Mom's suit against DSHS: 'I'm still fighting, it's the right thing to do'
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SEATTLE -- The Pfaff family is among other families at the heart of what could be the biggest DSHS payout in our state's history -- at least $110 million.
It could be big money to taxpayers, but it was also big money to the tens of thousands of families who saw benefits to just some disabled people cut.
Those families wonder how the state could have made what they consider a heartless decision, and they wonder why the state continues to fight a case they have lost over and over again -- particularly since every month of delay is nearly $1 million more in interest.
The Pfaff's daughter Natasha had a disability that was almost invisible at first: A birth defect that left her subject to massive brain hemorrhages. Surgery after surgery couldn't fix the problem, and the brain bleeds took away more and more of Natasha.
"And it was horrible," said her mother Maureen Pfaff. "She lost her colon, she had pancreatitis, she got MRSA pneumonia over and over and over."
Eventually, Natasha couldn't walk or talk or see. In spite of urgings to institutionalize her, Natasha's mother Maureen refused.
"Nobody else can take care of your child like you can," she said.
At 18, the state began paying for Natasha's care. But the family didn't realize the state reduced her benefits by 15 percent just because her mom was her caregiver.
"The people who were being short-changed here were severely disabled folks," said attorney John White.
White says in 2003, DSHS arbitrarily decided to save money by cutting care payments to disabled people who lived with their caregiver -- like Natasha. It affected more than 38,000 people.
"It's not right to balance the state budget on the backs of severely disabled people who aren't able to defend themselves," White said.
After several courtroom losses, DSHS reversed itself. A lower court decided the state owed $95 million to those thousands of families.
But the state hasn't paid and interest keeps piling up. Today, the bill is nearly $110 million.
"After my daughter's passed away, I'm still fighting but... it's the right thing to do," Maureen Pfaff said.
Maureen Pfaff says it's not about money, it's about people.
"Hopefully they will not do something like this again," she said.
DSHS has appealed the award to the State Supreme Court. They've declined an interview but said in a statement emailed to KOMO News: "The judgment in this case is unprecedented and undermines the fiscal planning needed for all DSHS programs" and "is detrimental to the people who rely on funding for DSHS Services."
It could be big money to taxpayers, but it was also big money to the tens of thousands of families who saw benefits to just some disabled people cut.
Those families wonder how the state could have made what they consider a heartless decision, and they wonder why the state continues to fight a case they have lost over and over again -- particularly since every month of delay is nearly $1 million more in interest.
The Pfaff's daughter Natasha had a disability that was almost invisible at first: A birth defect that left her subject to massive brain hemorrhages. Surgery after surgery couldn't fix the problem, and the brain bleeds took away more and more of Natasha.
"And it was horrible," said her mother Maureen Pfaff. "She lost her colon, she had pancreatitis, she got MRSA pneumonia over and over and over."
Eventually, Natasha couldn't walk or talk or see. In spite of urgings to institutionalize her, Natasha's mother Maureen refused.
"Nobody else can take care of your child like you can," she said.
At 18, the state began paying for Natasha's care. But the family didn't realize the state reduced her benefits by 15 percent just because her mom was her caregiver.
"The people who were being short-changed here were severely disabled folks," said attorney John White.
White says in 2003, DSHS arbitrarily decided to save money by cutting care payments to disabled people who lived with their caregiver -- like Natasha. It affected more than 38,000 people.
"It's not right to balance the state budget on the backs of severely disabled people who aren't able to defend themselves," White said.
After several courtroom losses, DSHS reversed itself. A lower court decided the state owed $95 million to those thousands of families.
But the state hasn't paid and interest keeps piling up. Today, the bill is nearly $110 million.
"After my daughter's passed away, I'm still fighting but... it's the right thing to do," Maureen Pfaff said.
Maureen Pfaff says it's not about money, it's about people.
"Hopefully they will not do something like this again," she said.
DSHS has appealed the award to the State Supreme Court. They've declined an interview but said in a statement emailed to KOMO News: "The judgment in this case is unprecedented and undermines the fiscal planning needed for all DSHS programs" and "is detrimental to the people who rely on funding for DSHS Services."
