In his recent speech, President Obama described two visions. In one view the United States should responsibly meet obligations to the impoverished, elderly and disabled, making careful decisions to reduce the national debt. Contrasted with this were short-sighted measures threatening basic commitments to each other and future generations.
Well said, Mr. President. But not all crazy cuts are dreamed up by belt-way deficit hawks or in red states. In Illinois, a Democratic administration is set to subvert basic commitments to people with disabilities (with local Republicans, of course, arguing that the cuts don't go far enough).
…Medicaid…provides care for millions of seniors in nursing homes, poor children, and those with disabilities. We are a better country because of these commitments. I'll go further – we would not be a great country without those commitments…I will not tell families with children who have disabilities that they have to fend for themselves.
President Obama, April 13, 2011.
But Illinois has already told 21,000 to fend for themselves....
After laudable (if fiscally painless) progress on civil unions and the death penalty, Illinois Governor Pat Quinn is on the verge of making further devastating cuts to Medicaid funded programs for people with disabilities (loosing federal matching dollars in the process). Shifting limited revenues back to large state institutions, Quinn is planning to drastically cut community services. His proposal blocks any recognizable path to progress.
Among a handful of states that serve the highest number of intellectually disabled citizens in prison-like settings, Illinois’ funding for community based services has long ranked near the bottom of all 50 states. Over the past decade late payments have pushed not-for-profit providers up to, and in some cases over, a financial cliff. Many vulnerable people have lost or are currently denied services. At this point 21,000 individuals with conditions such as Autism, Down Syndrome, and Cerebral Palsy languish on a waiting list---with 14,000 identified emergency cases. None are applying to large state institutions. All expect full community integration. But Quinn, in a backwards move, is increasing by 30 million the budgets of archaic state institutions long slated for closure, while slashing community-based programs. Likely to be named in a federal law suite over this fiasco, Quinn knows that housing people in massive, segregated facilities flaunts the 1999 Olmstead decision. People with disabilities have a constitutionally protected right to live in the community.
But Quinn has tied his own hands.
Unlike Wisconsin Governor Scott Walker, who has the American Federation of State, County and Municipal Employees (AFSCME) picketing on his door step, Quinn struck an agreement. AFSCME asked Quinn to once again stall planned closure of state-operated facilities for the disabled and in turn AFSCME will accept a delay in this year's pay raises. But these out-sized facilities, once called “state hospitals,” pull limited dollars away from smaller not-for-profit providers that have worked to build community-based services in Illinois. For decades the union has reflexively stalled closures.
The obvious financial incentive is for AFSCME to keep well paid workers in place. Of course, AFSCME played a critical role in Quinn's surprising election victory. Without better than expected voter turn out in Democratic strongholds, Bill Brady would certainly have won. At this point, some might argue that the state should just assume direct responsibility for community-based services. Why not create a cadre of well-paid union jobs? But this is not in cards.
Over the past 50 years, local not-for-profits, often founded by family members of people with disabilities, rose to meet demands for community integration. The overwhelming incentive for Illinois is to continue to use this type of 501(c)3 organization---which defrays operating costs through charitable contributions, pays lower wages and benefits, while reducing the state's legal and pension liabilities. Consequently, AFSCME continues to work against the most viable path to progress by keeping institutions open and revenues tied up in maintaining them.
Today, this leaves not-for-profits struggling to hang on to a smaller piece of a shrinking pie. Ideally, we should not have to frame this in win-loose terms. But realistically, there are limited funds Illinois will spend. Under the Quinn-AFSCME framework, community care givers are loosing badly.
In the past two decades, in fact, AFSCME has organized a significant number of community provider agencies. But after a decade of late payments and funding cuts, such agencies often struggle just to meet payroll. Collective bargaining with charity operations run on tight budgets is not a formula for adding to the bottom line of a large public sector union.
For AFSCME, workers at private not-for-profits represent a tiny sliver of revenues. Compared to those employed at state facilities, community-based direct care workers in Illinois earn half the pay. Often they hold two jobs to make ends meet. But now, thanks, in part, to the one-sided deal-making, these dues paying AFSCME members at community agencies will face the brunt of pay cuts and job losses.
It appears some union members, the lowest paid, are more expendable than others. Expendable, also, are the needs of 21,000 people with disabilities knocking on Pat Quinn’s door. They expect full participation in society, not a life shut away behind brick walls and security gates.
Our previous two governors, Ryan and Blago, ended their careers in scandal and prosecution. But Pat Quinn's legacy may ultimately be worse: a state that raised taxes while turning its back on the vulnerable; a state that built more prisons, hired more unionized prison guards, while it dismantled drug treatment and prevention programs; a state that continued to invest in outmoded institutions as it allowed community integration for the disabled to disintegrate. A living wage for state workers, lay offs and wage cuts for the rest. A life shut away in institutions for some, a loss of critical supports for the rest.
You can contact Pat Quinn and tell him to listen to President Obama. Stop telling families with children who have disabilities to fend for themselves. Invest in the future. Stop wasting a growing share of limited funds on segregated institutions while 21,000 people with disabilities and their families languish without services.