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Mark E. Engberg
(MD State Coordinator Voice of the Retarded
/ Volunteer)
February 21, 2006
Re: Written testimony in support of DDA / DHMH Fiscal Budget 2007 DDA Budget
Hearing Senate Health and Human Services Subcommittee
Senator Gloria Lawlah - Chair
Health and Human Services Subcommittee
Dear Senator Lawlah and Subcommittee Members,
My name is Mark Engberg. I am a long-time advocate for Holly
Center in Salisbury, MD and the MD State Coordinator for VOR. All of my activities and efforts for citizens with mental retardation
are in a volunteer capacity. I am here to support the proposed DDA budget. I would like to thank this subcommittee for their
commitment to helping those with developmental disabilities and mental retardation and for their hard work on behalf of all
citizens of this state. I applaud the Governor¡¦s fiscal increases to the DDA budget.
I am here to thank
this committee for continuing to fund the four State Residential Centers (SRC's) in Maryland. These underutilized facilities
could and should help meet the needs of some of our most vulnerable citizens on the DDA residential waiting list who are in
crisis at virtually no additional cost to the state. We fully understand that the majority of citizens with mental retardation
receive good services in the community and would never consider facility based care. However, there are some citizens whose
needs are so intensive and disabilities so profound, that the CHOICE of an SRC should be an option. Admission to the SRC's
has been virtually impossible for 10 years. I speak with many citizens throughout Maryland who would love to secure a placement
for their disabled loved-one at one of the remaining SRC's.
You no doubt will hear from the MD DD Coalition and all
of their member groups.
+ They will continue to paint the picture of the ugly institution of old, which is blatantly
false. These are modern facilities that provide the highest quality of care in a safe and home-like setting.
+
They will misrepresent the Supreme Court's Olmstead decision to say it mandates closure of facility-based care; this too is
blatantly false.
Olmstead v. L.C., 119 S. Ct. 2176 (1999)
"We emphasize that nothing in the ADA or its implementing
regulations condones termination of institutional settings for persons unable to handle or benefit from community settings...Nor
is there any federal requirement that community-based treatment be imposed on patients who do not desire it." 119 S. Ct. at
2187.
"As already observed [by the majority], the ADA is not reasonably read to impel States to phase out institutions,
placing patients in need of close care at risk... Each disabled person is entitled to treatment in the most integrated setting
possible for that person - recognizing on a case-by-case basis, that setting may be an institution¡¨ [this citation
taken directly from VOR's Amici Curiae brief]." 119 S. Ct. at 2189.
+ You will hear from the self-advocates
say that everyone wants to leave the SRC's. This too is blatantly false. The self-advocates do not speak for our disabled
loved-ones, we do. The self-advocates are very intelligent, high functioning individuals. Our disabled loved-ones have profound
mental retardation and profound cognitive impairments. They can not speak for themselves.
+ You will hear that
the cost of care at the SRC's is too expensive, this too is blatantly false. As previously provided, the VOR cost comparison
study has clearly shown there are no significant savings obtained by shifting from facility based care to community based
care. The MDLC interpretation of the cost comparison is a complete manipulation and distortion of the facts. They have lumped
together the cost of thousands of high functioning individuals with all the others in the community. They are not comparing
costs for similar populations. They also do not identify what costs they are comparing. The cost of care at the SRC's include
many aspects which are extra in the community, such as medical services, therapeutic services, day programs, case management,
and so on. In addition, the SRC's could be more fiscally efficient if allowed to take some admission. Dozens of citizens
on the DDA's residential waiting list could be served today at virtually no cost to the state.
+ We oppose the
$412,800 allowance (M00M - Analysis FY 2007, Pg. 11) to provide an independent resource coordinator for residents of the
SRC's to develop a written plan. This process has been clearly in place in for many years and this is a waste of money.
Why not use it for other areas of critical need, such as transportation.
+ We oppose the budget analyst's recommendations
(M00M - Analysis FY 2007, Pg.3) to reduce DDA staffing costs ($616,000) and to reduce funds for Special Olympics ($150,000).
+ We find it outrageous that the MD DD Coaltion and its member groups will receive increases of $43+
million dollars (which we fully support), and yet they call for a supplemental appropriation to force residents out of the
SRC's. We ask that you flatly reject this arrogant request which harms our disabled loved-ones. The key tenant of being
an advocate is "do no harm", however, this group clearly threatens the well-being of the remaining residents of the SRC's
and those on the waiting list who could benefit from the services these facilities offer.
+ And lastly, I would
like to remind everyone that the very generous Federal Medicaid Waiver funds (well over $200 million annually) require
CHOICE.
[Cite 42CFR411] Title 42 Public Health (Sec. 441.302)
Unless the Medicaid agency provides the
following satisfactory assurances to CMS, CMS will not grant a waiver under this subpart and may terminate a waiver already
granted:
[[pg 272]] (2) Given the choice of either institutional or home and community-based services.
Both models of care have validity. Maryland is a better place by offering the CHOICE of an SRC for those with very
specialized needs.
Thank you for allowing me to speak and thank you for your dedication to Maryland.
Respectfully
submitted -- Mark E. Engberg
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