Money mattered in the decision to close adult daycare

Credit: DaytonDailyNews

Butler County DD board closes adult daycare

Credit: DaytonDailyNews

Liberty Adult Center was scheduled to close in 2017.

Money played a role in the decision to close the adult daycare the Butler County Board of Developmental Disabilities formally shuttered last week.

The DD Board had until 2024 to close Liberty Adult Center that served 125 mentally disabled adults but Superintendent Lisa Guliano said they were considering closing even before the federal government found it was a conflict of interest for boards to provide case management and direct services.

“To be honest we would have had to look at this program, even if the CMS (Center for Medicare and Medicaid Services) rules had not changed and forced our hand,” Guliano said, adding they closed three other centers a while back because of budgetary concerns.

The board has seen federal and state funding shrink and they were also subsidizing Liberty Center while shouldering a budget deficit of about $2 million. The deficit a year ago stood at $4 million but Business Services Director Hailey Quinn said a state cost reimbursement has halved the amount.

“The operations at our day service was paid 60 percent by federal Medicaid, 40 percent by by local DD levy dollars, which is the same as we do with any service program in the county, except for this operation we were staffing at a higher level and providing more support to the tune of an additional $1 million a year,” Guliano said.

By shutting down the center early they will save $180,000 on top of the $1.4 million savings the total closure provides.

George Matusak, whose elderly brother John Matusak, had Down Syndrome, dementia and was physically frail. He had been going to the center at 5645 Liberty Fairfield Road five days a week for nearly 30 years. They took him out of the center earlier this year and moved him into nursing home, he died shortly thereafter.

Matusak always maintained Liberty Center was an asset and Godsend for people like his brother. He also surmised financing was part of the formula in the closing decision.

“I believe it was more of a financial decision than anything,” he said. “The management of Liberty Center it was a big drain on the budget. There was a lot of money that was not reimbursed by the state or federal. They have been running at a deficit for several years. This was more of a way to stop the bleeding monetarily than the best benefit of the clients. I don’t know that to be true, but I’m sure it did enter into the question.”

Now the work has begun dismantling the facility that once served more than 100 clients and staffed 40 people.

Boards of developmental disabilities can no longer provide direct services, according to new federal and state mandates. Despite a deadline to get out of the adult daycare business by 2024, the Butler County board announced its intention to close its Liberty Adult Center by March 2017.

After the announcements employees and clients began leaving in droves. In April staffing at the center had dropped 30 percent, from 40 to 28 employees. Enrollment went from 125 to 91 people. By mid-October six of the seven clients left at the center found new services. Staff continues to work with the one remaining family to find an alternative.

Guliano said there are seven direct support staff, two managers and one nurse left who will be paid through the end of the year and are helping to clear out the large building. The center closed officially on Nov. 10.

Guliano said her staff are now contacting former clients to make sure their new situation is acceptable.

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 took over the routes.

The Journal-News has been with this story every step of the way since the Butler County Board of Developmental Disabilities decided to shutter its adult daycare early.