Nearly 7,000 intellectually disabled Tennesseans who benefit from state-sponsored medical care are expected to bear the brunt of $48 million in cuts, ending an era of round-the-clock care.
"It's going to be a change, which is not the best thing in the world for them," Tennessee Department of Intellectual and Developmental Disabilities Commissioner Jim Henry said Friday during an editorial board meeting at the Chattanooga Times Free Press. "Any time you change [conditions for] these kind of folks ... there's problems there."
The state currently provides two personal assistants each to 27 severely disabled patients, Henry said, but it costs "over $230,000 per person, per year." Henry described the care as "unlimited" and "24/7."
The personal assistants help patients "get up, bathe, go to bed, let Mom go to the grocery store," among other tasks, Henry said.
In cuts recommended to Gov. Bill Haslam, Henry has proposed limiting personal assistants' work to 215 hours per month.
Carol Westlake, executive director of the Tennessee Disability Coalition, put it another way.
"You have to know how to feed somebody without killing them," she said. "What if he quits breathing?"
Funding for personal assistants is expected to be cut by $3.4 million, Henry said, and nursing care could be docked by as much as $5 million. Some patients will be given the option to move away from their families into "community homes," Henry said.
"Which won't save the state money," Westlake said. "[Taxpayers] would now undertake room and board along with medical [care] in settings that are generally less appropriate."
Henry said the department's Home and Community Based Services branch helps about 6,800 people - the same number currently on its waiting list.
The biggest part of the reduction initially was proposed by former Gov. Phil Bredesen, but President Barack Obama's American Recovery and Reinvestment Act forestalled the cuts until stimulus funds expired this year.
The Department of Intellectual and Developmental Disabilities was created in January after years as a division of the Department of Finance and Administration.
Asked if his staffers searched for instances of duplication to eliminate before cutting personal assistants and nurses, Henry said they did, but his $800 million department "offers different services" than the Departments of Mental Health or Human Services.
"There are savings to be had," Westlake said. "They spend tremendous amounts of money on committees that do this, task forces that do that. There are much more efficient uses of that money."