| Crisis Looms for Community-based Service Agencies |
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A federal deadline is looming for Kentucky’s Cabinet for Health and Family Services. At issue is how the Cabinet will implement sweeping changes for community based service agencies working with people with mental retardation and physical disabilities with a commitment of $ 45 million dollars.
The Cabinet for Health and Family Services, which oversees the community services program, must explain how it intends to proceed with commitments to fully fund the program changes called for in a 2006 court agreement.
A complex timeline of events and court actions frame this issue. Below is a short time map of where Kentucky is in regard to the court order.
2002......Agency sues Cabinet
The Kentucky Department of Protection and Advocacy, a state agency that represents people with mental and physical disabilities, sued the Cabinet for Health and Family services in 2002, alleging that the state did not provide adequate services to people with physical and mental disabilities. More than 2,500 people were on waiting lists for services such as day programs, personal care and therapy.
2006....Parties reach agreement
In a landmark settlement agreement announced in January 2006, the state said it would put more money, approximately $45 million over five years, into the Medicaid program to pay for more community-based services for the disabled. About 70 percent of that would come from the federal government.
At the time of the agreement, both sides acknowledged that federal authorities had to sign off on the changes to the Medicaid program, which meant that a July 2006 start date outlined in the agreement was unlikely.
2007...Federal approval
Federal authorities approved the changes to the Medicaid program in August 2007, and officials with Protection and Advocacy were repeatedly told -- even as late as Oct. 30 -- that the program was on target to begin in January 2008, according to court documents.
2007...Governor Fletcher’s administration pulls state money
Then in November, Protection and Advocacy officials were told there was no money in the current budget for the program and it might not be until April, at the earliest, that money would be allocated for it. Gov. Steve Beshear, shortly after taking office in December, announced that the state was in dire fiscal straits and that the current and future budgets would be cut.
2008...Governor Beshear
In documents filed in federal court, Kentucky Protection and Advocacy argues that the state was slow in drafting changes to the Medicaid program that had to be approved by federal regulators, causing the delay. There was money for the program, but because the state was tardy, that window of opportunity to fund the new programs by January 2008 passed.
But state officials say they have asked for money in next year's fiscal budget, which begins July 1, to pay for the expansion in community-based services.
Beshear has proposed $17.5 million a year for the program, and it was "one of the few areas that received additional funding," said Vikki Franklin, a spokeswoman for the Cabinet for Health and Family Services. Cabinet officials are working with Protection and Advocacy to ensure that all parts of the settlement agreement are implemented, Franklin said.
2008...February 15th deadline
Attorneys with the Cabinet for Health and Family Services and Protection and Advocacy met Feb. 15 in front of U.S. Magistrate Judge Gregory Wehrman to try to work out an agreement. Wehrman gave the cabinet until Friday to explain why the settlement has not been implemented, said Protection and Advocacy attorneys.
If the two sides can not come to an agreement, the matter will be referred to U.S. District Judge Joseph Hood, who presided over the original settlement. Hood could order that the state comply with the original agreement.
The state money for fiscal years 2009 and 2010 could be at risk if the Governor’s plan for new revenue is not fully funded by a casino amendment to the state’s constitution.
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