Families, clients face uncertain future with adult day center closing

Local families affected by the upcoming closure of an adult day center for people with developmental and intellectual disabilities are coming to terms with the new realities their loved ones will soon face.

The Butler County Board of Development Disabilities will close Liberty Adult Center, its adult day center, in March of 2017 to comply with federal rules changes.

The change is expected to impact hundreds of local residents with developmental and intellectual disabilities, as well as their families, private providers and some county board employees.

The county board’s decision to close Liberty Center, 5645 Liberty Fairfield Road, came from a state directive and was prompted by a rule enacted by the Centers for Medicare and Medicaid Services.

County boards of developmental disabilities across the state and country are being required to take the same or similar steps to meet federal guidelines for services paid for using federal money.

The federal rule prohibits organizations from providing direct services to individuals with disabilities with federal waivers if they also provide their case management.

Tanya Coffey, the DD Board’s director of Service and Support Administration, said they are actively working to get their clients transitioned to other providers and one solution to the reduced services problem could rest with the 35 to 40 private providers operating in the county.

“Liberty Center is more than willing to open their doors to other providers coming in and giving pretty much coinciding, paralleling services so we can piece it together,” Coffey said.

That may be more difficult than anticipated, according to Board of DD Superintendent Lisa Guliano.

The DD Board has had talks with private providers, but those organizations want the board to subsidize them, Guliano said, adding that one provider wanted $500,000.

“They want a financial commitment from the board to help them operate and we’re not in a position to do that,” Guliano said.

The board is operating with a $3.6 million deficit this year.

Further complicating things on the provider side is Medicaid is in the process of creating a new rate structure, and Guliano said that will impact what providers can offer their clients.

Staffing levels impact offerings

Adria “Addie” Moon can’t carry on a conversation, but a smile fills her face when she has visitors.

Moon is profoundly autistic, and her parents worry about the effect staffing losses at the DD Board will have on her.

Moon’s father, Craig, said the 32-year-old self destructs when her contact with others is cut off. He shared a photo of his daughter with a red bruise on her cheek, an example of the pain she inflicts on herself when her routine is disrupted, he said.

“The getting out, the walking, the moving, the car ride, all of that interacting with other people gives her the vestibular input she needs,” Moon’s mother, Melanie, said. “That’s the vestibular input that keeps her from beating herself, becoming aggressive toward herself.”

Since the DD Board’s decision to close Liberty Adult Center in March 2017, staffing at the center has dropped 30 percent, from 40 to 28 employees. Enrollment, however, has only dropped 23 percent from 125 to 91 people.

“We didn’t expect (the staffing drop) because they had over a year’s notice and time to work on finding work,” Guliano said. “But with the unemployment market the way it is, people have found some pretty decent jobs. We have lost a third of our direct support staff and supervisors.”

With the staffing losses, there are some weeks where Addie Moon has not had and outings and her behavior is starting to deteriorate because of it, Melanie Moon said.

The Moons said they were given notice that their daughter’s services would be cut in about three weeks. They have filed action with the state to have their daughter’s services fully reinstated.

The DD Board gets paid $125 a day on a Medicaid waiver, which is expressly for integrating the developmentally disabled out in their community.

“Our issues with BCDD are that they are billing Addie’s waiver but not providing all the supports they authored and agreed upon as important for her success,” Melanie Moon said.

Guliano said she cannot discuss the Moon’s situation.

The center has three levels of staffing-to-client ratios based on an individual’s need:

• Highly functional: one staffer to 12 clients
• Middle acuity level: one staffer to six clients
• Profoundly disabled: one staffer to three clients

The Moons also question programs the DD Board continues