Thursday, September 26, 2024

DDS budget for FY 2026: in on the Ground Floor

I'm sending out a quick note today as a reminder that tomorrow, September 27, at noon, the Department on Disability Services Friday forum will be dedicated to a discussion of priorities for the FY 2026 budget.  That may seem far away, but FY 2026 will start on October 1, 2025, and preparations will begin ramping up very early in 2025.  You'll recall that DC's FY 2025 budget was much tighter than in years past (FY2025 budget update), and FY 2026 will be at least as tight.

This time, the Friday forum will require RSVPs, so contact Charlisa Payne if you'd like to be a part of the discussion:  Charlisa.Payne2@dc.gov

Thursday, September 19, 2024

DBH: Below the Tip of the Iceberg

My last blog post about bill B25-0692 ("Bill B25-0692 needs disability community involvement") has elicited a lot of comment, and also unearthed other concerns about how DBH interacts with the disability community in DC.  (See DC Disability-Related Organizations and Terminology.)

First, with respect to the bill:  I was very pleased to hear back immediately from Committee on Health chair Christina Henderson (chenderson@dccouncil.gov) in response to my blog post.  She informed me that “the legislation was not jointly referred to the Committee on Facilities and Family Services which is why there was no hearing with that Committee on this bill. At the hearing in July we had testimony from several witnesses representing the disability rights community.”  She further invited me to discuss the bill further with her staffer, Marcia Huff (mhuff@dccouncil.gov), who has since contacted me.  I’ve appreciated the responsiveness, and plan to follow up. 

But beyond the bill, my blog post surfaced another issue, this one not before the council.  That issue is the abrupt closure, in less than two weeks, of the DBH program at 35 K, which for many years has provided top-drawer psychiatric services for people with intellectual and developmental disabilities.  As best I understand it, DBH had already indicated in its FY24 budget that it was planning to phase out direct services such as this one and to redirect people toward its community implementing partners (DBH core service agencies).  However, those actually receiving the services at 35 K were only given a few weeks’ notice of the October 1 closure.  Given how extremely difficult it is to locate psychiatric services of any kind, much less psychiatric services for those with co-occurring disability and behavioral health issues, this short lead time is truly unthinkable.  DBH owed, and owes, it to the people with disabilities that it serves to provide more advance notice of proposed changes.

And we mustn’t think that it stops there.  DDS has been trying for a long while, not always with great success, to foster closer coordination with DBH.  And why? Well, think about it.  If someone calls 911 about someone with a disability:

  • If they’re lucky then a community response team (DBH community response) will be deployed instead of, or with, the police;
  • They may then be taken to CPEP, the Comprehensive Psychiatric Emergency Program location (CPEP) OR
  • They may wind up at the much-investigated Psychiatric Institute of Washington (PIW) for psychiatric detention; AND
  • In the most extreme cases, a disabled person can be charged, tried in court, and sentenced to be institutionalized at St. Elizabeth’s (St. Elizabeth's).

All of these, with the exception of PIW, are directly administered by DBH, and PIW, the only one that isn’t, receives a huge number of the psychiatric referrals from DBH.  But DBH is set up, by and large, to serve people with behavioral-health issues but not cognitive, developmental or other disabilities (and even less so, now that they’re closing 35 K!).  We’re seeing more and more people with unrecognized disabilities, or with dual diagnoses of disability and mental illness, being served by behavioral-health entities, so there needs to be even greater collaboration happening between DBH and DDS – which mostly means that DBH and the DC council need to recognize this and make sure the outreach to DDS, and to the disability community more broadly, occurs on a regular and ongoing basis.  And we, the constituents, need to watch DBH and any bills affecting DBH in the DC council, much more closely. 

Start by letting DBH director Bazron (DBH "Ask the Director") and Committee on Health chair Christina Henderson (again, chenderson@dccouncil.gov) know you have a stake in the outcome of bill B25-0692, and the DBH’s abrupt closure of 35 K.  Let your voice be heard, and do it today!

Do you know something more about this issue?  Want to correct something I've written?  Comment below! 

