Faced with a growing waiting list for services and no new money to pay for them, the state's disabilities board on Thursday approved a plan to use vacancies in one program to help some of those waiting the longest to get into another.
The Department of Disabilities and Special Needs, which cares for thousands of those with intellectual disabilities, autism, brain and spinal cord injuries, currently has more than 8,000 people on its waiting list for services for the state's biggest and most expensive program, the Intellectual Disability and Related Disabilities Waiver (ID/RD).
Some people who want into that program have been waiting up to four years.
Another 3,113 people are on the list for the state's Community Supports Waiver, which offers fewer services and is capped at $14,000 per year per individual. There's no individual dollar cap in the ID/RD program.
The state recently received news that its application to renew its ID/RD waiver program, which costs more than $300 million a year, has been approved by the federal government, after a difficult two-and-a-half-year process. And with that renewal, an increased number of people can be served.
"The bad news is we have no new funds," Beverly Buscemi, executive director of DDSN, told the agency's commission on Thursday.
So the board was presented a list of four options of how to reallocate money that becomes available during the year from vacancies. Some people die, move out of state, or for some other reason leave the program, creating the vacancies.
Some in the community supports program are also on the waiting list for the ID/RD program. So if they are approved for that program, they will create a vacancy in the community supports program.
Those waiting for the community support program have been in line up to seven months, officials say.
Under a plan Buscemi recommended, and the board approved, for every four vacancies created in the community support program, the funding for three will be sent to the ID/RD program, which funds in-home services as well as residential placement, until 600 additional in-home services slots have been awarded.
Lois Park Mole, a spokeswoman for DDSN, said because some of those waiting for the ID/RD program are already receiving services in the community supports program, any vacancies could create ripples in the system, potentially sending those people to the more expensive program and opening up another vacancy.
"So there will still be some pretty significant turnover in the community supports program," she said.
There is less attrition in the ID/RD program, she said, because not many people simply choose to leave it. That's one reason why the waiting list for that program remains high.
Because officials say the ID/RD program does not have an annual financial cap, that program also poses more of a financial liability for the agency. Officials are not sure how long it will take to reach 600.
With state funding in recent years, the waiting times for the ID/RD program has been reduced but still can take years.
"This will definitely help to move that," Mole said. "We don't know how quickly all of that movement can occur.
In-home services are being targeted, officials say, because residential placement on average is more than four times as expensive.
About 250 people leave the ID/RD program each year, according to the agency, and that money is reserved for those on a critical needs waiting list, the highest priority of those wanting services. That list includes people who have been abused by a primary caregiver, are homeless or recently experienced a loss of their caregiver.
About 30 percent of those waiting for the community supports program have been previously offered a slot in the program but turned it down and then asked to be put on the waiting list again. Some have been offered a slot multiple times, officials said.
About 60 percent of those on waiting lists are receiving some type of government health service, such as Medicaid or DDSN family support funding, according to the agency.