DSHS, and CPS have, from day one, have been state agencies that have cost the state billions
in law suits. They are out of control and this issue is just another indication of their total and
complete incompetence.
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Both agencies need to be rebuilt from the top down, or simply shut down and be replaced
with competent individuals without the current top heavy make up of the current agencies.
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Too many are in the management levels, and there are not enough case workers.
I don't see DSHS, cutting benefits to undocumented people, and their families. On the east side of the state, they even get their phone and internet services paid for.
This may be a sad story, and I'm truly sorry for the families affected by this, however, why does this lady believe that she has the right to a free lunch? I don't want one penny of my tax dollars going to this freeloader.
 @Smashquail She doesn't believe she has the right to a free lunch.  She believes that she has a right to be paid for the hours she worked.  Don't you believe that as well?
The State of Washington, City government, and everybody with a rubber stamp as part of their toolkit needs to have a real awakening. Weed out fraud and abuse and then do the job you are supposed to do. That is NOT to take whatever power you think you have, and make people who need help suffer any more than they already do.
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My wife and I have worked since we were teenagers. We've paid taxes and paid our bills. Until about two years ago we were doing okay. My wife was dealing with some health issues and was treated like dirt by her work. She dealt with her medical problems, but before she could return to work full time, her boss got rid of her. This was a job with the City mind you. We lived on her retirement money while she looked for suitable work. She had always been the wage earner. I never earned nearly what she did. After a few months we couldn't justify her COBRA payments ($1300 a month), so we lost health insurance. In this tough economy she couldn't find anything that was going to pay the bills. And believe me she heard "you're overqualified" a lot as she started to apply for jobs with much lower salary.
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In May of last year we found out she had cancer. I was advised by social workers at the hospital to apply for help. Without them I would not have known where to turn. I thought going online would point me to a quick answer, but navigating through the deluge of information never got me a clear answer. I got word a couple of months later that my paperwork had been received by DSHS and they had me fill out some more information. So here we are, both of us unemployed, and my wife desperately ill. We had no income so I had to ask friends and family to help out while we waited for DSHS to approve her benefits. They, in their wisdom, deemed the money we were scraping together as "income" and denied our benefits. I called the "customer service" number only to reach an untrained, and uncaring dolt (after about 45 minutes in their queue) who's first response to my plight was, "Andâ¦?". After a twenty minute battle over the fact that we actually had NO INCOME, he finally said he could put me in for a fair hearing on the decision. He literally sighed out loud as he started that process.Â
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A couple weeks went by and nothing. I decided to go into the local office. You may think that would yield better results. Not so fast. You wait for one, maybe two hours before you get to see one of their braniacs. You think they are inputting the information you are giving them into some system that is going to straighten everything out. That does not seem to be the case. I ended up making several trips down there, each time talking to somebody different who, guess what, usually had a different answer on how everything was supposed to work. When I finally thought I had resolved the problem, it would come right back in a week or two. And I in turn would have to come back to their office and go through it all over again. Fortunately another social worker advised that we should apply for Social Security Disability since my wife would probably not be able to work for quite some time. That office had their own issues, but she was approved in a rather short time due to their "compassionate allowances". Quick approval does not mean quick payment as SSD has a FIVE MONTH waiting period before they payout any benefit. They acknowledged that she was disabled in May. They acknowledged that there was no way she could work. But we had to go five months before receiving any money. So we had to rely on DSHS. All they were going to do anyway was pay for food and medical. We still had other bills to pay. So we've been borrowing to keep a roof over our heads and heat in the home. Then, in their ultimate wisdom, DSHS decided that since we were going to be getting all this money from SSD, that they should cut my wife's benefits. Let me remind you that she hadn't actually gotten any SSD benefit yet. That was another three or four trips to the local office. In the mean time our food benefit would disappear, and the medical would become inactive. Imagine trying to treat cancer and you can't even tall your doctor or pharmacist if you do or don't have any type of insurance. And during their spend down period you pay out of pocket for any prescriptions. I've sent in receipts to DSHS two months ago and haven't gotten any indication whether they are going to pay us back a dime.
