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Letter: Cutbacks would harm those with disabilities

To the editor,

More than 35 years ago, The Arc of North Dakota sued the state for violating the constitutional rights of individuals with intellectual and/or developmental disabilities (I/DD) who resided at two of the state-run institutions in North Dakota, due to poor living conditions, overcrowding and lack of adequate care. The federal judge agreed and his ruling resulted in incredible changes for the way people with I/DD are cared for in North Dakota.

Now, most people with I/DD live in their local communities as productive citizens. But this could change and North Dakota could return to outdated methods of serving people with I/DD if the Senate votes to cut and cap Medicaid.

More than 114,000 North Dakotans receive health coverage and long-term services through Medicaid and Medicaid Expansion. Of that number, more than 15 percent have an I/DD. According to the publication State of the States in Developmental Disabilities 2015, 4,613 individuals with I/DD were using Home and Community Based Services and relied on Medicaid for these supports. North Dakota receives more than $90 million in federal funds just to pay for Home and Community Based Services.

Over the last two decades funding for Home and Community Based Services has grown because of widespread bipartisan support. These services have had bipartisan support as disability knows no political, or geographical, ethnic or socioeconomic boundaries. They provide dignity to people with I/DD through assistance with meals, bathing and dressing, toileting, in-home skilled nursing, and communication support, to name but a few.

The Senate is considering the same $830 billion cut to the Medicaid program as passed in the House. We fear that because Home and Community Based Services are "optional" services, states will cut them first if confronted with this greatly reduced federal commitment. States, like North Dakota, may return to outdated modes of serving people with disabilities, congregating large numbers of individuals in facilities with inadequate staffing and no real-life opportunities. The per-capita cap proposal will pave a path backwards to institutional care and segregated services.

Call on our senators to protect Medicaid and to continue the 52-year commitment to providing healthcare and long-term services and supports to persons with disabilities.

Rachel Hafner,

executive director

The Arc, Upper Valley

Grand Forks