Oregon boosts care for developmentally disabled

PORTLAND, Ore. (AP) - An expansion of Oregon's services for people with developmental disabilities has families and caregivers cheering, but is also raising concerns about the price tag and the availability of services.
   
Under a provision of the federal health care law, many of the 9,000 Oregonians living at home with developmental disabilities are now eligible for a big increase in state funding to pay for services. That can mean tens of thousands of extra dollars for each person to use for things like in-home caregivers.
   
Eden Braman, a 7-year-old girl with Down syndrome from St. Helens, needs constant supervision. She was eligible for about $3,400 a year in services, such as 20 hours a month with an in-home caregiver. She's now eligible for $70,000 a year, or at least 100 hours of care each month.
   
"It has been a wonderful blessing," her mother, Emily Braman, told The Oregonian. "It's eased some of my stresses, made the quality of our family life better and reduced some of my stresses so I can be a better mom."
   
But there have been growing pains.
   
Some families say there aren't enough qualified service providers to go around.
   
"You have a program on paper that's millions of dollars over budget, but there is no labor force to execute the plans," said Michael Bailey, whose 26-year-old daughter, Eleanor, has Down syndrome. "The result is that many, many people who used to have good, reliable services now have a plan with tons of money in it, but there's nobody to execute it."
   
Bailey, of Portland, is on the boards of Disability Rights Oregon and the National Disability Rights Network.
   
The federal government covers 70 percent of the costs, with the state picking up the rest. Clients get an annual "needs assessment" from state officials based on their disability and the services they would need to live independently, even though few do.
   
The new system is part of the "K Plan," a Medicaid option that aims to reward states for funneling clients into home and community services rather than more-expensive institutions. In Oregon, which had no institutions for developmentally disabled people, the effect has been a dramatic boost in most families' benefits. Oregon is the second state to roll out the plan, after California.
   
Officials with the Oregon Department of Human Services say they're monitoring the numbers and say many clients won't deplete their benefits.
   
So far, officials have seen a slight increase in the monthly per-case cost. March department statistics, the latest available, show that 9,083 Oregonians received on average of $2,951 in services each. That compares with 9,292 receiving an average of $2,339 each in January 2013.
   
But at least a few signs point to higher spending ahead. At Independence Northwest, a brokerage that helps provide services for about 435 Portland-area adults with developmental disabilities, the average plan this year is running in the low to mid-$30,000 range, compared with about $11,000 last year, Executive Director Larry Deal said.
   
So far, the brokerage has seen an increase in average spending of about 16 percent, he said, and he expects that to rise if more providers become available.