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About a two months ago we finally got a letter about our fair hearing. A week later we got another letter saying that since my wife was now getting SSD that the fair hearing was null and void. We had to send back a signed letter agreeing with that fact. Then they sent another letter telling us that we would not need or get a fair hearing: the hearing that was about benefits originating in May.
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We worked for years and years and paid our bills and paid our taxes. We earned the right to those benefits. My wife now has been told that her cancer has returned after months of chemo and radiation. Her Oncologist told us she had at the most a month left on this planet. What really sticks in my gut is that she has had to deal with the stress of DSHS's ignorance all of this time. We're not going on vacations or buying diamonds and gold here people. We lost our house and our car. It just saddens me that her last few months with me has had so much that time taken up, worrying about keeping the lights on. What maddens me are the comments by some of you in this forum. I'm personally glad they stuck it to DSHS. That "organization" needs to get it's own house in order. Clear our the riff raff that work there and hire new. I'd love to see them try to navigate the DSHS waters themselves.
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DSHS is right to appeal this all the way to the Supreme Court if necessary.Â
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This mother brings great shame to the memory of her daughter.Â
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"From 2003 to 2007 DSHS applied a version of the âshared living rule.â Home care clients who lived with their care providers had an automatic reduction of approximately 15 % in their hours. This reduction took into consideration that these providers perform all or parts of certain home care tasks, such as meal preparation and housekeeping, that benefit them. The rule maximized the distribution of limited Medicaid funds to needy individuals. The rule did not reduce the care a client received; it recognized a legal requirement that Medicaid funds not be used to pay for services that benefit non- Medicaid clients."
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I can only imagine how horrible this must be for a parent. It's a terribly sad story. But, as a tax payer, I loath this person and the law suit she's bringing on tax payers. The state (all of us who pay taxes) generously helped this person with money for care and surgeries, and now she sues us. Yes, it is about the money, and no, I don't think we should give her another dime. Maybe the 15% difference in benefits she received isn't fair, but life isn't fair, and we the taxpayers have already paid a lot. This is a selfish lawsuit from somebody who feels entitled to more than she was already given. In exchange we should send her a bill for all the money she has been given, and the money the lawsuit has already cost the state. Sue her and take it all back.
 @Bellevue Scott She actually isn't "bringing a law suit on tax payers".  The courts have already decided this issue, and the decision was against the state.  The state, however, is refusing to pay what the courts decided. Â
It doesn't make sense that they cut the benefits if the person lives at home with family as their caregiver. Wouldn't that be less expensive than paying for them to stay in a full care facility and paying for someone else to care for them?  Once again....our states budgeting makes no sense!
The state figures, in its infinite wisdom, that if it takes long enough everyone it owes money to will die.
I truly sympathize with this family...DSHS is the most deplorable, inept  government bureaucracy in the state.
Hopefully Inslee will shake it up and get rid of the incompetents..
Somehow in our Society we have become conditioned that our problems belong to everyone else and everyone should pay. Good families take it on the chin and do what is necessary for their children by taking care of them and not looking for someone else to pay the way. I have never expected anyone to pay for my child care, it is something I do because I love them and it is my responsibility.
 @darkhelmet I think it's great that you pay for your child care.  However, what this is about is care for adults.  Adult children.  Most of us expect and plan to take care of our children until they are 18.  Some of us, though, end up with children that need care for their entire lives.  Some of the families recognize that they are not able to care for their adult children, and many of these children end up in care facilities, which are paid for by the state (since they are adults).  Some of the families, though, believe that they can provide better care at a more reasonable cost by caring for the children at home.  They get paid for that service at the incredible rate of $10/hour.  And they do not typically get paid for all the hours they work. Â
So if you are still providing 24-hour care for your child when they are 30, then I think you can weigh in on this subject. Â Until then, perhaps you should keep your opinions to yourself; that way you will not sound quite so unintelligent.
