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Montana mom speaks out on state budget cuts for developmental disability care

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(MTN News photo) (MTN News photo)

HELENA – Vicki LaFond-Smith lives in the Helena Valley with her twin adult sons, Matthew and Christopher. Both were born more than three months premature.

Now 27, they each have severe cognitive and developmental disabilities, including cerebral palsy and left-side paralysis. Matthew also has autism. Christopher uses a wheelchair and requires a feeding tube.

“The twins each need 12 hours of care, seven days a week,” said LaFond-Smith.

LaFond-Smith is her family’s sole financial provider. When she is at work, her sons rely on in-home caregivers, provided through the Community First Choice and Personal Assistance Services programs of the Montana Department of Public Health and Human Services.

The care workers help her sons with needs like meal preparation, exercise and household tasks.

LaFond-Smith self-directs her sons’ care, meaning she hires and trains the caregivers, but contracted providers handle their salaries and employment paperwork.

The CFC/PAS programs are intended to allow older people and those with disabilities and special needs to remain in the community, instead of requiring more intensive forms of care.

“I want to always be able to have resources so that I can take care of them in our home, and not have them go into any institutional group home settings,” said LaFond-Smith.

But DPHHS leaders announced this year that they would have to cap the number of hours allotted for CFC/PAS services, as a response to massive budget cuts at the agency.

Gov. Steve Bullock was authorized last year to make cuts of up to 10 percent in state agency funding as a way to close a $227 million projected budget gap. He eventually announced $49 million in reductions at DPHHS, which the Montana Legislature codified during its special session in November.

LaFond-Smith first contacted MTN in January, after receiving a letter from DPHHS officially announcing the new service caps. For her sons, the changes amounted to about five fewer hours of in-home care each week.

“What it will mean is that I will not be able to work my typical eight hours a week,” said LaFond-Smith. “I would have to leave my job in order to come home and fill in those care gaps.”

She argued that the time limits – 300 minutes a week for meal preparation, 210 minutes a week for exercise and 180 minutes a week for laundry, shopping and other tasks – were simply not enough to meet her sons’ needs. She also said caregivers weren’t given enough time to come up with alternatives for the people they served. In her case, she said the reductions took effect just two weeks after she was notified.

“No one had time to adjust to that change,” she said.

Since the reductions took effect, LaFond-Smith says she has used hours of paid leave from her job as a paralegal. She said her employer has been very helpful, but that she will soon have no choice but to take unpaid time away from work.

“It’s only a matter of time,” she said adding that two of her sons’ caregivers have left for other jobs after their hourly pay was cut – another effect of the budget cuts. “It’s a domino effect."

According to DPHHS, about 1,600 CFC/PAS care plans have been reduced. Leaders say there is no standard reduction, but that total spending on Community First Choice will be cut by about $2.2 million in the 2018 fiscal year.

“DPHHS is doing all we can to minimize the impacts to the people we serve,” said agency director Sheila Hogan in a statement. “Many factors were considered in all the reductions before us, including protecting those persons who are most vulnerable and most in need. A $49 million funding reduction is painful, and the fact remains, that what we’re seeing now are the real-life consequences of the Legislature’s budget decisions in the past year.”

DPHHS leaders said they met with providers and members in October before the budget cuts were finalized. They said the message they heard was that the agency should focus on retaining core services and apply the cuts equally to all program types.

LaFond-Smith said she understands the need to balance the budget, but said the state could have found other places to make cuts. “I just can’t imagine that anything would be, or any programs would be, more important than taking care of our people,” she said.

She said she wanted to share her story to show the public what impact the state’s decisions have on families like hers. “This is real life we’re talking about,” she said.

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