Lifeline for many developmentally disabled people threatened by state cuts [The Fayetteville Observer, N.C.]

Dec. 27--George Simms was homeless until he found Service Source. No one remembers exactly how the developmentally disabled 52-year-old found his way there, but the agency on Ames Street gave him a job and somewhere to live.

"We're his lifeline," said Betsy Torsell, program manager at Service Source, which employs more than 300 people with developmental disabilities in Cumberland County. Some workers pack machine parts and build equipment under contracts with the government and businesses. Others work in restaurants, retail and on Fort Bragg.

But state reform of mental health care is fraying the safety net for Simms and the hundreds of people like him who need lifelong help to keep up with the world.

The state cut about $20 million from its mental health budget in the summer, including $300,000 in Cumberland County alone. Caseworkers for the disabled were cut, stripping a valuable layer of support from Simms and his colleagues. Caseworkers help ensure the disabled get the services they need and are entitled to.

"It is a very complex, frustrating, very difficult system to navigate," said Diane Palmer, whose adult daughter Tracey works at Service Source. "The paperwork is monumental; a caseworker can help with all of that."

Desiree Shaffer cares for her three adult siblings, all of whom are developmentally disabled. Two of them are blind. They lose their caseworkers at the end of December.

"My hands are always full," she said. "I'm illiterate to all of that paperwork."

Without a caseworker, Shaffer fears her brothers and sister will be left behind.

"I don't want them to have to do without anything," she said. "If there's anything out there to make their lives easier, I feel they deserve that."

More state funding cuts are expected in the years to come. In January, local administration of mental health care will switch to a managed care organization based in Durham. The setup is akin to an insurance company that will authorize all publicly funded care.

Cumberland County has provided about $4 million a year in mental health funding, and commissioners have pledged to preserve that. But to maintain services in each of the last four years, the county Mental Health Center has dipped into a reserve fund that accumulated during less lean times. In July, the fund stood at about $14 million, but more than $1 million has been spent from it in each of the last four years. At that rate, the fund will diminish within a few years.

"We're going to have to start getting local appropriations other than fund balance," said Hank Debnam, the county's mental health director. "When you don't have fund balance, you've got to have something."

Jimmy Keefe, chairman of the Cumberland County commissioners, said he expects the managed care system to spend dollars more efficiently, but it will take at least a few months to see how the new system will work.

"I think that nobody really knows the impact we're going to have at the county level until the managed care organization is up and running," he said.

Dwayne Patterson is executive director of Cumberland Residential & Employment Services & Training. CREST houses 27 developmentally disabled people in a group home and employs another 60 in a vocational program.

"We are concerned," Patterson said, "but we have a lot of faith in the county commissioners, that they want things to stay the way they are with providing quality services."

CREST is a nonprofit set up about 30 years ago by Fayetteville parents who wanted to bring their disabled children home from state facilities. While Patterson called the cuts disconcerting, he said he is reserving judgment on how services will be affected by the managed care model.

"I will be hesitant to criticize until I have a reason to criticize," he said, "and I will be hesitant to applaud until I see a reason to applaud."

At Service Source, Torsell is now acting as case manager for everyone. She fears further cuts will only hurt the people who need help figuring out how to get from here to there, or where to find medical equipment, or who to turn to with questions.

"It's almost like this whole developmentally disabled population has been left out of the loop in managed care," she said. "We don't know how it's going to work in the future."

Staff writer Gregory Phillips can be reached at [email protected] or 486-3596.

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