So 15% was the expected kickback amount to the politicians.
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But overall this seems like a good idea. If the parents are better caregivers then pay the parents to be the caregivers. Now if they can just do that for homeschoolers we would have a generation of children who would dominate higher education.
@Iconoclast Homeschooling your children is a choice and I see no reason why in addition to paying for our over bloated school districts we should have to cough up even more to pay for those who choose to homeschool their children.
why are we (taxpayer) obligate to pay for the care?
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Fed & state gov't's carefree social programs pretty much bankrupted this country (among other programs & issues), so a 15% reduction in pay to care for their own child make one jump on the lawsuit bandwagon? Â Get a life!Â
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@BellevueRes By your logic, everyone needs to hire an outside stranger to take full advantage of this program. Look it over; if you are going to pay someone who doesn't know the person or someone who does (parent?) who would you choose?
 @BellevueRes Social programs are not what bankrupted America.
Zeke123, I hope that you stay in prime health. I hope that nothing happens to you that you ever have to deal with DSHS. Because once your health fails and you don't have the ability to keep your job which means you lose your ability to pay for your food, you lose the ability to care for yourself, you lose the ability to keep you nice warm house, you lose EVERYTHING.
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DSHS like to forget that it CAN happen to them. There are some people, myself included, who have had all the things in life just about taken away. As of this writing I am waiting for my SSI to kick in and DSHS has decided that I can get $197/month to try to keep an apartment. Oh, sure, food stamps are nice, but if you have no house, well, you really have nothing.
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There are people out there who are fighting to get what belongs to them because, all the governmental people forget that not everyone has a nice cushy job that pays for EVERYTHING.
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So, let's all take a walk down to DSHS, you, me, the others out there who have nothing and then those of us who have nothing can show ALL of you what it's like to live on nothing. Trust me, it sucks!
@Grey Wolfe Unfortunately this is as a result of the breakdown in families. It used to be families took care of their own, now it's just easier to let the governement take care of everything for everyone. But since the above woman isn't suffering for lack of income and it's just to prove a point perhaps she could give the taxpayers a break since she seemed to manage just fine on 15% less.
It's all about the money! She is lying since, she says it's not. This is one system they should do away with. Then all the freeloaders- Leaches would have to fend for themselves and get a job like the rest of us. As far as I'm concerned DSHS owes these people nothing. After all I'm sure they have picked up the bill for this girl's passed surgerys.
DSHS is an effing joke.
Take the director of DSHS and put him/her in prison for theft under color of authority. 10-15 years ought get the point across.
The state cuts benefits all the time to people that are very deserving all the time. I am a "working poor' with a documented 48% disability. The state cut my health care last summer. I make just under 26k and support a family. My wife makes minimum wage at the local drive through. We have a combined income of 38k and two kids. We get nothing from the state. Should I sue because I have a disability and my benifits were cut. NO I need to keep with school and retraining to get on with my life and find my own way.... That use to the American way but not any more. We now are expecting the government to take care of us from the cradle (if we make it there) to the grave (we all end up there).
@bustedupredneck You make a very good point. I think people sometimes need a handup, but in this country to many people think they have a handout coming anytime life hands them a bump. In this case the woman says it's not about the money but she seems to have the mentality that the 15% that was cut because the child lived in the home is due her. She should be grateful for the help she was given when she needed it.
@bustedupredneck
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If you make $26K on your own, and your combined income with your wife is $38K, why do you feel you should be getting benefits from the state? There are MANY people who make less than 1/2 of what you do, and THEY do not qualify.
 @LocalLady  @bustedupredneck LocalLady, I think you are missing his point, unless I am-- he says that he should take care of himself, and he is, earning 26K. (unless that is coming from the state...)  He said he had his health care cut, but isn't trying to sue about it.....  And, I don't have a problem with someone at that wage level having subsidized health care.  It costs "us" far less than emergency room visits for health care.  I know, I am self-employed, so I pay about 10K just for health care for my 2 kids and myself -- and we have a high a very deductible as well.  Fortunately we are all in good health......
