The New Hampshire biennial budget is in place. After months of discussion, hearings, advocating, and negotiating, we essentially ended up with Gov. Sununu’s original budget that was put forth six months ago. That budget was deemed, for the most part, acceptable for funding existing disabilities services, so there is some solace that we came back to this budget in the end. Please know that all your efforts to let legislators know the critical need for DD funding were not in vain, and were essential to avoiding cuts to the Governor’s original level of funding for services.

However a huge elephant still sits with us: the DD Wait List. The statewide Wait List budget is insufficient for projected needs. Without additional funds, New Hampshire will have record numbers of people still on the Wait List by the end of this biennium (June 2019).

Click here to find latest DHHS Wait List updates.

Let’s break down how the Wait List is built. To start with, the Wait List number is an evolving and revolving number. New additions come on to the list as new or additional needs arise, and reductions are made to the totals as people begin to receive services or are no longer in need of services.

For Wait List additions, there are three types of situations that are identified. First, there are those people with developmental disabilities turning 21 within the fiscal year, leaving the school system, who need new services – call them category A. Next, there are those newly eligible who are not in category A, who are not currently being served, but will need to start new services; these could perhaps be people who have been under the radar and not in our system for many years but now need services because of some life change – these are category B. Lastly, there are those already receiving partial services who have had a circumstance or life change and now require additional services – the C category. These might be people whose primary caregiver/parents have become critically ill or died, which could create a need for residential services on top of the day services they may already be receiving. Or there might be changes in an individual’s own health that require more and/or different services.

The latest statistics available from the Commissioner’s office as of 5/31/2017 show that there are 233 people statewide still on the Wait List. Of those, 64 are in category A (27%), 33 in B (14%), and 136 in C (58%). In terms of people moved from the Wait List into services, the majority have been in the A and B categories. Individuals and families in crisis who are already in the system are the ones who are most at risk of being left behind as they struggle to get supports in the midst of adjusting to worsening circumstances.

Here at MDS Region V, as we start FY 2018, we have 65 individuals on our Wait List. We have been given a budget of $1.1 million to serve only 34 of these people. This budget allocation translates to $32,000 per person.

The most recently calculated average service cost per person in New Hampshire is $51,000, which means that on average we will be $20,000 short per person. Although it’s difficult to predict because of unknown levels of services needed on an individual basis, if we use this average cost for forecasting, it means we could have a shortfall of $650,000 per year trying to serve just these 34 people (who represent 52% of those 65 people on our Wait List).

Statewide, the projected numbers going forward are as follows: 340 people are on the Wait List, with a budget of $11 million. Using the same per person budgets from above, this creates the need for an additional $7 million per year to be able to provide services for those on the list right now. As mentioned before, the numbers fluctuate as people come and go, but the more people we aren’t able to serve today, the more stacked up the funding need becomes over time.

What to do in the meanwhile? We are carefully managing timing and program allocations so we can serve as many in our region as possible, and doing our best to stave off the impending crisis of shortfalls in services for so many in need.

As a group, Area Agencies (through CSNI) will likely go to the Legislature this fall to ask for more money for the Wait List – to fund what has already been legislated then reneged on once again. It is hoped we will have a bill introduced to address this issue. Although it is highly unusual to ask for money this early in the budget biennium, we must ask now to cover this extraordinary unfunded need coming up. If we don’t get additional funds, we run the very real risk of leaving vulnerable people without the services they desperately need. That is not what the people of New Hampshire had in mind for supporting people with developmental disabilities, and technically it’s illegal.

We will continue to keep you posted as things progress. Your advocacy efforts make a significant difference in helping our state legislators understand the consequences of Wait List underfunding. It is families who bear the brunt, and your voices have the most impact.

Thank you.

By Alan Greene. Published in the Summer 2017 edition of The Clipboard.