a person who identifies as a Christian and living in the “Bilble Belt”, I find it to be both a terrible tragedy and horrifically hypocritical that the so-called Christian Right can be so amazingly heartless in caring for our brothers, sisters, neighbors. I suggest that if a person considers themselves to be centered in goodness, that they make an effort to speak up on behalf of the suffering and the needy. I am distressed with Oklahomans. This situation is undeniably “Not Ok.”

  5. I have a dear friend who is in a wheelchair and home-bound because of her various disabilities and medical conditions. She is able to stay in her home and out of a nursing home because of the Medicaid ADvantage program which pays for her in-home aide care. This program not only helps her, but saves the state on the much higher cost of nursing home care.

    She will be devastated if the legislature cannot give the supplemental appropriation so desperately needed by DHS to pay for her care and all of the other vulnerable in our state.

    As a Christian, I know that Jesus said, “As you do unto the least of these, so you do unto me.” It is time to act on these words.

  6. I have a dear friend who is in a wheelchair and home-bound because of her various disabilities and medical conditions. She is able to stay in her home and out of a nursing home because of the Medicaid ADvantage program which pays for her in-home aide care. This program not only helps her, but saves the state on the much higher cost of nursing home care.

    She will be devastated if the legislature can’t/won’t give the supplemental appropriation so desperately needed by DHS to pay for her care and all of the other vulnerable in our state.

    As a Christian, I know that Jesus said, “As you do unto the least of these, so you do unto me.” It is time to act on these words.

  7. I have emailed you …posted about programs that are more than duplication….
    I contacted groups when I found out that before the Oklahoma autism law…which I find to be horrible..because it now limits coverage..
    When coding and education could have gotten more coverage
    And pleading for grants for a physical reason to get coveage for PT. OT, and social skills ….I have prescription from an orthopedic surgeon for PT, for spatial body awareness …
    But people don’t want to listen.

    You continue to support the program Sooner Success. The programs we have have don’t know enough about resources..often gave me wrong information and don’t want kids with disabilities to succeed.

    I offered innovative ideas… Outsource the business part of an entity…

    Grants often give to a nonprofit so key groups…the children of those that run the groups benefit most. The grants mostly benefit those that run the nonprofit.

    Sure the nonprofit benefits others but all the politics is played so the game is played.

  8. I’m on a court-ordered psychiatric medication plan, and I am ecstatic about this lack of funding! I can’t wait until they run out! They have violated my constitutional rights and my privacy. I want them back, please. This is frickin awesome!

  9. I can’t believe their budget is this big to begin with! No wonder this state is over spent if each agency is as bloated as this!

  10. I can’t believe their budget is this big to begin with! No wonder this state is over spent if each agency is as bloated as this!>>>What an uninformed comment. You have absolutely no idea what is being spent without a detailed breakdown and for you to assume from a very basic pie graph that this agency is “bloated” is overly simplistic on your part. Do your research, discover what is actually being spent before you condemn a whole agency that I’m sure helps lots of people who are in dire need.

  11. This blog breaks my heart, and I can’t believe that they do all the things to have elder’s a comfort place to stay and have a good food to eat everyday to maintain their health and for the medication that they are taking. I am praying for the recovery of this institution that they have a good intention for the state. Best of luck everyone!

  12. Why can’t the lawmakers take a pay cut instead of taking away from programs so badly needed by older Oklahomans and the disabled? We pay our lawmakers way too much when they are having to resort to taking help away from the people who need it most! No one should have to suffer without care and assistance they need, nor should they have to make decisions like going without their meds or going without food, and trust me there are some who have to make hard decisions like this! Our law makers should be ashamed of themselves!!!

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