Her daughter has now passed from a disease and the mother is still asking for a breathtaking fortune of untaxable cash--a massive windfall. Â Sorry mom, I appreciate the circumstances, but me-no-like.
 @drippingwithwords --- It's like $2,500 per family. That is hardly a "breathtaking fortune" if you ask me.
@drippingwithwords Maybe you should re-read the article and digest the facts. This is for 38,000 families that were affected. Not one.
 @drippingwithwords The mother is not asking for a "breathtaking fortune of untaxable cash". According to the article, the state was ordered to pay a total of $95 million dollars to the families whose benefits had been cut. That money would be divided among 38,000 families. It would not all go to the mother.
 @tobility In rethinking this, it really makes more sense to change the law, rather than suing Wa state Taxpayers.  Work to change the law to bring parity to the situation to adjust for the 15% to stay at home parents.  Still, I am wondering why the state should be paying at all if the parent chooses to stay home.  On the 38,000 families, like other lawsuits unless they are straight Class Action,  some families may receive a larger portion depending on how it is handled, situation, total expenses, etc...  These families do need help and the DSHS should have handled this and the lack of notification about cutbacks much better. Â
Disabled or not, why should a parent get paid to take care of their own child?
 @Robinsnest In the case of our daughter, by paying us the state saves a lot of money, since our daughter qualifies for those hours to be worked by a registered nurse.  They pay us less than $11/hour, they would have to pay an RN a few times that.  Also, an institution for a total care child/adult costs a lot more than paying a family for in-home care (and the state knows it). Â
Those who can afford to stay at home and take care of their own should not be getting anything from the state. We bring those children into the world, our choice, and it's our responsibility to take care of them.
 @Jatok  @T2q Apples and oranges? Seriously? Years ago the state paid for adults with disabilities to be cared for in institutional settings. Since then, they have closed many of those institutions, and cut down on the number of individuals that they pay to be cared for in them. Instead, they pay to have adults with disabilities cared for in community settings. The state's preferred choice is to pay the least amount possible for that care. And frequently, paying the parents to provide care is less expensive than paying registered nurses. I choose to provide care for my adult daughter because I believe I can give her better care, and because it is a less expensive alternative for the state. As far as what the state is doing, the service provider is different (parent rather than institution) but the result is the same - the state pays caregivers to care for adults with disabilities.
@T2q Mom Okay, the bottom line here is that you are being paid by the state to take care of your own child. That didn't used to be the case years ago. If you chose to take care of your own child, which makes sense, the state didn't pay you to do it. You are still arguing apples and oranges. It's what you have come to accept as the normal, but it didn't used to be the normal years ago. Having said that, I think we'll just have to agree to disagree.
 @Jatok The lawsuit against the state (in the case cited) has already been decided by the courts in favor of the parents, who were not fully compensated for the hours of care that they were contracted with. The reason they were not fully compensated is that the state decided unilaterally that because care was provided in their own home the number of hours of care that they should be paid for should be less. The courts ruled that this was not valid. The courts ruled that the parents should be compensated for the hours of pay that were withheld.Â
Most of us choose to care for our children in our own homes for two reasons:Â 1) to provide better care in a community setting (as opposed to institutional); and 2) because it is a better use of taxpayer funding.Â
In our case, because I am providing care in our home, I am unable to work in our family owned business. The state understands that it is to their advantage to pay us, as a parent provider, rather than to pay 3rd party registered nurses. To have them unilaterally decide that we don't need to be paid full hours as per the care plan is a slap in the face.Â
What this mother was paid for - just as what I am being paid for - is to provide skilled nursing care.  So no, this woman was not receiving "aid". This woman was being paid to provide a service. And the state saves money by employing parent providers to provide that service, rather than to institutionalize the child or employe 3rd party providers.
