I am writing this letter (e-mail) with a great sense of urgency and as Chief Executive Officer for NADD, an association for persons with developmental disabilities and mental health needs. NADD, established in 1983, has as its mission “to advance mental wellness for persons with developmental disabilities through the promotion of excellence in mental health care.” We are a membership association established for professionals, care providers and families to promote understanding of and services for individuals who have developmental disabilities and mental health needs. We have membership representing every state in the country.
For the past 5 decades individuals with co-occurring developmental disabilities and mental health conditions have been able to live a high quality life in communities across the U.S. with the support of programs funded through Medicaid. These programs have allowed people to receive critical services including physical health care, quality behavioral health services, staff support in groups homes, direct support staff to train individuals to gain the skills needed to get and keep jobs, and receive services required to live as independently as possible in every state in the U.S. These services have prevented thousands upon thousands of people with significant disabilities from needing more costly institutional services or becoming homeless.
While there are many aspects of the Affordable Care Act that might need revision, many of the proposals in the American Heath Care Act (AHCA) will have a devastating impact on services that are so critical to the lives of people with disabilities. For example, while the concept of Medicaid per capita caps might look appealing, the reductions of funding immediately and compounded over time will result in service reductions that will lead to poorer health and exacerbated mental health conditions that will ultimately cost more money. Reduced community supports will create greater reliance on institutional care, rolling back 50 years of movement away from large institutions to community-based services. The indisputable fact is that a loss of home and community-based services would be devastating to children and adults with disabilities.
Medicaid funds more than 75% of supports and services to people with disabilities in the U.S. in addition to health care. This federal/state partnership has been incredibly effective. A change in this partnership will jeopardize services such as mental health care for this population, adequate staff in homes in the community along with many, many others.
Paul Ryan in his very moving speech following the tragic shootings in Virginia spoke about being “united in our humanity.” I urge you to take a serious look at the provisions in the American Health Care Act and what its impact will be not only on people with developmental disabilities and their families but on everyone who relies on Medicaid for services. America can and must do better.
Thank you for your consideration. If you would like to discuss these concerns more fully, please contact me.
Dr. Robert J. Fletcher, CEO & Founder
132 Fair Street
Kingston, NY 12401