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COVID-19 in Maryland Health Care

With State Budget Woes, Advocates Fear for Future of Developmental Disability Service Providers

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Like many others in this uncertain time, Linda Cades of Kent County is a concerned parent.

Her adult son, Aaron, is a client at the Kent Center in Chestertown. Although Aaron is 41 years old, Cades said his developmental disability causes him to function “at about the level of a 5-year-old,” and he can’t be left alone.

“If one of us is not there to take care of him, somebody else has to be there,” she said at a virtual rally held by the Maryland Association of Community Services on Monday. “And since 1999 when Aaron turned 21, that someone has been Kent Center.”

Cades said that the Kent Center supported Aaron during the day as she and her husband worked before they transitioned him into a group home two years ago. 

They pulled him out when the COVID-19 pandemic hit and his programs began to shut down. For now, she and her husband are providing most of the services that Aaron was receiving. 

She says her biggest fear is the Kent Center’s possible dissolution.

“I am not immortal. My husband is not immortal,” Cades explained. “What if we don’t survive the pandemic? Who is going to take care of Aaron when we’re gone if Kent Center or other service providers are not there?”

Because of the COVID-19 pandemic, Maryland has seen a massive decline in revenue, and with the state staring down the final days of the 2020 fiscal year, that could mean budget cuts for the Developmental Disabilities Administration, which funds programs like Aaron’s, as the 2021 budget sets to kick in.

“Every parent has this terror that our kids are going to end up on the sidewalk somewhere because there isn’t any center, any group home, any place for them to live,” Cades said. “DDA needs the funding that they require to support Kent Center and all of the other service providers so that they can support us. We cannot do without them.”

Ande Kolp, the executive director of the Arc Maryland, told attendees that over 17,000 Marylanders benefit from the Developmental Disabilities Administration.

Kolp said that these individuals have already been negatively impacted by service cuts brought on by the pandemic, which funding decreases will exacerbate.

“DDA providers are Medicaid providers, so that means they’re dependent on the state for most of their funding, and they can’t pass on any extra costs to their customers — it’s not allowed,” Kolp explained. “So any cut, any increase in costs that we endure or any cuts to our funding can have massive impacts to our community and the people we support.”

Kolp said the Developmental Disabilities Administration’s current budget rests around $1.3 billion, with a 4% increase planned for fiscal 2021. That $52 million increase would keep service providers on track with Maryland’s minimum wage acceleration plan, which is set to gradually increase to $15 by 2026. 

“In a state, that sounds like a lot of money, but in a state of our size it isn’t a ton of money,” Kolp said, adding that at least half of the state’s funding for developmental disability services comes from the federal government.

Advocates have reportedly not heard about specific threats to Developmental Disabilities Administration funding, but are prepared to fight should it reach the chopping block.

Senate Budget and Taxation Committee Chair Guy J. Guzzone (D-Howard) said he understands the state is in dire straits when it comes to revenue loss, but believes the Developmental Disabilities Administration should remain a top priority.

“I certainly understand the situation that we are in throughout the state, the nation, the world — the financial concerns that we have, but I keep coming back to, again, those things that are essential, we must protect,” Guzzone said. “And those things, again, that we must protect with a level of quality and assurance of care. And that’s why we need to step up.”

Guzzone said that, because the General Assembly is not in session, lawmakers “are sort of in the same place” as civilians who champion disability services right now.

“We’re going to be advocating to the members of the Board of Public Works that cuts not be made,” he told attendees. “We don’t have an immediate, direct control over that.”

Del. Kirill Reznik (D-Montgomery) described the budget as a “reflection of the state’s priorities,” and because the General Assembly’s leadership at this time has not made the decision to reconvene for a special session, those priorities lie at the feet of the BPW — Gov. Lawrence J. Hogan Jr (R), Comptroller Peter V.R. Franchot (D) and Treasurer Nancy K. Kopp (D).

“And so the question really comes down as what are their priorities?” Reznik said. “There are many options that are obviously on everybody’s table, but we need to make sure that the 4% [budgetary increase] goes forward in the best way that we can.”

Reznik told advocates that saving their budget increase is a matter of emphasizing the impact of developmental disability funding — and what a lack of it could mean. 

“Not all programs are made the same — not all programs have the same impact,” he said. “And in this particular case, DD funding could be the difference between life and, in some cases, death for folks, and the members of the Board of Public Works have to understand that.”

Reznik told rally attendees that because of the ongoing public health crisis, he, Guzzone and others will be left to advocate — not legislate — until the 2021 session begins in early January. 

Reznik said that “at least one member” of the legislature is recovering from COVID-19, and that reconvening would be a risk not only to the well-being of lawmakers, but also the public. 

“It wouldn’t be a short special session,” he said, noting that Hogan vetoed a series of high-profile bills that would need to be overridden. 

“It will take time to come back and override every single one,” Reznik explained. “And we can’t just leave a few for the next session. We have to do it all at once or we won’t get the opportunity to get the ones that we missed.”

‘You needed me’

Advocates aren’t just worried about what could happen to their family members, but fear for the future of those who take care of them, too.

Chris Collins, a client of Arc Maryland, is concerned about his direct service professional, who he said helps feed and bathe him. 

Collins, a former high school football star, became a quadriplegic in 2005. Before Collins found Arc Maryland, he was living with his mom in an inaccessible home. He said that the agency’s residential program and the care he receives gave him his social life back.

“When I became a member of the Arc residential program, I became, you know, more free,” he said.

Collins asserted that if their wages are cut, direct support professionals would be able to earn just as much as if they worked at a fast-food restaurant.

“But they do it because they care for us,” he explained.

Some care so much that they have put themselves in harm’s way.

Derek Gross, a direct support professional at Creative Options in Baltimore City, quarantined himself with a disabled COVID-19-positive individual for two weeks to ensure that he had access to everything he needed to pull through. 

He said that the individual’s family would not have been able to safely help him.

“He needed me; my executive director Dr. [Monica] McCall needed me; the state of Maryland needed me; you needed me to be on the frontlines and I was there,” Gross said. “Please do not cut the budget. There’s a need for more of me — more DSPs — to be there.”

McCall said that even before the onset of the pandemic, Creative Options needed assistance to maintain its direct support professionals and pay them a reasonable wage. She told rally attendees that the pandemic has more clearly cemented their place as “essential frontline employees.”

“DSPs have always been our essential frontline employees and they must be provided a wage that would not require them to work multiple provider agencies in order to support their household,” she said. “We have to see what they’re doing and what they continue to do, and Derek and other DSPs deserve a wage to support their family’s household and the resources required to keep them safe while they take us through this pandemic.”

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With State Budget Woes, Advocates Fear for Future of Developmental Disability Service Providers