How big of a policy geek am I? I’m such a geek that I’ve been browsing through the President’s 2006 budget. One of the last things we did before leaving Washington was to meet with White House Budget Director Josh Bolton and he mentioned that lots of people would be unhappy with the proposed cuts. Many in the disability community are not likely to be happy with reductions in programs like housing for people with disabilities (cut from $238 million to $128 million) and the Office of Disability Employment Policy (from $47 million to $28 million). Bolton did say that they tried to propose cuts in programs that were not living up to performance measures, but my concern is that those measures may not take into account the time needed for some of these programs to show results. The budget does propose some interesting demonstration projects, including:
Money Follows the Person
This demonstration would use federal grant funds to pay for home and community based waiver services for individuals who transition from institutions to at-home care. Costs would be funded at a federal matching rate of 100 percent for the first year with the condition that states would agree to continue care after the first year at the regular Federal Medicaid Assistance Percentage and to reduce institutional long-term care. Over five years, $1.75 billion is authorized for this program.
Community Alternative to Children�s Residential Treatment Facilities
This demonstration would allow states to provide home- and community-based services to children who would otherwise receive care in psychiatric residential treatment facilities. This demonstration would permit the delivery of intensive mental health services for children in their homes and communities. This program would cost $5 million in FY 2006 and $99 million over five years.
Respite Program for Caregivers
Two of the demonstrations would provide respite care for caregivers of disabled children and adults. The respite program for caregivers of disabled adults would test whether respite care can lead to reductions in primary caregiver fatigue. The administration argues that such fatigue or �burn-out� can lead to institutionalization of persons with disabilities. This proposal would cost $7 million in FY 2006 and $134 million over five years. The program for caregivers of children with substantial disabilities would collect specific data about the cost and utilization of respite care services. This proposal would cost $1 million in FY 2006 and $23 million over five years.
Whether or not these initiatives go anywhere is up to Congress. I seem to remember these same proposals being offered up last year and then falling off the map. And let’s not forget that this budget doesn’t include the additional $70-80 billion to fund our presence in Iraq. Meanwhile, this Administration wants to make the recent tax cuts permanent, proving that everyone can have their cake and eat it too. Please note that “everyone” doesn’t include farmers, college students, inner-city residents, the rural poor, veterans, and people with disabilities.
