Thursday, April 30, 2015

A Complicated Picture

Sometimes it pays to stay until the end. I was reminded of that at yesterday’s hearing on DDS’s FY 2016 budget before the DC Council’s Health and Human Services committee, chaired by council member Yvette Alexander (Ward 7).  DDS director Laura Nuss testified ( after seventeen other witnesses, and the chair’s very last question to her touched on eligibility criteria for waiver services and the inclusion of persons who have a developmental disability but not an intellectual disability.  The director indicated that DDA is planning to institute greater flexibility with respect to the IQ cutoff of 69 or below, but on expanding eligibility, I was concerned to hear her reply that “a better financial climate for the city” is required.  I’ve heard Laura speak much more forcefully on this subject before, and I’m concerned her answer may mean that expanding Medicaid waiver services to other D.C. citizens in need is not going to be a budget priority for the new mayor.   I continue to be encouraged, however, that the issue has the committee chair’s attention, and hopefully she’ll keep the light shining on this grave and longstanding concern.

The budget hearing ranged across a great variety of topics.  Witnesses’ testimony fell mainly into the following categories (recall that DDA and RSA both fall under the DDS budget): 

-          -- Advocates applauding DDA and strongly supporting its budget.  Several individuals currently benefiting from the DDA waiver (almost all of them receiving services from one particular provider) spoke out forcefully in this regard.  In my own testimony, I advocated in favor of the proposed budget to ensure that DDA can meet its current commitments to waiver-eligible individuals, but at the same time I pointed to the need for services to expand to others who are not currently eligible.

-          -- Advocates for the proposed increase in the RSA budget.  Several of these witnesses were from organizations that have received funding from RSA, and in the interest of transparency, I believe the council should require witnesses to disclose any such past, present, or potential financial interest in their testimony.  These favorable commentaries were challenged by at-large council member Grosso, who said he has heard from many individuals – some of whom testified in February at the performance review hearing - about substandard service from RSA.

-          -- Critics of DDS, a number of whom spoke about reimbursement rates and other policies affecting DDS providers while others addressed problems with the department’s internal personnel policies.    At-large council member David Grosso was especially vocal about this last issue, on which several individuals had apparently approached him personally.  One parent also spoke eloquently about the difficulties she has had in gaining waiver eligibility for her daughter and her ongoing struggles in getting appropriate, community-based services from DDA.  Committee chair Alexander asked whether my personal experience was similar, and I confirmed that it was, although this family’s ongoing challenges with DDA are more significant than those we’ve encountered recently.

I realize this summary won’t provide enough detail on the particular concerns that you may have, and I encourage you to watch the video of the hearing at  The hearing actually starts about 20 minutes into the video and begins with an initial panel from the Office of Disability Rights.  Then come several panels of witnesses addressing DDS issues, and DDS director Nuss’s testimony starts around the beginning of the third hour.

Finally, a word on council members’ attendance.  Committee chair Alexander was of course there for the whole time, and very engaged.  At-large member Grosso had to leave a couple of times, but had a staff member there throughout and was obviously extremely active and interested in the subjects covered, especially but not only where he saw overlap with the Committee on Education, which he chairs.  Ward 1 member Brianne Nadeau was briefly there at the beginning of the hearing and made a statement.  And the remaining member of the committee, Mary Cheh, as in February, won the prize for her utter, complete, and unexplained absence.  I hope she does not imagine there are no persons with disabilities in Ward 3.

In light of some of my past postings about the need for DDS to get more information online, I’d like to give Erin Leveton a shout-out for having provided the link to the Power Point presentation on the budget:  You should find this quite a bit more readable than the version I scanned for my last posting.

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