Action Alert: Make Calls to Stop PCA Cuts
Last week saw the release of the governor's proposed budget, and it was very much a mixed bag for people with disabilities. On the plus side, the budget includes additional funding for wheelchair repair, as well as increased funding for agencies that provide various social care services, which will hopefully spur increased hiring and help resolve staffing shortages.
Unfortunately, the proposal also calls for cuts to the PCA program that would reduce spending by approximately $100 million compared to maintaining currently policies. Masshealth's plan to achieve these cuts is to slash weekly meal prep hours for everyone in the program from 13 hours to 7 hours, and to deny eligibility to any adult who has fewer than 10 hours per week of assessed Activities of Daily Living (ADL) need (i.e. activities such as bathing, dressing, feeding, and transfers), shunting these applicants into the Adult Foster Care and Home Health programs instead. (Services for children cannot legally be cut because of federal regulations.)
We earnestly believe that MassHealth officials tried their best find the least damaging way to make these cuts, which we appreciate. Unfortunately, there is simply no way to take this much money out of the program, and these proposed measures will cause real harm to people with disabilities. Firstly, one hour a day of meal prep assistance is not remotely sufficient for many members who have complex dietary needs or need to have their food cut into small pieces or blended in order to be able to safely consume it (it may also negatively impact members with children.)
Secondly, the 10-hour eligibility threshold will result in thousands of people no longer being eligible for the PCA program. The harm will fall particularly hard on adults who are autistic, have developmental disabilities, learning disabilities, or traumatic brain injuries. This is because members of these communities often need lower levels of help with ADL needs but higher levels of Instrumental Activities of Daily Living (IADL) need, such as taking medication, organization, cleaning, and paying bills—and IADL need is not taken into account for the cutoff. As such, many members of these communities will find themselves booted from the program, as will people with many other types of disabilities.
We are not convinced that the people who are denied PCA care will get their needs met by the other programs that MassHealth is saying will serve them instead. The Adult Foster Care program, for instance, requires that someone have a live-in family member or friend (who cannot be a guardian or spouse) who is willing and able to provide care, which would not be the case for many of the people losing eligibility. Meanwhile, many home health agencies already have waiting lists, and the advocates and experts we spoke to were deeply skeptical that that program would be able to effectively absorb thousands of people who were previously receiving PCA services. Even if they could, however, home care programs (while valuable) are by no means an ideal substitute for PCA care: they provide fewer services and dramatically less consumer control, meaning that many people with disabilities would be significantly less able to have a say in how they receive care.
For all these reasons, we believe these cuts are harmful and inappropriate, especially just one year after this state spent a billion dollars on tax cuts. The budget should not be balanced on our community's back.
If you agree, we would urge you to call Governor Healey's Office at (617) 725-4005 or email them via the form HERE and tell them you're opposed to any cuts to the PCA Program.