I'm fully aware of how things were handled back then. If you had a child or adult that was considered impared and unable to live normally in society they became wards of the state and were institutionalized. Which is apparently how your grandparents chose to deal with it. You are talking apples and oranges here. The original post had a woman who chose to care for her child in her OWN home and apparently had the ability to do it. She was given aid by the state but was 15% less because everything was done in her home. That meant it didn't require paying for separate quarters. She is suing the state because she feels she was beat out of something she was due. I'm sorry, you might not see anything wrong with this, but I do. By the way my child did die because of a medical mistake. Is there anything else you feel is relevant to this conversation that you think I'm not aware of?
 @Jatok  @T2q Actually, my grandparents had a child that was born with a disability (Down Syndrome), in 1915.  She was committed to a state-run institution when she was 7, on recommendation of the family doctor.  And her parents never saw her after that.  Until the 1970s, it was uncommon for children with severe or profound disabilities to be cared for at home.  The standard protocol was to "put them away". Â
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In contrast, we have cared for our daughter at home from infancy, in spite of her profound disabilities. Â After a stay at Harborview 5 years ago, when she was left medically fragile by a hospital-acquired infection (actually 2), and was sent home to die, her care plan was revised for the increased care that she needed. Â Primarily because of the quality of care that we were able to give her, she no longer has a death sentence from those infections. Â However, because of the damage caused there, she will never again eat by mouth, and she is permanently trached. Â
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Perhaps you should research things before you state them as facts.
@T2q Mom Your comment doesn't surprise me because you are of a completely different generation and of a completely different age of looking at things. When we bring a child into this world it is our responsibility to take care of them. 30 or 40 years ago people did it all the time without government aid. I realize what you would expect/do would be a lot different than what I would expect/do but that's just the difference between the generations/expectations.
 @Jatok And are you taking care of your adult children?  Are you expecting to take care of your adult children for the rest of their lives?  If you read the story, you will see that the state didn't start paying for anything until the daughter turned 18.  Until then, the parents did everything and didn't receive assistance for doing so. Â
When we had children, we expected that they would be totally dependent on us while they were young, and then as they became adults they would go to college, find employment, and be self-sufficient. Â Imagine how much your life changes if the child you have is as dependent as a newborn infant for their entire life - and if that life is 30, 40, 50 years. Â Would you still be prattling on about your responsibility to take care of them? Â
 @T2q Mom  @Robinsnest You also have less overhead cost you do not have to pay workers benefits or pay into L&I or a business tax as institutions such as group homes, nursing homes or even state facilities do.
 @Blevnangels  @Robinsnest Actually, we do have overhead - we've had to completely remodel our home, in order to accommodate our daughter's needs (which by the way were significantly increased by two drug-resistant lung infections she got while being cared for at Harborview). Â
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And we are required to pay union dues for the privilege of getting paid by the state to care for our daughter at $10/hour. Â
 @robinsnest:Â
It is actually MUCH less expensive for the disabled to live at home & be cared for by family members than to put them in care facilities. The other advantage is that they receive better care from people who actually care about them as opposed to someone making barely over minimum waage who has to look after 20 different patients as a CNA all at the same time.
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 @deadcandance  @Robinsnest I'm confused. Are you saying the nobody should get paid for providing care to a disabled person in Washington state?
 @Bianca  @tobility  @deadcandance  @Robinsnest So then you think it's a good idea for the state to pay more for an unrelated person to provide care for an adult with disabilities?
 @Bianca  @deadcandance  @Robinsnest OK, because @deadcandance said "NOBODY SHOULD GET PAID", which would imply that nobody should get paid...Â
 @tobility  @deadcandance  @Robinsnest --- No, I am pretty sure she meant no parent should be paid by taxpayers to care for their own child. I agree.Â
The ones that get paid are the parents that have to take classes to care for the child, quit work, pretty much give up their life. There is not many people that have the knowledge to care for high needs kids or the support. With all the doctors, therapy, and so on and so on, you lose more money. I believe it was found that when a parent has a high needs child like this, it helps release stress to help them out. There is less abuse, abandonment, and the state does not have to find someone who qualifies to take care of the child.
I guess so they can sue the state to ensure some sort of platinum retirement for themselves...