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Greitens’ budget proposes cuts to 20,000 seniors and people with disabilities

Emma Minx, Logan Chiropractic Paraquad Clinic senior intern, turns on the power plate exercise machine for Paraquad participant Leon Zickrick. The machine vibrates to help break up joint adhesion in his shoulder. (July 25, 2014_
File Photo | Camille Phillips | St. Louis Public Radio
Emma Minx, Logan Chiropractic Paraquad Clinic senior intern, turns on the power plate exercise machine for Paraquad participant Leon Zickrick on this photo form July 2014. The machine vibrates to help break up joint adhesion in his shoulder.

Nonprofit organizations that serve seniors and people with disabilities say their clients would be harmed by Gov. Eric Greitens' proposed cuts to assistance programs.
The governor's proposed budget would raise the eligibility requirement for Medicaid recipients who receive coverage for nursing home care or consumer-directed services provided in the home, according to Dan Haug, the state’s acting budget director. He told reporters this month that the move would affect 20,000 people who currently qualify for the care, and save the state $52 million a year.

But the proposal has alarmed advocates for people with disabilities. 

“[Consumer-directed] services are cost effective, and they make a real difference,” said Cathy Brown, public policy director of Paraquad, which provides services to people with disabilities. “Some folks with disabilities just need a little bit of assistance in order to live a good life in the community.”

Groups that provide these services point out that eligibility is based on the level of care needed, not income. Disabled persons must have an income of less than 85 percent of the federal poverty line to qualify for Medicaid coverage — about $2,178 a month for a family of four. For a Medicaid enrollee to qualify for consumer-directed services, they must also be rated on a point system that takes into account their physical condition, type of medications and ability to complete daily tasks independently.

Suzan Weller, program director for the Disability Resource Association in Festus, estimated that about half of the organization's 400 clients who use these services would be caught in the gap.

“Hospitals will get flooded, because really there’s really no other place that these individuals can go,” Weller said. “That’s a lot of consumers, and we’re just one organization.”Elinor Simmons, a 30-year home care attendant and member of the union's bargaining committee, speaks during a protest outside of Paraquad in St. Louis.

Elinor Simmons, a 30-year home care attendant speaks during a protest outside of Paraquad in St. Louis. (June 2015)
Credit File Photo | Durrie Bouscaren | St. Louis Public Radio
Elinor Simmons, a 30-year home care attendant, speaks during a 2015 protest for higher wages outside of Paraquad in St. Louis.

If nonprofits like DRA must absorb the cuts, Weller said she worries about the future of other services they offer that are not reimbursed by Medicaid, such as transportation to medical appointments. Caregivers also would see a pay cut.  

Nancy Murphy, the executive director of the Delta Center in St. Peters, said the cuts are frightening to some of her clients who may fall in the gap. Murphy said she knows the state is facing tough decisions with its budget this year, but she hopes state legislators will prevent these cuts from taking effect.

“My concern is that it’s shifting costs," Murphy said. "It’s not necessarily going to save the state any money.”

Seniors and people with disabilities make up more than a quarter of Missouri Medicaid enrollees, but about two thirds of the program’s total annual costs.

The Greitens administration did not return a request for comment.

Follow Durrie on Twitter: @durrieB