Portland Autism Resource Faces Closure Under New Federal Funding Program
Monday, April 13, 2015
At first, it seemed the new Medicaid funded system would provide more resources for services and support. Yet, a new classification from the state caused Empowerment Services to run up massive deficits and drop clients.
“If they never would’ve shown up, we would’ve been happy and worked with what we had,” said John Horton, whose son is a client at Empowerment Services. “It was a really short time between saying ‘you get the whole world’ and ‘no, now you don’t.’ It’s killing us right now.”
The program is now operating at a deficit of $10,000 a month. Owner Marie Johnson says unless the state makes exceptions for the program or clients, Empowerment Services could be closed by May.
Empowerment Services
Empowerment Services caters to adults with various degrees of Autism who have been turned away from most other places. It is one of the only in the state that provides such services in a one-on-one facility. Many parents have told Johnson without Empowerment Services, their child would have no place to go. Horton said it is a lifeline for his 24-year-old son.
“They take people who are kicked out of other programs for being too autistic or school districts who don’t want to deal with them,” Horton said. “Empowerment Services is their last hope.”
Johnson started the program after years of working with autistic children in the education system. She realized after children graduated, there were few resources to help them learn to cope with society.
In Empowerment Services, Johnson and her team build unique plans to help adults adjust towards independence. Most of the clients have demanding behavioral issues, which require one-on-one attention inside the facility.
The program is funded by federal funds awarded to the client, handled through outside brokerage firms.
The K-Plan
In 2013, Oregon was one of the few states to implement the K Plan—a new Medicaid state program authorized under the Affordable Care Act.
“People are able to access more services if they needed new services,” said Lilia Teninty, Director of the Oregon Office of Developmental Disabilities Services (ODDS). “Most importantly, we are serving a significantly larger number of children and adults.”
Teninty explained the new program makes an assessment on a case-by-case basis, to determine how much funding will be given for services. K Plan created more funding for more children and adults and allowed an individualized funding plan instead of a flat bundled rate.
When Johnson first heard of the new plan, she began hiring new staff to cover all the new pay hours she assumed would be allotted.
However, last fall she learned the state classified her as a facility where one employee would oversee up to eight to ten clients. Yet for Empowerment Services’ one-on-one methods, the system did not work.
“Right now, we are making $8.15 an hour on some clients,” Johnson said. “We can’t provide support at that rate and it doesn’t cover overheads like workman’s comp, insurance, rent, and supplies.”
Oregon is the only state to completely implement the K-Plan. Over the last two years, the state has been evaluating thousands of adults and children under the new standards.
Empowerment Services
“Some services have benefited financially from the changes. Others have had to rethink things,” Deal said. “You’re looking at a complete system overhaul. It’s a learning process.”
Fight For Classification
Johnson and many parents have been trying for the last few months for the state to make an exception for Empowerment Services or its clients, so the resource can stay open.
ODDS has said this is a unique case and is reviewing the funds awarded for each client. However, Johnson said the appeal process has consumed a lot of time and manpower, and produced few results.
“We are holding on by a thread,” Johnson wrote in an email to ODDS. “I am not clear why your tour, video clips, exception letters by Empowerment Services, exception requests done by PAs, parent letters, a candid interview between parents and your team, as well as an interview with myself does not suffice? What else could you possibly need?”
Teninty said ODDS will be meeting with Empowerment Services soon and working with them on ways to alter their business model to adapt to the new process.
“They do provide a very unique service, and support some clients with specific needs,” Teninty said. “But we we do have providers who service those needs—they just look at it differently.”
Trying To Move Forward
The changes over the last few months have been creating a strain on the business, Johnson said. Employees have been putting in numerous volunteer hours to keep up with the workload, while Johnson said they have had to revamp their programs, billing process, and schedules.
Yet clients at Empowerment Services have been affected most by the change. Johnson said behavior incidents have gone up, as more clients are forced into group situations they are not prepared for. She has also had to to turn away clients.
“It goes against my grain because I don’t believe only people who can afford it should get help,” Johnson said. “Everybody is entitled to good service.”
Patty Moran’s son Brian has been going to Empowerment Services for two and half years. During his time there, Moran said he has progressed to a place of greater independence and peace of mind. The unique setting of Empowerment Services created a way for him to improve his confidence, health, and security to a level Moran said he never would’ve reached without Empowerment Services.
“Without them, this never would’ve happened,” Moran said. “If they take it away, I’m afraid he will regress—I know he will. That’s why it’s so important they continue.”
Related Slideshow: 20 Oregon Hospitals That Charge The Most
Which Oregon hospitals charge the most? Act Now for a Healthy Oregon analyzed 2013 data from Oregon Health Authority’s Inpatient Discharge Data for each of the 100 most frequent MSDRG primary diagnoses. An average charge was calculated per diagnosis (MSDRG) per hospital for patients with commercial insurance.
Follow us on Pinterest Google + Facebook Twitter See It Read It