Citing a conflict of interest, a federal agency has ordered the closure of an adult day care facility operated by the Butler County Board of Developmental Disabilities, which could cost 60 employees their jobs and require relocating 125 people with developmental disabilities.
“In our state, county boards of DD are required to do the case management function so we have to do that,” said DD Superintendent Lisa Guliano. “We also provide direct services through our Liberty Fairfield Road site,” called Liberty Adult Center.
However, a mandate of the Center for Medicare and Medicaid Services said it is a conflict of interest for agencies to provide case management and direct services. Under this mandate, Liberty Adult Center must close by 2024, according to Guliano.
The Board of DD is working to find an entity in the private sector to take over operations of the facility, similar to how Tri-State Easter Seals took over the Hamilton facility and Miami Valley Goodwill the Middletown center in the early 2000s. Guliano said they handed those centers over due to financial constraints.
The closure has been met with criticism from some whose loved ones attend Liberty Adult Center.
George Matusak worries his brother, John, won’t have anywhere else to go when Liberty Adult Center closes.
Matusak said his 68-year-old brother, who has Down Syndrome, dementia and is physically frail, has been going to the center at 5645 Liberty Fairfield Road five days a week for nearly 30 years.
“He has all kinds of activities, they take him on outings, they work with him and they just do a real nice job,” Matusak said. “It’s very upsetting that they are going to be closing because they are one of the only safeguards that many of population are going to be using in the future.”
Matusak said some private service providers — there are 29 private adult day centers in the county — are not equipped to deal with people like his brother.
“The Liberty (Adult) Center takes all comers, if they are a behavioral problem, or they have severe medical problems they take them, where the providers do not take them,” he said. “They are a true safety net for the developmentally disabled population. If you don’t behave properly you can’t go to many of these other providers.”
Medicaid provides 60 percent of the funding for services provided to people with developmental disabilities who don’t need to be institutionalized and local taxpayers fund the remaining 40 percent.
As a result of the CMS mandate the DD board also cannot provide non-medical transportation services. The Butler County Regional Transit Authority will be taking over the routes, which may actually save the county Board of DD money, according to Accounting Supervisor Hailey Quinn.
“Back in 2010 when we started transportation, at that time we saved over $1 million taking over transportation through our agency,” Quinn said. “As insurance costs increased as salaries increased over time, and those related benefits, we’re at a point where we’re not saving, so it was a good time to get out.”
The Board of DD’s budget also faces budget challenges, which Guliano recently shared with commissioners. The $30 million budget calls for a $4 million shortfall, but they are going into the year with a $25 million cash balance.
Some of the things impacting the budget are the complete phase out of the Tangible Personal Property Tax, which was slated for next year for DD. So $416,000 will be erased from the spending plan, but the board was able negotiate a slight give back, so $65,000 will be received next year and in 2017.
The DD board also is expecting to take another $250,000 hit if the “white collar” rule proposed by the U.S. Department of Labor comes to fruition. The measure raises the threshold of exempt employees from $23,660 to $50,440. For DD that means about 75 employees move to hourly wages and are eligible for overtime.
“The feedback that we’ve gotten, people are voicing out is, ‘this is going to cost us millions,” Quinn said. “Across the state, millions, across the nation. They say it might happen in January or mid-‘16, but when it does you’ll have 30 to 60 days to implement it.”
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