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The parents had a series of meetings to
plan for the transition; they spoke with
representatives from JARC, the agency they
chose to provide staffing for the home,
and with their respective case workers
from MORC (Macomb Oakland Regional
Center), the agency that funds many of the
services provided to individuals with spe-
cial needs and their families. While neither
agency could make any guarantees, the
agency staff members seemed optimistic,
and a move-in target date was set for March
of this year. The three young women spent
time together socially in preparation for
becoming housemates.
Today, because of massive funding cuts to
mental health services budgets throughout
the state of Michigan, Elana and her poten-
tial roommates are still living with their
families, and the Kaminers have leased the
young women's would-be home to a tenant
until the situation is resolved. Kaminer is
shocked, overwhelmed and discouraged.
"My husband has already had two heart
attacks; I don't know how much longer we
can continue to take care of Elana at home
Kaminer said. "She needs help with every-
thing, and it's so demanding."
Marlowe Robinson B'sheart, a high
school English teacher in West Bloomfield,
is the parent of six children, including a
10-year-old daughter, Moby, who has devel-
opmental delays and cognitive impairment.
For the past five years, B'sheart has received
a monthly respite allowance from MORC,
which provides parents of children with dis-
abilities with a much-needed break.
"It was invaluable," she said. "It enhanced
my ability to be a healthier parent, to have
one-on-one time with my other typical chil-
dren. It allowed me to regroup and re-ener-
gize to honor my other children's needs:'
Last August, B'sheart was notified her
annual budget had been cut and her respite
services would be discontinued. When she
requested an appointment with her MORC
caseworker to have her case reviewed, she
was told the cuts were going to take place
and there was no need for an appointment.
"Two weeks later, my services ended, just
in time for the school year," B'sheart said.
"I was getting 60 hours [of respite care] a
month. It was a dramatic shift to go from 60
hours to zero overnight:'
Losing respite care has been detrimental
to Moby now that B'sheart can no longer
spend as much individual time with her.
"It affects her ability to make progress
— I don't have the time and energy to facili-
tate her therapy and academic learning at

8

May 7 • 2015

Marlowe Robinson B'sheart and her daughter, Moby, 10 — B'sheart lost her monthly
respite allowance to budget cuts from the Macomb Oakland Regional Center; the
respite allowance gave her more time to spend with her other five children.

Now What?

Budget cuts to clients with disabilities
burdens families and agencies.

Ronelle Grier I Contributing Writer

home B'sheart said.
Her other children, who range in age
from 8 to12, have been affected, too.
"There is no longer any way for them
to have one-on-one time with me, and it
impacts them to have a parent who is utter-
ly and completely exhausted:' B'sheart said.
"We're still acclimating:'
B'sheart said she has heard of hundreds
of other families who have completely lost
their services. Families whose income is low
enough to qualify for Medicaid were able
to keep respite care benefits; it is middle-
income parents like B'sheart who were hit
hardest by the latest round of budget cuts.
"I'm a teacher, so my salary puts me
above poverty level, but I don't make
enough to pay for respite care," she said.

Funding Facts

B'sheart and Kaminer are among thousands
who have been affected by the budget cuts,
which are attributable to several causes.
For fiscal year 2014, the Oakland County

Community Mental Health Authority
(OCCMHA), which distributes money
to several service providers in Oakland
County, experienced a $14.5 million
reduction in Medicaid revenue from the
Michigan Department of Community
Health (MDCH). This was the result of
"rebasing," a redistribution process intend-
ed to equalize Medicaid funds across the
state. As a result, funding to counties such
as Oakland, Macomb and Wayne was sig-
nificantly reduced. In addition, reductions
in the MDCH budget caused an additional
$8 million decrease in state funding to
OCCMHA. At the same time, the demand
for services in Oakland County increased by
$7 million.
While OCCMHA used reserves to cover a
portion of its shortfall, a deficit of approxi-
mately $11.5 million was passed along to
its providers, which includes MORC, in
addition to other smaller organizations
such as Easter Seals and Community
Living Services of Oakland County. Across-

the-board budget cuts of 6 percent were
imposed on agencies that contract with
MORC to provide direct care services, such
as JARC, Kadima and JVS.
"Because Medicaid funding has remained
relatively flat over the last decade, it is the
direct care providers who are left to make
up the shortfall said Carol Kaczander, who
is the strategic gifts associate for JARC as
well as the parent of Robbie, 35, who has
disabilities and lives in a JARC home.
In the Jewish community, these providers
include JARC, which provides residential
options for people with
developmental dis-
abilities; Kadima, which
provides housing and
support services for
individuals with men-
tal illness; and Jewish
Vocational Service (JVS),
which offers vocational
Carol
programs and other sup-
Kaczander
port services for people
with disabilities as well as to the general
community.

Caregiver Crisis
Because the majority of these agency bud-
gets is devoted to staffing, this is the area
that suffered the strongest blow.
According to Lisa Rothberger, JARC's
chief talent officer, the agency has cut
administrative staff and, last year, an
across-the-board salary cut of 5 percent was
imposed on all employees.
"We've always paid a premium wage and
had great luck recruiting the best in the
field:' said Rothberger, adding that cutting
the starting wage of direct care workers
from $11.09 per hour to $10 per hour had
a detrimental impact on the agency's appli-
cant pool. "We used to get a minimum of
100 job applications a week; now a good
week is about 20 applications:"
While the strongest impact has been on
providers who primarily serve those with
developmental disabilities, Kadima is also
experiencing fallout from the budget cuts.
When Eric Adelman attended his first
meeting as executive director in February
2014, he learned one of the agency's provid-
ers had eliminated its transportation reim-
bursement, a yearly amount of $36,000.
While Kadima has not had to cut salaries or
services, Adelman said the agency is being
indirectly affected through the service
authorization process.
"We are getting a sense that the core pro-
viders are loathe to authorize residential ser-
vices because they are expensive he said.

Now What? on page 10