An earlier post described the approaching "tsunami" of autistic adults in New Jersey. The Bergen Record picks up the story, pointing out a problem with client-centered financing:
The Alpine Learning Group, a school for children with autism in Paramus, operates an adult program for its graduates.
"The cost of the program exceeds what we're allowed to bill through DDD, [NJ's Division of Developmental Disablities] " said Bridget Taylor, Alpine's executive director. "Our staff is one adult for every two participants, because these are very challenged clients who have significant support needs. We're talking about aggressive, self-hurting behaviors that require complex behavior management. The cost is close to $50,000 per participant. Typically what we get from a participant's state budget is around $28,000."
The difference has to be made up through fund raising; the division won't allow programs for adult disabled individuals to charge clients fees beyond what the state pays. In most cases, the clients have little or no income anyway beyond their disability checks from the federal government.
Both Quest and Alpine are looking to expand their programs, and several other non-profits that serve other people with developmental disabilities have proposed new programs for adults with autism. But the new way the state funds such agencies is making that difficult to do.
The state will no longer provide agencies with any funds to create programs. Instead, the division now gives families a budget with which they can pay for the services they select. By putting control of the spending in the families' hands, the state's theory goes, community agencies will have to create programs that provide the most needed services since those are the ones that families will choose to pay for.
"We don't want to tie money to a slot at a program; we want to tie it to a person," explained Dawn Apgar, the state's deputy human services commissioner and interim executive director of the division. The policy is across the board, affecting programs for all disabled adults, not just those with autism. "We want people to have portability. If you're not happy there and you want to go somewhere else, you can."
But the state's funding policies leave programs in a classic Catch-22:he only way for a new program to get start-up money is to sign up enough clients to pay for it. But agencies find it almost impossible to get families to sign up for a program that doesn't exist yet.