Funding cuts put foster-care businesses in peril

[Guest guest]

Well it has made the news of the Care Providerwhich I have

recently become and now this.

Irma,20,DS/ASD

Re:

Funding cuts put foster-care businesses in peril

02:02 PM CST on Sunday, November 2, 2008

By EMILY RAMSHAW / The Dallas Morning News

eramshaw@...

Tom and Berry devoted their careers to the severely disabled and

opened their home to people without one. In 2004, the Rowlett couple

and their children turned their passion into a small but bustling

business: matching people with profound disabilities with foster

families.

Now, a federally mandated funding change is threatening to close their

doors – a move they and dozens of other foster-care businesses say

will halve their income and force more people with disabilities out of

family homes and into group homes.

" The state told us that sometimes there are winners and sometimes

there are losers, and in this case we're the losers, " Mr. Berry said.

" But we're not just going to be losers. We're going to be closed. And

foster care is going to be a thing of the past. "

Under Texas' Home and Community-based Services – a Medicaid waiver

program that is an alternative to living in a state institution –

people with profound disabilities can receive care while living

independently, in a group home or in foster care with their own family

or another family.

Care providers range from large multistate corporations, which often

run 100 or more group homes, to owner-operated businesses like the

Berrys', working predominantly in foster care.

For years, all of these care providers have received a lump-sum

administrative fee for every client they oversee, money that pays

salaries, rent and other business expenses. But a new federal mandate

is forcing the state to itemize this administrative fee, and the

proposed pricing structure will increase payments for group-home

placements while cutting them for foster care.

Trying to be fair State health officials caution that the new pricing

structure isn't final and doesn't go into effect until next year. They

say they're working hard to ensure the rate adjustment is fair to

everyone, including the group-home providers who say the previous

system left them under-compensated.

" We're looking to see what we can do to make sure the folks providing

foster homes still have the resources they need, " said

Goodman, spokeswoman for the Texas Health and Human Services

Commission. " When you reallocate funds, there are always people who

get more and people who get less. "

Under the proposal, the Berrys say, their business will hemorrhage

$80,000 a month – revenue they and other foster-care providers need to

stay operational.

And people like Amelia Granado, who serves as a foster parent for her

24-year-old son, say they'll lose the providers they've come to rely

on. Ms. Granado said the Berrys have become a family unit for her,

helping , who has cerebral palsy and epilepsy, participate in

bowling and horse-and-buggy rides, and to get a wheelchair-accessible van.

" It'll be a great loss for a lot of us that work so hard to keep our

children at home, " Ms. Granado said. " I know for some people group

homes work, but for us, it wasn't an option. "

Care providers who work predominantly in group homes say their

administrative fees should be higher, because the services they

provide are generally more extensive. They say businesses that work

solely in foster care may need to consider diversifying into group

homes or partnering with other companies to stay profitable.

" I know the foster-care folks think this is creating a hardship on

them, but for those of us who have a lot of [group-home] clients,

we've lived with a hardship for a long time, " said Mickey Atkins,

president of D & S Residential Services, which operates more than 100

group homes in Texas. " I feel for them, I do. Hopefully, they'll still

be able to make money. But they're going to have to look at changing

their business model. "

What people want -care providers dispute the idea that group

homes have higher administrative costs. Nor do family-run businesses

have the start-up capital to buy and operate multiple group homes,

they say, even if they want to.

And, the foster-care providers say, they got into the business because

it's what consumers want. About 45 percent of the people who receive

these Medicaid waivers are in foster care; 32 percent are in group homes.

" The data shows that families and consumers are choosing foster care

more than residential right now, " said Carole , executive

director of the Private Providers Association of Texas, which

represents both foster-care and group homes. " Our goal is to ask the

Legislature for more dollars ... or for transitional dollars while

people restructure their businesses. "

For the Berrys, the change stings even more because they practice what

they preached. They say they pay their 35 salaried employees and 200

contract workers higher-than-average wages. They take personal care of

their 160 foster families. And they and their adult children currently

foster people with severe disabilities in their own homes.

" These people are getting penalized because of the way they've chosen

to operate, " said state Sen. Bob Deuell, R-Greenville. " If they go out

of business, there's not going to be anybody out there doing what

they're doing. "

HOME AND COMMUNITY-BASED SERVICES IN TEXAS

Resident type

Number of consumers

care (with their own family or another family)

6,538

Three- or four-bed group home

4,660

Their own home or a family home (without foster care)

3,255

Total

14,453

SOURCE: Texas Department of Aging and Disability Services

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