 

Sunday, September 8, 2024

Bill B25-0692 on DBH reforms needs disability community involvement

 This past week, DRDC-ULS (see DC disability-related organizations and terminology) brought to my attention a proposed bill, B25-0692 – now before the DC council’s Committee on Health (see B25-0692 DC council page) - which, among other things, would extend emergency involuntary detention at psychiatric facilities such as the notorious Psychiatric Institute of Washington.  The bill contains a number of other provisions as well that advocates in the hearing considered unnecessary (already possible under existing safeguards) and damaging to individual rights.  The council has not yet voted on this bill, which contains a number of provisions that could harm people with developmental disabilities in our city.  Please take the opportunity to review the video of the July 11 hearing on the bill starting around minute 50 in the- Video of July 11 hearing - in which Jaclyn Verner of DRDC-ULS (around 1 hour and 45 minutes into the video) and others raised serious issues with the bill.  

Please write and express your concern to committee chair Christina Henderson about the bill by writing to her here: chenderson@dccouncil.gov.  Ask her, at a bare minimum, to hold up the bill until a joint hearing with the committee on facilities and family services, chaired by councilmember Janeese Lewis George, can be arranged. The large number of dually-diagnosed people finding their way into psychiatric facilities requires this broader consideration.

Write chenderson@dccouncil.gov today to delay voting on B25-0692 and allow for a more thoughtful assessment of needed reforms at the Department on Behavioral Health.

Thursday, September 5, 2024

DC Disability: Housing vs. Choice?

Over the past couple of years, I’ve been part of a working group, chaired by DDS/DDA deputy director Winslow Woodland, that has been examining different options and partnerships to make housing more available, accessible and affordable for people with disabilities in DC.  The efforts this group is undertaking go well beyond DDA-funded residential supports for people who qualify for its services, but DDS has hoped that this group could help identify housing alternatives to enable it to move away from paying rent for people under the IDD waiver (see DC disability-related organizations and terminology).  DC is indeed unusual in having its disability support agency pay rental costs – most states rely on housing vouchers or other programs, separate from disability services - but in this city where so many are priced out of the rental market and the waitlist for housing vouchers can be decades long, I admit to being unsure if it’s desirable for DDS to extricate itself from paying housing costs for those it supports.  Lately, though, I’ve realized there’s another side to this coin that could complicate the future direction of advocacy in DC.

DDS/DDA has always sought to place new recipients of residential supports into vacant slots in existing apartments for which it already is paying rent.  Lately though, as the DC budget faces increasing constraints, DDA is taking a harder line on enforcement.  If you’ve tuned in to recent DDS Friday forums (Power Points and recordings), particularly this past June, you will have heard DDS officials explaining to some of DC’s newer provider agencies why they are not receiving referrals for provision of residential services.  Simply put, this is because existing providers in DC are the ones that already have available vacancies, and given budget realities, the DDS position is that it can’t incur new rental costs from a new agency when there are vacancies in paid-up apartments elsewhere. 

Why this may matter comes down to whether people are happy with the existing cast of DC provider agencies or believe that there is a need for new blood and greater choice. When advocates and families were celebrating success in having pushed through the DDERAA bill (see DC disability-related organizations and terminology) in 2022, we expected that new agencies with more cutting-edge knowledge of autism and other developmental disabilities would enter the field alongside more established, longtime DC residential providers whose expertise was shaped by DDS’ pre-2022 focus solely on people with intellectual disabilities.  What’s now becoming evident, though, is that newer providers are having trouble getting referrals as long as there is a vacancy backlog with existing providers – 60 vacancies as of June, according to DDS director Andy Reese.

This is a dilemma, and I don’t have an automatic solution to propose.  But if DDS support for housing is standing in the way of new providers entering DC, that does provide food for thought and is going to require careful consideration as we move forward to create a more inclusive service system in DC while the budget noose keeps tightening.

Do you have any thoughts on this?  If so, please enter your comments below!

Carol Grigsby is a dedicated advocate (she/her/hers) focused on advancing rights and increasing opportunities for people with developmental disabilities in Washington, DC.  I am a former member and chair of the DC Developmental Disabilities Council and serve on several committees and groups chaired by DC’s Department on Disability Services.  In addition to advocating for full inclusion of people with disabilities in our local community, I strongly support statehood for DC, where I have lived since 1978, since without that no DC resident, disabled or non-disabled, will ever be fully empowered. Opinions in this blog are my own.